Defecation Frequency Research Articles

The Relationship of Handwashing Behaviour with Soap and Incidence of Diarrhea Among Students at Elementary School 04 Rantau Utara

<p><em>Diarrhea can be defined as a condition where a person experiences an increased frequency of defecation, which results in liquid or non-solid faeces. Washing hands with soap is</em><em> a fundamental and essential technique for preventing and controlling the spread of infectious diseases</em><em>. Hands are one of the main routes for bacteria to enter and infect the body</em><em>. </em><em>Diarrhea is one of the factors causing death, so there must be prevention of diarrhea incidents. This study aimed to analyze the relationship between hand washing behavior using soap and the incidence of diarrhea.This research includes quantitative research analysis using a cross-sectional design. Research activities were conducted at State Elementary School 04 Rantau Utara from February to March 2024. The population studied in this research were all students from Elementary School 268 Negeri 04 Rantau Utara.</em> <em>The sampling technique used was random sampling, which resulted in a research sample of 71 people.</em> <em>The variables examined in this research include hand washing behavior using soap and the incidence of diarrhea.. Data was collected through questionnaires. Data analysis carried out included univariate and bivariate analysis using the Chi-Square test using SPSS version 24 software.</em> <em>Based on the analysis results, a p-value of 0.000 </em><em><</em><em>0.05. This shows that there is a statistically significant relationship between handwashing behaviour using soap and the incidence of diarrhea. This is due to a lack of good and correct hand washing with soap, which causes diarrhoea. Many still need to understand the basic techniques for washing hands with soap properly. Having hand washing facilities and infrastructure will make it easier for children to wash their hands properly so that they can effectively break the chain of bacteria.</em></p><p> </p><p><strong><em>Keywords: School Children, Diarrhea, Adequate Facilities, Hand Washing Behavior</em></strong></p>

Prunus persica (L.) Batsch blossom soluble dietary fiber synergia polyphenol improving loperamide-induced constipation in mice via regulating stem cell factor/C-kit, NF-κB signaling pathway and gut microbiota

This study aimed to investigate the ameliorating effects of peach blossom soluble dietary fiber (PBSDF) and polyphenol (PBP) combinations on loperamide (Lop)-induced constipation in mice, together with the possible mechanism of action. The results demonstrated that the combined use of PBSDF and PBP could synergistically accelerate the gastrointestinal transit rate and gastric emptying rate, shorten first red fecal defecation time, accelerate the frequency of defecation, regulate the abnormal secretion of gastrointestinal neurotransmitters and pro-inflammatory cytokines, and down-regulate the expressions of AQP3 and AQP8. Western blotting and RT-qPCR analysis confirmed that PBSDF + PBP up-regulated the protein and mRNA expressions of SCF and C-kit in SCF/C-kit signaling pathway, and down-regulated pro-inflammatory mediator expressions in NF-κB signaling pathway. 16S rRNA sequencing showed that the diversity of gut microbiota and the relative abundance of specific strains, including Akkermansia, Bacteroides, Ruminococcus, Lachnospiraceae_NK4A136_group, and Turicibacter, rehabilitated after PBSDF + PBP intervention. These findings suggested that the combination of a certain dose of PBSDF and PBP had a synergistic effect on attenuating Lop-induced constipation, and the synergistic mechanism in improving constipation might associated with the regulating NF-κB and SCF/C-kit signaling pathway, and modulating the specific gut strains on constipation-related systemic types. The present study provided a novel strategy via dietary fiber and polyphenol interactions for the treatment of constipation.

Overview of the Use of Oralit and Zinc in Children with Diarrhea at the Community Health Center

Diarrhea is still one of the main problems can cause illness and death, especially in children. Diarrhea is an infectious disease caused by bacteria, virus or other microorganism which is characterized by abnormal frequency of defecation, 3 or more times in 24 hours with a soft feces consistency, the presence or absence of blood or foam in the feces. Giving oralit and zinc can reduce the incidence of diarrhea in children. The aim of this study was to determine the description of the use oralit and zinc in children suffering from diarrhea at the kawatuna Community Health Center during the peroid October 2022-March 2023. Method of this study is retrospective descriptive using secondary data, namely prescription sheets for pediatric patients with diarrhea who received oralit and zinc therapy. The research results showed that the population of diarrhea cases was 125 and the sample used was 96 cases. The highest use of oralit and zinc for treating casess of diarrhea is in October 2022 and the least in March 2023. The age of children most a affected by diarrhea is 1-6 months (50%) and the age least affected by diarrhea is 12-17 years (7,3%).

