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Excessive fluid intake as a cause of chronic diarrhea in young children
Insights
Excessive fluid intake may cause chronic nonspecific diarrhea (CNSD). Reducing fluid intake significantly improved symptoms in patients with CNSD, suggesting a direct link between high fluid consumption and the condition.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Clinical Nutrition
Background:
- An increasing incidence of chronic nonspecific diarrhea (CNSD) has been observed.
- This rise coincides with the widespread use of oral fluid-electrolyte therapy for managing diarrhea.
- A potential link between increased fluid intake and CNSD incidence is hypothesized.
Purpose of the Study:
- To investigate the relationship between fluid intake and chronic nonspecific diarrhea.
- To determine if reducing fluid intake can alleviate symptoms of CNSD.
Main Methods:
- An outpatient study involving 105 referred patients, with 85 showing no malabsorption.
- Forty patients meeting CNSD criteria were divided into two groups based on fluid intake: Group A (high intake) and Group B (low intake).
- Nonprotein fluid intake was reduced to 90 ml/kg/day for all patients, with follow-up evaluations at two and six to eight weeks.
Main Results:
- Patients in Group A (high fluid intake) showed a significant decrease in stool frequency and improved stool consistency after fluid reduction.
- No significant changes in stool patterns were observed in Group B (low fluid intake).
- The reduction in stool frequency ranged from four to ten per day down to zero to three per day in Group A.
Conclusions:
- Findings suggest a cause-and-effect relationship between excessive fluid intake and some cases of chronic nonspecific diarrhea.
- Reducing nonprotein fluid intake is an effective intervention for managing CNSD in patients with high fluid consumption.
- This study highlights the importance of assessing fluid intake in the diagnosis and management of CNSD.
Abstract:
An increased incidence of chronic nonspecific diarrhea has been coincident with popularization of orally administered fluid-electrolyte therapy for management of diarrhea, and led up to postulate than an increase in fluid intake might be related to this increased incidence. Of 105 referred patients, 85 were found to have no clinical or laboratory evidence of malabsorption. Forty of these patients had characteristic features of CNSD: diarrhea for at least three weeks, normal growth, and no evidence of enteric pathogens. An outpatient study evaluated fecal output, dietary energy-protein intake, and nonprotein fluid intake. Patients were separated into two groups whose fluid intakes were highly different: group A, 196 +/- 32 ml/kg/day, and group B, 91 +/- 15 ml/kg/day (P less than 0.001). The nonprotein fluid intake was then reduced to 90 ml/kg/day with no change in diet. Evaluation at two weeks and again at six to eight weeks showed a decrease in stool frequency (from four to ten per day to zero to three per day) and increase in stool consistency in all patients in group A, but no significant change in stool patterns in group B. Our findings suggest a cause-and-effect relationship between excessive fluid intake and some cases of CNSD.