Paralytic Ileus, a Serious Complication in Acute Diarrhoeal Disease among Infants in Developing Countries

Murtaza, A.; Khan, Sayeedur Rahman; Butt, Kiran; Finkel, Yigael; Aperia, Anita

doi:10.1111/j.1651-2227.1989.tb11129.x

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…Paralytic ileus was found in 30(23.07%) children in our study population whereas it was reported significantly higher by Murtaza A, et al 15 They have reported that 35% infants with acute diarrhoea showed abdominal distention and 12% had full clinical picture of paralytic ileus in 1989. 15 Potassium deficiency alters functions of several organs and most prominently affects the cardiovascular and neurological systems, muscles and kidneys. 2 These effects ultimately determine the morbidity and mortality.…”

Section: Manifestationcontrasting

confidence: 51%

Clinical Manifestations Of Hypokalemia

2006

J Liaquat Uni Med Health Sci

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PATIENTS AND METHODS: Children less than 5 years of age with acute watery diarrhoea and vomiting who were found to have hypokalemia were included in this study. Children with chronic diarrhoea (more than 14 days duration) or hypokalemia of any other cause such as Bartter's syndrome etc. were excluded. Children with paralytic ileus due to other causes such as anti-diarrhoeal drugs etc. were also excluded. Serum potassium levels were checked at Isra University research laboratory by the standard ion selective electrode method. Hypokalemia was defined as serum potassium level of less than 3.5 mEq/l. The clinical presentations of children with hypokalemia were recorded and statistically analysed. RESULTS: During study period, 350 children with acute watery diarrhoea were admitted. Of these, 130 (37.14 %) were hypokalemic and were included in this study, whereas 220 (62.85 %) children were normokalemic (normal serum potassium level) and therefore were excluded from study. Abdominal distention was the commonest manifestation in 110(84.

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Section: Manifestationcontrasting

confidence: 51%

Clinical Manifestations Of Hypokalemia

2006

J Liaquat Uni Med Health Sci

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“…The effect of these drugs is mostly palliative as they do not improve rehydration, and the reduction in discharge can mask the underlying disease. They are contra-indicated because they can cause paralytic ileus [22] and blocking discharge while fluid continues to accumulate in the bowel can have lethal consequences. Furthermore, these drugs can negatively impact disease resolution by reducing the expulsion of bacteria.…”

Section: Current Treatment and New Therapeutic Opportunitiesmentioning

confidence: 99%

Developing Novel Antisecretory Drugs to Treat Infectious Diarrhea

Hostos¹,

Choy²,

Nguyen³

2011

Future Med. Chem.

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Diarrhea, a disease of poverty and poor sanitation, kills an estimated two million children each year. Oral rehydration therapy is a very simple and inexpensive treatment that has significantly reduced mortality from secretory diarrhea caused by rotavirus, cholera and enterotoxigenic Escherichia coli. The efficacy and adoption of oral rehydration therapy would be enhanced by a drug that reduces fluid loss associated with these diseases and alleviates disease symptoms. Secretion and absorption by the intestine offer a number of potential drug targets to reduce fluid loss. Among these, the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel is the most attractive because it is the primary driver of secretion in cases of diarrhea caused by enterotoxigenic bacteria. CFTR can be inhibited by both natural products and synthetic small molecules. iOWH032 is a synthetic CFTR inhibitor that has recently entered clinical trials for this indication.

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“…Abdominal distension and potentially fatal paralytic ileus have been reported in infants and young children treated with loperamide. [48][49][50] Toxic effects on the central nervous system have most commonly been observed in children <6 months of age. In conclusion, loperamide has no place in the routine management of diarrhea in children.…”

Section: Antimotility Drugsmentioning

confidence: 99%

Treatment of Infectious Diarrhea in Children

Alam

Ashraf

2003

Pediatric Drugs

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Diarrheal diseases remain an important cause of childhood morbidity and death in developing countries, although diarrheal deaths have significantly declined in recent years, mostly due to successes in the implementation of oral rehydration therapy (ORT), which is the principal treatment modality. Diarrhea may occur for varied reasons; however, most episodes of diarrhea in developing countries are infectious in origin. Three clinical forms of diarrhea (acute watery diarrhea, invasive diarrhea, and persistent diarrhea) have been identified to formulate a management plan. Acute diarrhea may be watery (where features of dehydration are prominent) or dysenteric (where stools contain blood and mucus). Rehydration therapy is the key to management of acute watery diarrhea, whereas antimicrobial agents play a vital role in the management of acute invasive diarrhea, particularly shigellosis and amebiasis. In persistent diarrhea, nutritional therapy, including dietary manipulations, is a very important aspect in its management, in addition to rehydration therapy. Rehydration may be carried out either by the oral or intravenous route, depending upon the degree of dehydration. Oral rehydration salts (ORS) solution (World Health Organization formula) is recommended for ORT. Intravenous fluid is recommended for initial management of severe dehydration due to diarrhea, followed by ORT with ORS solution for correction of ongoing fluid losses. Antimicrobial therapy is beneficial for cholera and shigellosis. Antiparasitic agents are indicated only if amebiasis and giardiasis are present. Appropriate feeding during diarrhea is recommended for nutritional recovery and to prevent bodyweight loss. Antidiarrheal agents do not provide additional benefit in the management of infectious diarrhea. Although some probiotics have been shown to be beneficial in the treatment of acute diarrhea due to rotavirus, their use in the treatment of diarrhea is yet to be recommended, even in developed countries. The children of developing countries might benefit from zinc supplementation during the diarrheal illness, but its mode of delivery and cost effectiveness are yet to be decided.

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Paralytic Ileus, a Serious Complication in Acute Diarrhoeal Disease among Infants in Developing Countries

Cited by 10 publications

References 7 publications

Clinical Manifestations Of Hypokalemia

Clinical Manifestations Of Hypokalemia

Developing Novel Antisecretory Drugs to Treat Infectious Diarrhea

Treatment of Infectious Diarrhea in Children

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