Probiotics combination effectively improves constipation in pregnancy by modifying the gut microbiota composition.

Constipation during pregnancy can induce serious complications, including miscarriage and preterm labour, while the evidence of probiotics in improving constipation during pregnancy was little. In this study, 29 healthy pregnant women and 65 constipated pregnant women were enrolled to assess the effectiveness of probiotics on constipation during pregnancy. Our results showed that the probiotics were effective in improving the Constipation Severity Scale (CSS) and Bristol Stool Scale (BSS) scores, including increasing defecation frequency, decreasing defecation time, and improving fecal characteristics. 16S rRNA sequencing revealed that the probiotics effectively restored the diversity of intestinal microbiota. At the phylum level, Firmicutes (13.27% vs 57.20%) and Actinobacteria (3.77% vs 12.80%) were increased, while Bacteroidetes (77.82% vs 20.24%) was decreased. At the level of the genus, Faecalibacterium (2.03% vs 10.33%), Bifidobacterium (1.21% vs 8.56%), and Phascolarctobacterium (0.05% vs 2.88%), the beneficial bacteria were increased, while the Bacteroides (29.23% vs 12.28%) and Prevotella (24.32% vs 4.92%) were decreased. In conclusion, these results indicated that probiotics can effectively relieve the constipation symptoms by improving the diversity of intestinal microbiota, regulating the disturbance of microflorae, and restoring the balance of microflorae to exert a stronger moderating effect than diet and lifestyle modification. Our results provided clinical data and a theoretical basis for the exploitation of probiotics in treating constipation during pregnancy. Chinese Clinical Trial Registry: ChiCTR2100052069.

A Systematic Review and Meta-Analysis of Kiwifruit’s Impact on Functional Constipation

Introduction: Kiwifruit is rich in nutrients and fibers that benefit the digestive system. Despite various clinical investigations on the efficacy of kiwifruit for constipation, conflicting results are present. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness of kiwifruit in treating functional constipation. Methods: The study’s main goal is to quantify the frequency of defecation. Randomized-controlled trials (RCTs) were explored from four databases, including Cochrane Library, ProQuest, Science Direct, and MEDLINE, with Google Scholar as an additional database for hand-searching purposes. The Risk of Bias 2 (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tools were employed to evaluate the certainty of evidence. The meta-analysis was carried out using RevMan. Results: After critically appraising the individual articles, the study includes five randomized controlled trials (RCTs). The results indicated that defecation frequency improved considerably, with a p-value of 0.0008 and a weighted mean difference (WMD) of 0.07. However, the GRADE analysis showed low-quality evidence. Conclusions: Kiwifruit may be a secure and efficient treatment for people with functional constipation. However, further high-quality clinical investigations are needed to confirm these results.

PREVALENCE OF ESCHERICHIA COLI, COLIFORM AND NON-COLIFORM BACTERIA IN MUD BUFFALO IN RANGGAGATA AND SERAGE VILLAGES, SOUTHWEST PRAYA SUBDISTRICT, DISTRICT OF CENTRAL LOMBOK, WEST NUSA TENGGARA

