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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Much clinical experience has been gained in the use of the glucose/electrolyte oral solutions in the treatment of acute diarrhea. Those patients who are in shock or too weak to drink need intravenous fluids to correct their total deficit. With isotonic polyelectrolyte fluids rehydration may be achieved in 2-4 hours. Subsequently, most of these patients can be given oral fluids to replace continuing stool loss. Patients who are not in shock and who are sufficiently strong to drink at the outset nearly always can be rehydrated with oral fluids alone. Vomiting is most likely caused by acidosis and volume depletion, and these can be corrected in severely dehydrated patients by intravenous therapy and by oral therapy in those not in shock and able to drink by oral therapy. Proponents of oral glucose/electrolyte therapy for diarrhea, like other proponents of new treatments, have great visions of its benefits to the world, yet these visions require validation. The biggest problem will be getting glucose and electrolytes to where they are most needed -- at the level of home and village.
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PMID:Editorial: Oral glucose/electrolyte therapy for acute diarrhoea. 4 28

20 consecutive child admissions to a Calcutta, India, hospital with acute diarrhea and moderate to severe clinical dehydration were studied. They were treated with an oral sucrose/electrolyte solution, which achieved complete hydration in 19 out of the 20 cases; 1 child did not respond and needed intravenous therapy. Vomiting, abdominal distension, and appearance of sugar in the stools during oral therapy did not interfer with its success. A child was considered to have recovered when the body weight had stabilized and when there was no further diarrhea, a process requiring 5-6 days. In addition, recovery involved restoration of plasma-bicarbonate to normal levels, falls in the hematocrit values and in the plasma specific gravidity, and complete clinical recovery. Solutions of glucose/electrolytes have already been used in the treatment of acute diarrhea. Replacement of glucose with sucrose is preferable since it is less expensive and more readily available in developing areas. This study showed that replacement of the glucose with sucrose is as effective.
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PMID:Evaluation of a sucrose/electrolyte solution for oral rehydration in acute infantile diarrhoea. 6 56

The paper describes the first controlled trial of an oral glucose electrolyte solution designed on the basis of the optimum pathophysiological needs for rehydration in infantile diarrahoea. The solution, having a sodium concentration of 50 mmol/l, was tried in a group of 20 infants with moderate to severe dehydration due to acute diarrhoea and was compared with a matched group of 19 infants predominantly under 2 years of age taking a 'standard' oral solution with a sodium concentration of 90 mmol/l. They could be hydrated as well with a low sodium oral solution alone as with the standard solution. Intravenous fluid was not required in either group. The group treated with the high soldium 'standard' solution appeared to develop hypernatraemia and/or periorbital oedema more frequently than the other group. Also, the low sodium solution eliminated the need for additional free water orally.
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PMID:Oral rehydration in infantile diarrhoea. Controlled trial of a low sodium glucose electrolyte solution. 34 25

For oral treatment of acute dehydration in infants a solution of electrolytes and glucose in water is indicated. Selfmixing of this solution is not advisable. 30 infants with dehydration caused by acute diarrhoea were treated with a granulat (Normolyt) dissolved in water resulting in a solution of appropriate composition. The solution was well accepted and well tolerated. All babies without clinical signs of shock were successfully rehydrated by the solution. No untoward effects were observed.
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PMID:[Oral treatment of acute dehydration in infants by an electrolyte-glucose-solution (author's transl)]. 46 68

Diarrheal disease is bacterial in much of the Third World and viral elsewhere. In the poorest underdeveloped country, as many as 15% of children die from diarrheal disease before their third birthday. This association with geographical or climatic areas of the world, however, is actually a reflection of low socioeconomic levels and poor sanitation for practically all of diarrhea's infectious agents are in fact ubiquitous worldwide. Clinical problems associated with acute diarrhea, irrespective of etiology, relate to dehydration that results from abnormal loss of water and electrolytes in stools. Because an infant's total body weight is 70% water (as opposed to 60% in adults), diarrhea is a particular threat. During diarrheal disease, the major event is the disruption of the recycling of electrolyte-rich digestive fluids, which are nomally secreted into the gastrointestinal tract and then 99% reabsorbed. Treatments include preventive methods, such as public health improvements, and rehydration with glucose-water solutions, either orally or intravenously, depending on extent of dehydration. Vaccine development against rotavirus infection has been stymied by inability to cultivate the organism. However, immunoprophylaxis of bacterial diarrheas has made progress in developing vaccines against enterotoxigenic Escherichia coli. The role of immunity transmitted by breastfeeding is also emphasized.
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PMID:Acute diarrheal infections in infants. I. Epidemiology, Treatment, and prospects for immunoprophylaxis. 51 Nov 28

Citrinin fed to mature laying hens at levels of 0, 50, and 250 mug/g. of diet for three weeks had no effect on body weight, feed consumption, egg production, egg weight or egg shell quality. A moderate diarrhea occurring about three days after feeding 250 mug. citrinin/g. of diet was observed. However, the diarrhea subsided once the birds were returned to a normal diet. Young broiler chicks were fed a diet containing either 0, 62.5, 125, 250, or 500 mug. citrinin/g. of diet from hatching to three weeks of age. Body weight was decreased by the 500 mug/g. level whereas all levels of citrinin resulted in enlarged kidneys and an improvement in feed conversion when compared to control values. There was also a slight dose-related increase in liver size. The 250 and 500 mug./g. levels resulted in a dose-related increase in water consumption accompanied by an acute diarrhea. Dietary citrinin had no effect on serum protein, glucose, cholesterol, uric acid, calcium, potassium and sodium concentrations or packed cell volume.
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PMID:Effect of citrinin, a mycotoxin produced by Penicillium citrinum, on laying hens and young broiler chicks. 95 61

