Abstract
Context: Since ancient times diarrhoea has been a highly fatal disease and even today diarrhoea, the topic of this review, is a problem affecting millions of people around the world despite the efforts of governments and professionals from the medical area. Worldwide the most common cause of children’s death is diarrhoea. Evidence Acquisition: Diarrhoea disorders generally appear with watery stools, sometimes mixed with blood, accompanied by abdominal pain, vomiting and fever. The symptoms depend on the content and distribution of body fluid, daily water requirements and physiological water loss in connection with age through sweating, urination and breathing, the degree of fluid and electrolyte loss in the liquid stool. Results: Several effective interventions have been introduced as part of diarrhoea management in the last two decades such as rehydration solution, zinc supplementation, vitamin A supplementation and administration of antibiotics and vaccines. To reduce the mortality rate, control of safe drinking water, good sanitation and vaccination against typhoid and cholera are recommended, especially in high-risk populations. Probiotics have been proposed, after more than a half of century, as additional therapy in the treatment of acute diarrhoea. Several probiotic strains showed benefit in meta-analyses of randomised controlled trials. Conclusions: Due to the high level of evidence available, the term oral bacterio therapy, used for decades in the prevention and the rapyof gastroenteritis in the growing age and adults, has expanded, but probiotics are acquiring significant scientific value based on theresults from human trials. The future of probiotics depends on further explanation/elucidation of basic mechanisms, allowing scientists and physicians to maximize their health benefits.
Highlights
Context: Since ancient times diarrhoea has been a highly fatal disease and even today diarrhoea, the topic of this review, is a problem affecting millions of people around the world despite the efforts of governments and professionals from the medical area
The low osmolarity oral rehydration solution with reduced concentrations of sodium and glucose, (≤ 270 mOsm/L) and zinc supplementation is associated with fewer unscheduled intravenous fluid infusions, lower stool volume and less acetone vomiting than the standard ORS and is recommended in treating adults and children
The cost utility of racecadotril with oral rehydration solution (ORS) for the treatment of acute watery diarrhoea (AWD) was studied on children younger than five years showing that racecadotril is more effective as adjuvant therapy and less costly compared to ORS [54, 55]
Summary
The present paper is a review on diarrhoea, including pathogens that cause several types of diarrhoea, mortality trend around the world and methods to detect the causative agents. The authors overviewed all the interventions to fight diarrhoea, such as oral rehydration therapy (ORS), zinc and vitamin supplementation, antibiotics, vaccine and probiotics in diarrhoea management
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