Escherichia coli (E. coli) is a common bacterium that inhabits the intestines of humans and animals with hundreds of different strains, both harmful and harmless. One of the diseases that can be caused by E. coli is diarrhea. Diarrhea is a disease in the form of increased frequency of defecation, thinner stool consistency and increased intestinal peristalsis. This study aims to determine the number of E. coli, coliform and non-coliform bacteria in mud buffaloes in Ranggagata and Serage Villages, Southwest Praya Subdistrict, Central Lombok Regency, West Nusa Tenggara with samples used are fresh feces samples, a total of 14 samples. Sample cultivation was carried out on Eosin methyleneblue agar (EMBA) media then samples suspected of E. coli colonies were Gram stained, and biochemical tests on Triple Sugar Iron Agar (TSIA) media, Sulfide Indole Motility (SIM), Methyl red-Voges Proskauer (MR-VP) media, Simmons Citrate and catalase tests. The results showed the number of bacterial populations varied depending on the age of the buffalo with an average number of E. coli bacteria 162.143 ± 196.476, average coliform 272.000± 328.307 and average non-coliform 110.714 ± 201.855. Based on the results of the study it can be concluded that there is an increase in the number of E. coli, coliform and non-coliform as the age of buffalo increases, namely for E. coli is Y = 2.527+0.009x, coliform is Y = 2.525+0.05x and non-coliform bacteria is Y = 3.199+0.007x. Further tests need to be conducted related to other strains or species of E. coli, coliform and non-coliform bacteria in mud buffalo feces.

Effectiveness of physiotherapy in children with functional constipation.

The objective was to compare the immediate effects of pharmacological versus physiotherapy intervention versus a combination of physiotherapy and pharmacological treatment, as well as the quality of life and the recurrence of symptoms in children with functional constipation after 3months. A total of 69 children with functional constipation between the ages of 5 and 14years of either gender were assessed and randomly assigned to one of three groups: Group A, B, and C. Visual Analogue Scale, Bristol Stool Form Scale, frequency of defecation, PedsQL GI symptom scale, and PedsQL Generic Core Scale were used as outcome measures. Pharmacology was used to treat Group A, physiotherapy was used to treat Group B, and a combination of both was used to treat Group C. The study revealed statistically significant results on Visual Analogue Scale, Bristol Stool Form Scale, and frequency of defecation in all groups. However, no significant changes were observed on the PedsQL GI symptom scale and the Generic Core scale in Group A, whereas significant changes were observed in Groups B and C. In this study, we found that there were significant differences in the short- and long-term effects across all groups. More changes occurred in Group C than in Groups A and B.

Bowel function in a prospective cohort of 1052 healthy term infants up to 4 months of age

The purpose of this study is to describe the defecation pattern of healthy infants up to 17 weeks of age. We included 1052 healthy term infants from the prospective HELMi cohort (NCT03996304). Parents filled in recurring online questionnaires on feeding, gastrointestinal function, and crying weekly for the first 17 weeks of life. Defecation frequency was highest at the age of 3 weeks (a median of 4 times/day, interquartile range (IQR) 2.9–5). At each time point, the median defecation frequency of breastfed infants was higher than that of infants receiving formula (e.g., at week 17 a median of 2 times/day, IQR 0.9–3.6, and a median of 1.1, IQR 0.6–1.4, respectively). The dominant color of the stool was most often yellow or light brown. Nearly black stools were reported in the first week of life in 3.4%. Nearly half (47.4%) of the infants had green stool color dominating for at least 1 week, with comparable frequency among breastfed (47.7%) and formula-fed (45.2%) infants. Green stools were associated with a higher defecation frequency (linear mixed-effect model p < 0.0001). Occasional blood in stool was reported in 9.3% and recurrent blood in 5.2% of the infants with no difference in stool consistency. Hard stools were rare (≤ 1%). Conclusion: This study enlightens the spectrum of defecation patterns in healthy term infants during the first 17 weeks of life. A better understanding of bowel function helps healthcare professionals distinguish normal from abnormal when addressing defecation, the color of stools, and the type of feeding.What is Known:• Breastfed infants have more frequent and more yellow-colored stools than formula-fed infants.• Stools with green color are often suggested by the parents or even by medical professionals to indicate disease or discomfort in early life.What is New:• Nearly half of the healthy term infants had green stool dominating for at least one week during the first 17 weeks and occasional blood was reported in almost 10% of the infants during this period.• Data on normal variation in bowel function and stool may serve primary health care professionals when educating the families and caretakers of infants.

A case-control study of the risk factors for fistula-in-ano in infants and toddlers

BackgroundLimited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives.ObjectivesThe purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies.Design and settingsA retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021.Independent variables(a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors.ResultsMothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089).ConclusionBased on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.

In Vivo Antidiarrheal Potential of the Leaf Extract of Maytenus addat (Loes.) Sebsebe and Its Major Compound.

