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Current Management of Acute Diarrhoeas

Use and Abuse of Drug Therapy

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Summary

Acute diarrhoeas in infants and children should be regarded as a protective physiological response of the gastrointestinal tract to flush out harmful organisms and toxins, thus limiting the morbidity from this illness. The approach to therapy of acute diarrhoeas must be physiological rather than pharmacological. Prevention and early correction of acute dehydration with oral rehydration is the most physiological approach to the successful management of acute diarrhoeas, which generally have a self-limited course. The use of antidiarrhoeal drugs is limited to a few isolated cases. These may include the short term administration of antimicrobials in selected cases of acute diarrhoea caused by enteropathogens where antimicrobials are proven to be efficacious. Antisecretory drugs which are devoid of unwanted side effects may be tried in persistent cases of acute diarrhoeas, but kaolin-pectin mixtures and antimotility drugs should be avoided for infants and children. Generally, the management of acute diarrhoea is simply to stop the dehydration rather than the diarrhoea, not with drug therapy but with oral rehydration therapy.

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References

  • Angelides A, Fitzgerald JF. Pharmacologic advances in the treatment of gastrointestinal diseases. Pediatric Clinics of North America 28: 95–112, 1981

    PubMed  CAS  Google Scholar 

  • Bacallan LD. Loperamide toxicity. Postgraduate Pediatrics 2: 22, 1981

    Google Scholar 

  • Booth IW, Harries JT. Regulatory mechanism of secretory diarrhoea and electrolyte imbalance in acute and chronic diarrhoea in infancy. In Lebenthal E (Ed.) Chronic diarrhea in children. Nestle Nutrition Workshop Series, Vol. 6, pp. 307–317, Raven Press, New York, 1984

    Google Scholar 

  • Bradshaw MJ, Harvey RF. Antidiarrhoeal agents: clinical pharmacology and therapeutic use. Medical Progress 10: 55–65, 1983

    Google Scholar 

  • Brown J. Toxic megacolon associated with loperamide therapy. Journal of the American Medical Association 241: 501, 1979

    Article  PubMed  CAS  Google Scholar 

  • DiJoseph JF, Mir GN. Lidamidine’s effects on the lower GIT: a review. Drug Development Research 7: 101, 1986

    Article  Google Scholar 

  • Donowitz M, Wicks J, Sharp GWG. Drug therapy for diarrhoeal diseases: a look ahead. Reviews of Infectious Diseases 8 (Suppl. 2): 188, 1986

    Article  Google Scholar 

  • Dupont HL. Nonfluid therapy and selected chemoprophylaxis of acute diarrhoea. American Journal of Medicine 78: 81, 1985

    Article  CAS  Google Scholar 

  • Dupont HL. Bismuth subsalicylate in the treatment and prevention of diarrheal disease. Drug Intelligence and Clinical Pharmacy 21: 687, 1987

    PubMed  CAS  Google Scholar 

  • Dupont HL, Hornick RB. Clinical approach to infectious diarrhea. Medicine 52: 265, 1973

    PubMed  CAS  Google Scholar 

  • Eichenwald HF. Diarrhea in children. Philippine Journal of Pediatrics 25: 163, 1976

    Google Scholar 

  • Gall DG. Pathophysiology of viral diarrhea. Etiology, pathophysiology and treatment of acute gastroenteritis. 74th Ross Conference on Pediatric Research, pp. 66–70, 1978

  • Gyr K. Infectious diarrhoeas and gastrointestinal hormones: potential therapeutic implications. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 135, 1984

    Google Scholar 

  • Hieber JP. Antimicrobial and antidiarrheal therapy during acute gastroenteritis. Etiology, pathophysiology and treatment of acute gastroenteritis. 74th Ross Conference on Pediatric Research, pp. 114–121, 1978

  • Hughes S. Acute secretory diarrhoeas: current concepts in pathogenesis and treatment. Medical Progress 10: 25–39, 1983

    Google Scholar 

  • Iyngkaran N. Acute infective enteritis in infants and children. Mother and Child 5: 9–17, 1979

    Google Scholar 

  • Kamath RK. Intractable diarrhoea in children: diagnosis and management. Proceedings of the 16th Annual Convention of the Philippine Pediatric Society, Manila, 1979

  • Kerzner B. Pathogenesis of diarrhea. Diagnosis and management of acute diarrhea. Report of the 13th Ross Roundtable, pp. 39–42, 1982

  • Keusch GT, Donowitz M. Pathophysiological mechanisms of diarrhoeal diseases: diverse aetiologies and common mechanisms. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 33–43, 1983

    CAS  Google Scholar 

  • Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, Aye-Khaw, Tin-U. Clinical trial of berberine in acute watery diarrhoea. British Medical Journal 291: 1601, 1985

