[Refractory diarrhea in infants: experimental basis of current therapeutic perspectives]

Intractable diarrhoea is a severe condition of early infancy producing prolonged food intolerance, massive watery diarrhoea and malnutrition. Although the etiology remains unknown in more than half of the cases, a basic physiopathological mechanism appears to be a variable inhibition of the maturation and differentiation of the crypt cell resulting in immature villus cells. Among the known nutritional and hormonal factors that control maturation of the enterocytes, polyamines (spermine, spermidine) emerge as the most trophic substances potentially useful for humans. Clinical studies are warranted to determine whether semi-elemental diets enriched in polyamines would provide some benefit for patients with intractable diarrhoea or with an adapted bowel after extensive enterectomy.