Diarrhea continues to be one of the top causes of death in children under the age of five, particularly in developing nations. In Ethiopian traditional medicine, a variety of medicinal plants are used to treat diarrhea. One of these plants is Maytenus addat (Loes.) Sebsebe (fam. Celastraceae), which is endemic to the Afromontane forests, especially along forest margins, of Ethiopia. The air-dried powdered leaves of M. addat were macerated with 80% methanol to yield a crude extract. Additionally, the powdered plant material underwent sequential solvent extraction using chloroform, methanol, and water to obtain solvent fractions. The 80% methanol leaf extract, solvent fractions, and an isolated compound from M. addat were evaluated for their antidiarrheal activity using castor oil-induced diarrheal model, anti-enteropooling test, and charcoal meal test in mice. The results showed that the 80% methanolic leaf extract significantly reduced the onset of diarrhea, the weight of feces, and the frequency of defecation in all the tested doses. The methanol and water fractions of the hydroalcoholic extract also exhibited dose-dependent antidiarrheal activity, with the methanol fraction showing the highest activity at 400 mg/kg dose. Subsequently, the most active methanol fraction was subjected to C-18 solid phase extraction, resulting in the isolation of a 3-hydroxyflavone, identified as quercetin by ESI-qToF-MS, 1H, and 13C-NMR spectroscopic techniques. Quercetin demonstrated a strong antidiarrheal activity in a dose-dependent manner. Thus, the present study provided evidence that the leaves of M. addat possess genuine antidiarrheal activity upholding the traditional medicinal use of the plant for the treatment of diarrhea. The findings also suggest that quercetin is responsible, in full or in part, for the activity of the plant.

The effect of abdominal massage and in-bed ROM exercise on gastrointestinal complications and comfort in intensive care unit patients receiving enteral nutrition: A randomized controlled trial.

Abdominal massage facilitates gastric and colonic motility, reduces intra-abdominal distension and increases circulation. In-bed range of motion (ROM) exercise has effects on muscle strength, cardiac parameters and excretion. The aim of this study was to assess the effects of abdominal massage and in-bed ROM exercise on gastrointestinal complications and patient comfort in intensive care patients receiving enteral nutrition. This randomized controlled trial was conducted in the internal intensive care units of two tertiary public hospitals. The sample consisted of 130 patients randomly assigned to three groups (abdominal massage = 44, in-bed ROM exercise = 43, control = 43). The individuals received abdominal massage and in-bed ROM exercises every morning before enteral feeding for 3 days. We assessed gastrointestinal complications and comfort levels of the patients 24 h after each intervention. While the differences in abdominal distention, defecation status, constipation, and gastric residual volume complications were significant (p < .05), there was no significant difference in diarrhea and vomiting (p > .05). Comfort level showed a statistically significant change in the experimental groups in the in-group comparison (p < .05). Abdominal massage and in-bed ROM exercise reduce abdominal distention, constipation and gastric residual volume. Abdominal massage affects the frequency of defecation; and, both interventions increase the comfort while reducing the pain level over time.

Sacral neuromodulation in children and adolescents with defecation disorders.

Even if understanding of neuronal enteropathies, such as Hirschsprung's disease and functional constipation, has been improved, specialized therapies are still missing. Sacral neuromodulation (SNM) has been established in the treatment of defecation disorders in adults. The aim of the study was to investigate effects of SNM in children and adolescents with refractory symptoms of chronic constipation. A two-centered, prospective trial has been conducted between 2019 and 2022. SNM was applied continuously at individually set stimulation intensity. Evaluation of clinical outcomes was conducted at 3, 6, and 12 months after surgery based on the developed questionnaires and quality of life analysis (KINDLR). Primary outcome was assessed based on predefined variables of fecal incontinence and defecation frequency. Fifteen patients enrolled in the study and underwent SNM (median age 8.0 years (range 4-17 years)): eight patients were diagnosed with Hirschsprung's disease (53%). Improvement of defecation frequency was seen in 8/15 participants (53%) and an improvement of fecal incontinence in 9/12 patients (75%). We observed stable outcome after 1 year of treatment. Surgical revision was necessary in one patient after electrode breakage. Urinary incontinence was observed as singular side effect of treatment in two patients (13%), which was manageable with the reduction of stimulation intensity. SNM shows promising clinical results in children and adolescents presenting with chronic constipation refractory to conservative therapy. Indications for patients with enteral neuropathies deserve further confirmation.

