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  • Title: Persistent diarrhoea still a serious and difficult problem.
    Journal: Glimpse; 1992; 14(6):1, 4. PubMed ID: 12344717.
    Abstract:
    In Bangladesh, the likelihood of a diarrhea episode becoming chronic ranges from 7.5-23%. If health providers knew the clinical characteristics of the early phase of diarrhea that becomes persistent diarrhea, they could manage that early diarrheal episode to limit its duration and minimize adverse effects. In Bangladesh, aggregative adherent Escherichia coli (EAggEC) is the most common pathogen in initial stools of children with diarrhea. Further, Shigella, Giardia, Aeromonas, and rotavirus are found more often in stools of acute diarrhea cases. thus, a research thinks that diet, nutritional status, or variations in virulence factors may play a larger role in persistent diarrhea than specific pathogens. Conversely, other studies have also demonstrated that EAggEC is often in children with persistent diarrhea. Acute and persistent diarrhea are highest in 6-11 month olds, and among 5 year olds the diarrheal risk is less than 50% of that of 0-2 year olds. Other risk factors of persistent diarrhea include clinical dehydration, vomiting, blood and mucus in the stool during the first week, reduced breast feeding, ingesting cow's milk, and malnutrition. In Bangladesh, 49% of diarrheal deaths occur in children with malnutrition associated persistent diarrhea. In fact, persistent diarrhea may induce malnutrition. A local diet consisting of rice powder, soya oil, glucose,egg white, and water improves the condition of 81% of the children with persistent diarrhea within 1 week, despite a significant reduction in nutrient absorption caused by diarrhea. Recovery is 2 times as fast in better nourished children than malnourished children. Malnourished children suffer more severely and experience less nutrient absorption. Yet, carbohydrate absorption does not fall in malnourished children, indicating that a high-carbohydrate diet is needed to manage persistent diarrhea. Oral rehydration therapy is needed for acute diarrhea. Yet, dietary management is the key to successful treatment of persistent diarrhea.
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