Treatment of Nonspecific Diarrhea in Infants

Blair, John E.; Fitzgerald, Joseph F.

doi:10.1177/000992287401300411

Clin Pediatr (Phila)

1974

DOI: 10.1177/000992287401300411

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Treatment of Nonspecific Diarrhea in Infants

John E. Blair

Joseph F. Fitzgerald

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1980

1989

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“…Conventional treatment of acute gastroenteritis in children has focused on parenteral administration of fluids in hospital and the concept of "resting the bowel" (5), with no oral intake for 24-48 hours and gradual reintroduction of feeding while monitoring the stools (1,6). This practice, however, has been challenged because of the results obtained in research on oral rehydration.…”

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Acute Gastroenteritis Changing Pattern of Clinical Features and Management

1989

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During seven epidemics of rotavirus from 1978 to 1987, 575 children younger than 3 years were admitted to hospital with acute gastroenteritis. The management before and during hospitalization, the status on admission and the outcome are reviewed. The mean age of the patients rose significantly during the study period, with the proportion younger than 12 months decreasing from 50 to 26%. Mild to moderate iso-osmolal dehydration was found in most cases, both hypernatraemia and hyponatraemia were rare. The home management had usually consisted of fasting except for "clear fluids". Oral rehydration and rapid feeding in hospital according to modern principles accelerated weight gain, shortened the duration of diarrhoea and the hospital stay and reduced the requirement for intravenous fluid therapy. This experience, together with the current rarity of acute gastroenteritis in young infants and of delay in recovery, suggests that oral rehydration and realimentation should be more extensively used in general practice.

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Acute Gastroenteritis Changing Pattern of Clinical Features and Management

1989

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The treatment of acute diarrhea in children. An historical and physiological perspective

Hirschhorn¹

1980

The American Journal of Clinical Nutrition

254

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This review examines the historical, physiological, clinical, and epidemiological evidence to support a method of therapy for children's diarrhea that may be recommended for general acceptance. The understanding and use of fluid and nutritional therapy of acute diarrhea in childhood have progressed over the years to a point where acute mortality can be reduced to nearly zero. At the same time, the ill effects on electrolyte balance and nutrition may be reduced to a minimum. Through use of an oral glucose electrolyte solution with a carefully designed composition, physiologically correct treatment may now be so simplified and inexpensive as to be readily available to the remote, under-served areas of the world where most of the morbidity exists; and be useful as well to more sophisticated settings. The method of therapy recommended in this paper has several important departures from traditional teaching. It advocates rapid restoration of extracellular fluid with a polyelectrolyte solution containing sodium, base and potassium; use of an oral glucose electrolyte solution for repletion of those not in shock and for maintenance; use of a single oral glucose electrolyte solution for all age groups, regardless of diagnosis, and quite early feeding with tolerated foods. Sodium loads given are generally higher than advocated by standard pediatric teaching. The origins of that teaching and support for the newer approach come from a detailed analysis of current knowledge in the epidemiological, clinical, and physiological aspects of diarrheal illness.

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Treatment of Nonspecific Diarrhea in Infants

Cited by 2 publications

References 5 publications

Acute Gastroenteritis Changing Pattern of Clinical Features and Management

Acute Gastroenteritis Changing Pattern of Clinical Features and Management

The treatment of acute diarrhea in children. An historical and physiological perspective

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