Efficacy and safety of Chinese herbal medicine in treating postcholecystectomy diarrhea: A systematic review and meta-analysis.

Postcholecystectomy diarrhea (PCD) is among the most distressing and well-known clinical complications of cholecystectomy. Despite various available treatment options, clinical outcomes are greatly limited by unclear pathophysiological mechanisms. Chinese herbal medicine (CHM) is widely used as a complementary and alternative therapy for the treatment of functional diarrhea. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of CHM for the treatment of PCD. Electronic database searches were conducted using the Cochrane Library, PubMed, Web of Science, Embase, Wanfang Data, China National Knowledge Infrastructure, and the Chinese Scientific Journal Database. All RCTs on CHMs for managing patients with PCD were included. The meta-analysis was performed using RevMan 5.4 software. The present meta-analysis included 14 RCTs published between 2009 and 2021 in China. The primary findings indicated that CHM had a higher total efficacy and cure rate as a monotherapy for PCD (P < .00001). Two trials reported the scores of the main symptoms with statistically significant differences in stool nature (P < .00001), defecation frequency (P = .002), and abdominal pain and bloating (P < .00001). In addition, CHM reduced CD3+ and CD4+ levels more effectively in terms of T lymphocyte subset determination (P < .00001). The main symptoms of PCD in traditional Chinese medicine (TCM) are splenic deficiency and liver stagnation. All treatments were used to strengthen the spleen and (or) soothing the liver. CHM had a favorable effect on PCD. No adverse events were observed. Larger, high-quality RCTs are warranted to draw definitive conclusions and standardize treatment protocols.

PHARMACOLOGIC TREATMENT OF THE IRRITABLE BOWEL SYNDROME: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: Abdominal pain and changes in stool frequency are two of the symptoms of Irritable Bowel Syndrome (IBS), a chronic gastrointestinal illness. As there is no known cure, treatment focuses on symptom management. Patients struggle with psychological and emotional issues that lower their quality of life. Clinical trials have demonstrated the therapeutic effects of several therapeutic drugs, which may improve GI symptoms and general quality of life. Effective treatment of IBS requires an understanding of the connection between pharmaceutical medicines and the illness. Methods: Following PRISMA 2020 guidelines, this systematic review concentrated on full-text English literature published between 2014 and 2024. Editorials and review articles that appeared in the same journal as the submission were not accepted without a DOI. The literature was assembled using a variety of online databases, including ScienceDirect, PubMed, and SagePub. Result: The study screened about 20.000 publications using reputable sources including Science Direct, SagePub, and PubMed. Seven papers were found to be pertinent for systematic investigation, after which the entire material was examined in more detail. Conclusion: IBS treatment has shown significant improvement in patients with Minesapride, a novel 5-HT4 receptor agonist, and tenapanor. Tenapanor showed significant improvement in symptoms, treatment metrics, and satisfaction, while geraniol improved the inflammatory profile. Melatonin showed improvement in IBS score and GI symptoms, but no significant improvement in frequency of defecations per week. Amitriptyline showed effectiveness over placebo, while co-micronized PEA/PD improved IBS symptoms in children.

A Comparison of the Effect of Kegel Exercises and Conventional Therapy versus Conventional Therapy Alone in the Treatment of Functional Constipation in Children: A Randomized Clinical Trial.