Infants and young children are particularly susceptible to a recently identified viral enteritis which is highly contagious and seems both common and universal. In this disease, virus invades the upper intestinal epithelium, causing acute diarrhoea with early fever and vomiting. We studied a similar disease in pigs, infecting three-week-old animals with transmissible gastroenteritis virus (TGE), which also invades the upper intestinal epithelium. In this model, diarrhoea is massive 16-40 hours after infection, when stools contain increased electrolytes but no excess of sugar. In the jejunum of intact pigs at the 40-hour stage we found altered Na+ and water flux, decreased mucosal activities of disaccharidases and Na+, K+-ATPase, but normal adenylate cyclase activity. At the same stage the response of Na+ flux to glucose was blunted in jejunal epithelium studied in Ussing short-circuit chambers and in suspensions of villous cells; Cl- flux responded normally to theophylline, and thymidine kinase and sucrase activities of cells isolated from jejunal villi were similar to those found in crypt cells. Probably by 40 hours after infection most virus has been shed from the mucosa. Viral diarrhoea clearly differs from enterotoxigenic diarrhoea. Consideration of its pathogenesis must take into account the dynamic nature of the mucosal epithelium and the factors governing differentiation of enterocytes as they migrate from crypt to villus. Sufficient information is available now to characterize one specific and apparently prevalent viral enteritis in man and to identify additional viral enteritides. There is hope that preventative therapy can be developed. Our understanding of the mechanisms of viral diarrhoea is limited, but the availability of an animal model and the promise of others makes us optimistic that these deficiencies can be remedied. Greater understanding of the pathogenesis of viral diarrhoea should better the active therapy of affected infants and children.
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PMID:Viral gastroenteritis: recent progress, remaining problems. 104 55

Since over half of the children aged 5 years and under in the developing world suffer from mild-moderate malnutrition, means of correcting nutrition deficiencies are essential. In the case of the child with diarrhea, malnutrition is exacerbated by a number of disease-related factors including anorexia, cultural or medical withdrawal of food, and purgation. It was discovered, in a study among Apache children, that early and rapid replacemtnt of volume loss and correction of electrolyte imbalance using glucose-electrolyte solutions administered orally can restore physical well-being and appetite to children suffering from acute diarrhea, and hence enhance these children's nutritional status. The solution recommended contained, in millimolar concentrations per liter: sodium, 81; potassium, 18; choride, 71; HC03, 28; and glucose, 139. A field trial of oral therapy for acute diarrhea in children is called for tod etermine the extent of effects on nutrition and mortality, as well as to indicate some of the cultural and logistical problems which remain to be solved.
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PMID:Oral glucose-electrolyte therapy for diarrhea: a means to maintain or improve nutrition? 105 11

Controversy continues regarding the optimal composition of glucose electrolyte oral rehydration solutions for the treatment of acute diarrhoea. Four perfusion models (normal human jejunum, normal rat small intestine, cholera toxin treated secreting rat small intestine and rotavirus infected rat small intestine) have been developed and used to compare the efficacy of a hypotonic oral rehydration solution with standard United Kingdom British National formulary and developing world oral rehydration solutions (WHO). Despite obvious physiological and pathophysiological differences between these models there was general congruence in the water and solute absorption profiles of the different oral rehydration solutions. Hypotonic oral rehydration solution promoted significantly greater water absorption than other oral rehydration solutions in all rat models (p < 0.001) but apparently increased water absorption failed to achieve significance in human jejunum. British National Formulary-oral rehydration solution was unable to reverse net water secretion in both rotavirus and cholera toxin models. Net sodium absorption from hypotonic and WHO-oral rehydration solutions was significantly greater than from the low sodium British National Formulary-oral rehydration solutions (p < 0.001) except in the rotavirus model when absorption was similar to hypotonic-oral rehydration solutions. These findings show that there is agreement in the apparent efficacy of oral rehydration solutions in these animal and human perfusion models, and that improved water absorption with adequate sodium absorption may be achieved by reducing oral rehydration solution osmolality.
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PMID:Water and solute absorption from a new hypotonic oral rehydration solution: evaluation in human and animal perfusion models. 148 67

In infants and children, the treatment of acute diarrhoea with glucose-based electrolyte solutions results in rehydration but does not reduce the severity and duration of diarrhoea. In german-speaking countries, rice- and carrot-based solutions have a long tradition in the treatment of diarrhoea and may also reduce stool output and the duration of diarrhoea. Therefore, we evaluated the efficacy and safety of a carrot-rice-based rehydration solution (Na 57 mmol/L, n = 70) and two conventional glucose-based solutions with high or low sodium concentrations (Na 90 mmol/L, n = 48 or Na 55 mmol/L, n = 60) in a prospective study. The study subjects were Pakistani boys and girls between 3 and 48 months of age with mild or moderate dehydration. We measured duration of diarrhoea, fecal and urine output, fluid intake and serum electrolytes. The duration of diarrhoea was significantly lower (p less than 0.05) in the group receiving the carrot-rice based rehydration solution (59.5 +/- 30.9 h) than in the groups receiving the high-Na (75.5 +/- 30.5) and low-Na (74.8 +/- 32.5) glucose-electrolyte solutions. The mean fecal output (p less than 0.01) and fluid intake (p less than 0.001) were also significantly lower in the infants and children receiving the carrot-rice-based rehydration solution. No major electrolyte imbalances were observed in the three groups. We conclude that the carrot-rice-based rehydration solution was safe and more effective than two conventional glucose-electrolyte solutions in the rehydration of infants and children with acute diarrhoea.
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PMID:[Acute diarrheal diseases. Treatment with carrot-rice viscous solution is more effective than ORS solution]. 150 19


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