Nutritional management of acute diarrhea: an appraisal of the alternatives

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.