There have been few studies on the effect of Kegel exercises on the treatment of functional constipation in children. Hence, the present study investigated the add-on role of Kegel exercises in children with functional constipation. This clinical trial was conducted on children with functional constipation, according to Rome IV, who were referred to the pediatric department of Imam Reza Clinic (Shiraz, Iran) in 2022. The sample consisted of 64 children who were randomly assigned to either the intervention or the control groups. In the control group, a pediatrician administered conventional therapy, including diet training, defecation training, and polyethylene glycol (PEG) syrup (0.7 g/Kg daily). In the treatment group, in addition to conventional therapy, a pediatrician taught Kegel exercises to the child both verbally and in writing in the presence of their parents. To investigate the effectiveness of the intervention, frequency of defecation, defecation time, assistance used for defecation, incomplete emptying, unsuccessful defecation, abdominal pain, and painful defecation were selected as the outcomes. Independent sample t test was used for continuous variables. Categorical variables were reported as frequency and percentages. To examine the difference in categorical outcome variables, Wilcoxon (pre and post), Chi square, and Fisher exact tests were used. Data were analyzed using SPSS software version 21. P<0.05 were considered statistically significant. Twenty-seven (88.4%) patients in the Kegel exercise group reported a defecation time of less than 5 min, while only 12 (37.5%) patients in the control group reached this time, and this difference was statistically significant (P=0.001). Moreover, patients in the treatment group showed significant improvements in terms of incomplete emptying of stool, unsuccessful defecation, abdominal pain, and painless defecation (P=0.001, P=0.001, P=0.001, P=0.037, respectively). After intervention, the use of laxatives, digits, or enemas to assist defecation was not significantly different between the groups (P=0.659). Kegel exercise was an effective adjunctive treatment for pediatric functional constipation.Trial Registration Number: IRCT20230424057984N1.

AYURVEDIC MANAGEMENT OF ULCERATIVE COLITIS (PITTAJA GRAHANI): A CASE REPORT

Ulcerative colitis (UC) is a form of chronic inflammatory bowel disease characterised by inflammation of the mucosa and submucosa in the colon, relapsing and remitting. It has a reported incidence of 9-20 cases per 100,000 people annually and can significantly impact both mental and physical health, causing distress to patients. Here is a case report of a 45-year-old female who presented with symptoms including increased frequency of defecation (7 times/day) with mucus discharge, bloody stool, abdominal pain, reduced appetite, general debility, weight loss (&gt;5 kg) and mental distress persisting for one year. She was found to be anaemic (Hb 6.8 gm%), and her pulse rate was 105 bpm. The colonoscopy report showed multiple superficial ulcers with erythematous mucosa, and a biopsy confirmed chronic active colitis. This case was diagnosed as Pittaja Grahani with Pandu (anaemia). The study aimed to evaluate the efficacy of Ayurvedic management in treating ulcerative colitis (Pittaja Grahani). Therapeutic measures included Ayurvedic oral medications and procedures such as abhyanga (oil massage), parisheka (sudation), takradhara, takra basti (buttermilk enema), pathyahara and yoga. Clinical parameters were assessed on the 1st, 12th and 45th day using the Truelove and Witts severity index scale for Ulcerative Colitis and the Patient Health Questionnaire-9 (PHQ-9) depression severity score. Improvements were observed in the frequency of defecation, bloody stool, pulse rate, general debility, and appetite throughout treatment. The results indicate marked alleviation of Ulcerative colitis symptoms with Ayurvedic management, suggesting its potential as a practical therapeutic approach in managing this condition.

Kandungan Fitokimia Daun Asam Jawa dan Potensinya sebagai Bioagen Antibakteri untuk Pengobatan Alami

Indonesia is known as a country that is abundant in various biological riches and their potential as medicines, so a review of natural antidiarrheal treatment methods using tamarind leaves was carried out. Diarrhea is a digestive disorder with a high prevalence rate, especially in developing countries. Diarrhea is a digestive system disorder characterized by stomach cramps, a liquid stool consistency, and an increase in the frequency of defecation more than 3 times in 24 hours. The research method used is to use literature review through online publications based on the Web, ResearchGate, Google Scholar and Scopus. The research sample used in this literature review was 22 articles. The research results show that the phytochemical content of tamarind consists of tannins, flavonoids, saponins, alkaloids, phenols and triterpenoids. The results of the analysis in the literature review show that tamarind leaves are an alternative natural treatment and are effective in inhibiting the growth of bacteria, for example the Escherichia coli bacteria that causes diarrhea.

The Effect of Metronidazole versus a Synbiotic on Clinical Course and Core Intestinal Microbiota in Dogs with Acute Diarrhea.

