PEDIATRICS Vol. 72 No. 6 December 1983, pp. 786-800
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Chronic Protracted Diarrhea of Infancy: A Nutritional Disease

Clifford W. Lo MD, MPH1 and W. Allan Walker MD1

1 From the Pediatric Gastrointestinal and Nutrition Unit, Massachusetts General Hospital, Harvard Medical School, Boston; and Department of Nutrition and Food Science, Massachusetts Institute of Technology, Cambridge

Diarrhea is an extremely common cause of morbidity in infancy. Occasionally, it becomes protracted, leading to a vicious cycle of malabsorption, malnutrition, and failure to thrive. A number of causes of chronic diarrhea in infancy are discussed, including postinfectious enteritis, celiac sprue, cow's milk allergy, and parasitic infection. Although many mechanisms may contribute to diarrhea, a similar pathophysiologic syndrome of mucosal atrophy, inflammation, and malabsorption results. Attention should be paid to recognition of malnutrition as well as etiologic diagnosis. Therapeutic efforts should concentrate on nutritional rehabilitation, through appropriate oral elemental formulas or total parenteral nutrition. However, encouragement of breast-feeding is probably a more effective way of preventing this difficult problem.

Key Words: chronic diarrhea • malabsorption • malnutrition • failure to thrive

Submitted on March 15, 1982
Accepted on March 23, 1983




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