    Article  PubMed  CAS  Google Scholar 

  • Kronborg IJ, Howard A. Diarrhoea: causes and specific treatment. Medical Progress 8: 25–33, 1981

    Google Scholar 

  • Ludan AC (Ed.). Handbook of rehydration — a publication of the Committee on Rehydration, Philippine Pediatric Society, Sinagtala Publications, Manila, 1979

    Google Scholar 

  • Ludan AC. Management of acute diarrheas. Postgraduate Pediatrics 2: 79, 1981

    Google Scholar 

  • Keusch GT, Donowitz M. Pathophysiological mechanisms of diarrhoeal diseases: diverse aetiologies and common mechanisms. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 33–43, 1983

    CAS  Google Scholar 

  • Ludan AC. Current management of acute diarrhoeas in the Philippines. Journal of the Singapore Paediatric Society 29 (Suppl. 1): 153, 1987

    PubMed  Google Scholar 

  • Ludan AC, Buenaventura S, Batac BR. A rational management of acute diarrheas in hospitalized patients. Philippine Journal of Pediatrics 32: 57, 1983

    Google Scholar 

  • McClung HJ, Beck RD, Powers P. The effect of a kaolin-pectin adsorbent on stool losses of sodium, potassium and fat during a lactose-intolerance diarrhea in rats. Journal of Pediatrics 96: 769, 1980

    Article  PubMed  CAS  Google Scholar 

  • Novack AH. Management of acute infectious diarrhea. Diagnosis and management of acute diarrhea. Report of the 13th Ross Roundtable, pp. 34–36, 1982

  • Pickering LK. Indications for specific therapy of children with acute infectious diarrhea. Diagnosis and management of acute diarrhea. Report of the 13th Ross Roundtable, pp. 23–29, 1982

  • Portnoy BL, Dupont HL, Pruitt D, Abdo JA, Rodriguez JT, et al. Antidiarrheal agents in the treatment of acute diarrhea in children. Journal of the American Medical Association 236: 844–846, 1976

    Article  PubMed  CAS  Google Scholar 

  • Rabbani GH, Butler T, Knight J, Sanyal SC, Alam K. Randomized controlled trial of berberine sulfate therapy for diarrhea due to ETEC and Vibrio cholerae. Journal of Infectious Diseases 155: 979, 1987

    Article  PubMed  CAS  Google Scholar 

  • Read NW. Speculations on the role of motility in the pathogenesis and treatment of diarrhea. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 45, 1983

    Google Scholar 

  • Rosenstein G, Freeman M, Standard AL, Weston N. Warning: the use of lomotil in children. Pediatrics 51: 132, 1973

    PubMed  CAS  Google Scholar 

  • Sack DA. Treatment of acute diarrhoea with oral rehydration solution. Medical Progress 9: 27–32, 1982

    Google Scholar 

  • Sandhu BK, Milla PJ, Harries JT. Mechanisms of action of loperamide. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 85, 1983a

    CAS  Google Scholar 

  • Sandhu BK, Tripp JH, Milla PJ, Harries JT. Loperamide in severe protracted diarrhoea. Archives of Disease in Childhood 58: 39, 1983b

    Article  PubMed  CAS  Google Scholar 

  • Sunoto, Pusponegoro TS, Suridwan, Sanborn WR. A question on the use of antibiotics in the treatment of acute diarrheal diseases. Paediatrica Indonesiana 18: 191, 1978

    PubMed  CAS  Google Scholar 

  • Suparto P. The role of antidiarrhoeals. Proceedings of the 24th SEAMEO-TROPMED Seminar on Diarrhoeal Diseases in Southeast Asia, Bangkok, Nov 9–12, 1981

  • Turnberg LA. Antisecretory activity of opiates in vitro and in vivo in man. Scandinavian Journal of Gastroenterology 18 (Suppl. 84): 79, 1983

    CAS  Google Scholar 

  • Valencia RP, Francisco FJ, Ludan AC. Hypokalemia: a potential side-effect of kaolin-pectin mixtures. Proceedings of the 19th Annual Convention of the Philippine Pediatric Society, Manila, May 3–6, 1982

  • WHO SWG. Recent advances in the development of non-antimicrobial antidiarrhoeal agents. Report of the Scientific Working Group (SWG) on drug development and management of acute diarrhoeas, 1982

  • WHO. A manual for the treatment of acute diarrhoea. WHO/ CDD/SER/80.2 Rev. 1, 1984

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Authors and Affiliations

  1. Department of Pediatrics, Cardinal Santos Memorial Hospital, Philippines

    Arturo C. Ludan

  2. University of the Philippines-Philippine General Hospital, Quezon City, Philippines

    Arturo C. Ludan

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  1. Arturo C. Ludan
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Ludan, A.C. Current Management of Acute Diarrhoeas. Drugs 36 (Suppl 4), 18–25 (1988). https://doi.org/10.2165/00003495-198800364-00005

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