Direct Nutrient Loss and Diarrhea

Abstract

The pathogenesis of malnutrition in diarrheal diseases is the principal theme of this volume. A meeting held in 1976 summarized the literature and drew renewed attention to the infection-nutrition relationship.1 New information on the specific interactions of diarrhea and nutrition is presented in this volume. Reduced dietary intake resulting from partial loss of appetite, lower digestive and absorptive capacity of the gastrointestinal tract caused by enzymatic deficiencies, short transit-time, and morphological changes in the intestinal villi, induced by repeated attacks of diarrheal diseases, are considered to be some of the main causes of malnutrition in tropical developing countries. Catabolic breakdown of body protein because of inflammation also contributes to malnutrition in some invasive diarrheas. There is, however, another cause of malnutrition, brought about by direct loss of nutrients into the gut, that has not so far been investigated adequately, mainly because of technical difficulties involved in its measurement. Loss of protein or other nutrients into the gut in a healthy individual is extremely small; whatever is secreted into the intestine undergoes breakdown and reabsorption. The major protein in the feces is in mucous secretions, undigested food material, and bacteria. Loss from the gastrointestinal tract becomes obvious when the quantity secreted exceeds the capacity of the intestine to reabsorb.