Diarrhea Health Article

Alternative treatment

It is especially important to find the cause of diarrhea, since stopping diarrhea when it is the body's way of eliminating something foreign is not helpful and can be harmful in the long run.

One effective alternative approach to preventing and treating diarrhea involves oral supplementation of aspects of the normal flora in the colon with the yeasts Lactobacillus acidophilus, L. bifidus, or Saccharomyces boulardii. In clinical settings, these "biotherapeutic" agents have repeatedly been helpful in the resolution of diarrhea, especially antibiotic-associated diarrhea. Their effectiveness is also supported by the results of a research study published in the Journal of the American Medical Association in 1996.

Nutrient replacement also plays a role in preventing and treating episodes of diarrhea. Zinc especially appears to have an effect on the immune system, and deficiency of this mineral can lead to chronic diarrhea. Also, zinc replacement improves growth in young patients. Plenty of fluids, especially water, should be taken by individuals suffering from diarrhea to prevent dehydration. The BRAT diet also can be useful in helping to resolve diarrhea. This diet limits food intake to bananas, rice, apple-sauce, and toast. These foods provide soluble and insoluble fiber without irritation. If the toast is slightly burnt, the charcoal can help sequester toxins and pull them from the body.

Acute homeopathic remedies can be very effective for treating diarrhea especially in infants and young children.

Prognosis

Prognosis is related to the cause of the diarrhea; for most individuals in developed countries, a bout of acute, infectious diarrhea is at best uncomfortable. However, in both industrialized and developing areas, serious complications and death can occur.

For those with chronic symptoms, an extensive number of tests are usually necessary to make a proper diagnosis and begin treatment; a specific diagnosis is found in 90% of patients. In some, however, no specific cause is found and only treatment with bulk agents or anti-motility agents is indicated.

Prevention

Proper hygiene and food handling techniques will prevent many cases. Traveler's diarrhea can be avoided by use of Pepto-Bismol and/or antibiotics, if necessary. The most important action is to prevent the complications of dehydration.

BOOKS

Fine, Kenneth D. "Diarrhea." In Sleisenger & Fordtran's Gastrointestinal and Liver Disease, ed. Mark Feldman, et al. Philadelphia: W. B. Saunders Co., 1997.

Friedman, Lawrence S., and Kurt J. Isselbacher. "Diarrhea." In Harrison's Principles of Internal Medicine, ed. Anthony S. Fauci, et al. New York: McGraw-Hill, 1997.

Hamer, Davidson H., and Sherwood L. Gorbach. "Treatment of Infectious Diarrhea." In Sleisenger & Fordtran's Gastrointestinal and Liver Disease, ed. Mark Feldman, et al. Philadelphia: W. B. Saunders Company. 1997.

Thielman, Nathan M., and Richard L. Guerrant. "Food-Borne Illness." In Conn's Current Therapy, 1996, ed. Robert E. Rakel. Philadelphia: W. B. Saunders Co., 1996.

Wolfe, Martin S. "Acute Infectious Diarrhea." In Conn's Current Therapy, 1996, ed. Robert E. Rakel. Philadelphia: W.B. Saunders Co., 1996.

PERIODICALS

Donowitz, Mark, Freddy T. Kokke, and Roxan Saidi. "Evaluation of Patients with Chronic Diarrhea." New England Journal of Medicine 332 (16 Mar. 1995): 725-729.

Dupont, Herbert L., and The Practice Parameters Committee of the American College of Gastroenterology. "Guidelines on Acute Infectious Diarrhea in Adults." American Journal of Gastroenterology 92 (1997): 1962-1975.

Fekety, Robert. "Guidelines for the Diagnosis and Management of Clostridium Difficile-Associated Diarrhea and Colitis." American Journal of Gastroenterology 92 (1997): 739-750.

Gianella, Ralph A. "Acute Infectious Diarrhea." Gastroenterology Clinics of North America (Sept. 1993): 483-707.

Penny, Mary E., and Claudio F. Lanata. "Zinc in the Management of Diarrhea in Young Children." New England Journal of Medicine 333 (28 Sept. 1995): 873-874.

"Traveler's Diarrhea: Don't Let It Ruin Your Trip." Mayo Clinic Health Letter (Jan. 1997).

"When Microbes Are on the Menu." Harvard Health Letter (Dec. 1994): 4-5.

ORGANIZATIONS

World Health Organization, Division of Emerging and Other Communicable Diseases Surveillance and Control. Avenue Appia 20, 1211 Geneva 27, Switzerland. (+00 4122) 791 21 11. <http://www.who.int>.

OTHER

"Directory of Digestive Diseases Organizations for Patients." National Institute of Diabetes and Digestive and Kidney Disease. <http://www.niddk.nih.gov>.

"A Neglected Modality for the Treatment and Prevention of Selected Intestinal and Vaginal Infections." JAMA. <http://pubs.ama-assn.org>.

Selected publications and documents on diarrhoeal diseases (including cholera). World Health Organization (WHO). <http://www.who.ch/chd/pub/cdd/cddpub.htm>.

David Kaminstein, MD