The usefulness of antibiotics in dogs with acute diarrhea (AD) is controversial. It is also unclear what effect metronidazole has on potential enteropathogens such as Clostridium perfringens and Escherichia coli. Thus, the aim of this study was to evaluate the effect of metronidazole vs. a synbiotic on the clinical course and core intestinal bacteria of dogs with AD. Twenty-seven dogs with AD were enrolled in this prospective, randomized, blinded clinical trial and treated with either metronidazole (METg) or a synbiotic (SYNg; E. faecium DSM 10663; NCIMB 10415/4b170). The Canine Acute Diarrhea Severity (CADS) index was recorded daily for eleven days. Bacteria were quantified using qPCR. Data were analyzed using mixed models with repeated measures. A higher concentration of E. coli was observed in the METg group vs. the SYNg group on Day 6 (p < 0.0001) and Day 30 (p = 0.01). Metronidazole had no effect on C. perfringens. C. hiranonis was significantly lower in the METg group than in the SYNg group on Days 6 and 30 (p < 0.0001; p = 0.0015). No significant differences were observed in CADS index, fecal consistency, or defecation frequency between treatment groups (except for the CADS index on one single day). In conclusion, metronidazole negatively impacts the microbiome without affecting clinical outcomes. Thus, synbiotics might be a preferred treatment option for dogs with AD.

Deciphering the Impact of Defecation Frequency on Gut Microbiome Composition and Diversity.

This study explores the impact of defecation frequency on the gut microbiome structure by analyzing fecal samples from individuals categorized by defecation frequency: infrequent (1-3 times/week, n = 4), mid-frequent (4-6 times/week, n = 7), and frequent (daily, n = 9). Utilizing 16S rRNA gene-based sequencing and LC-MS/MS metabolome profiling, significant differences in microbial diversity and community structures among the groups were observed. The infrequent group showed higher microbial diversity, with community structures significantly varying with defecation frequency, a pattern consistent across all sampling time points. The Ruminococcus genus was predominant in the infrequent group, but decreased with more frequent defecation, while the Bacteroides genus was more common in the frequent group, decreasing as defecation frequency lessened. The infrequent group demonstrated enriched biosynthesis genes for aromatic amino acids and branched-chain amino acids (BCAAs), in contrast to the frequent group, which had a higher prevalence of genes for BCAA catabolism. Metabolome analysis revealed higher levels of metabolites derived from aromatic amino acids and BCAA metabolism in the infrequent group, and lower levels of BCAA-derived metabolites in the frequent group, consistent with their predicted metagenomic functions. These findings underscore the importance of considering stool consistency/frequency in understanding the factors influencing the gut microbiome.

Bile Acid Diarrhea

Diarrhea is a very common gastrointestinal symptom, and the presence of higher concentrations of bile acid in the colon leads to bile acid diarrhea (BAD). In BAD patients, a portion of bile from the small intestine that is normally controlled by enterohepatic circulation is present at a high concentration in the lumen of the large intestine, resulting in increased motility and secretion of the large intestine. The prevalence of BAD is estimated to be 1-2% of the general population, and it comprises one-third of the instances of diarrhea-predominant irritable bowel syndrome. The clinical symptoms of BAD include chronic diarrhea, increased frequency of defecation, urgency to defecate, fecal incontinence, and cramping abdominal pain. The pathophysiology of BAD has not yet been fully elucidated. However, recent studies have reported increased intestinal permeability, shortened intestinal transit time, and changes in the intestinal microbial community to be the possible causes of BAD. Although fecal and serum bile acid tests are widely used for diagnosis, new test methods that are non-invasive, inexpensive, and have high sensitivity and specificity are needed at various institutions to facilitate the diagnosis. The selenium homo-tauro-cholic acid (SeHCAT) test is the gold standard for BAD diagnosis and severity assessment. The validation of several other serum markers, such as 7-hydroxy-4-cholesten-3-one (serum 7αC4) and the fibroblast growth factor 19 (FGF19) for use in clinical practice is ongoing. Although bile acid sequestrants are the mainstay of treatment, the development of drugs that are more effective and have better compliance is required. Farnesoid X receptor (FXR) agonists are showing promising results.