Environmental Enteric Dysfunction in Children: A Review.

Diarrheal diseases are a major cause of childhood death in resource-poor countries, killing about 760, 000 children under age 5 each year. While deaths due to diarrhea have declined dramatically, high rates of stunting and malnutrition have persisted. Environmental Enteric Dysfunction (EED) is a subclinical condition caused by constant fecal-oral contamination with resultant intestinal inflammation and villous blunting. These histological changes were first described in the 1960's but the clinical impact of EED is only just being recognized in the context of failure of nutritional interventions and oral vaccines in resource-poor countries. We review the existing literature regarding the underlying causes of and potential interventions for EED and poor growth in children, highlighting the epidemiology, clinical and histologic classification of the entity, as well as discussing novel biomarkers and possible therapies. Future research priorities are also discussed. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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