Diarrheal Episodes and Diarrheal Disease: Acute Disease with Chronic Implications

Diarrheal episodes and diarrheal disease are often considered to be acute events of limited duration; a review of current literature indicates that this is not true. Diarrheal episodes caused by many bacteria, viruses, protozoans and other parasites cause alteration of intestinal structure and function. Consequences of such diarrhea-associated gut alterations include loss of normal defense mechanisms against secondary opportunistic pathogens and the ability to exclude macromolecules from systemic circulation. Additionally, loss of endogenous nutrients and malabsorption of essential nutrients result from diarrheal episodes; the consequences of such losses, even of a single essential nutrient, is compromised immune function, which predisposes to further infection. The net result of such events in some persons is long-term debilitating disease(s) such as allergy, autoimmune disorders and neoplasia.