PEDIATRICS Vol. 73 No. 2 February 1984, pp. 119-125
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Nutritional Management of Acute Diarrhea: An Appraisal of the Alternatives

Kenneth H. Brown MD1 and William C. MacLean Jr MD1

1 From the Gastroenterology and Nutrition Unit, Department of Pediatrics; Division of Geographic Medicine, Department of Medicine, School of Medicine; and Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore; Instituto de Investigacion Nutricional, Apartado 55, Miraflores (Lima), Peru; and Ross Laboratories Columbus, Ohio

Whether fasting during an episode of acute diarrhea is necessary or desirable has recently been questioned. The principal argument advanced for limited fasting is the avoidance of the consequences of malabsorption, namely acidosis, excessive fluid losses, depletion of the bile acid pool, and possible mucosal injury from unabsorbed foods. Advocates of continued feeding during acute diarrhea suggest that the practice will prevent deficits of intakes of protein and calories, maintain or stimulate repair of the intestinal mucosa, and sustain breast-feeding in the breast-fed infant. There are only a limited number of clinical studies that address the issue. Available evidence suggests that, in most cases, current practice should be modified to minimize food withdrawal.

Key Words: diarrhea • malnutrition • nutrition • malabsorption

Submitted on August 18, 1982
Accepted on May 25, 1983




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