Symptoms Of Acute Diarrhea Research Articles

The Effect of Probiotics on Radiation Enteritis in Endometrial Cancer Patients Undergoing Radiotherapy

Introduction: Radiation enteritis is damage to the small and large intestines caused by radiation therapy for regional cancer treatment. The incidence is around 90% in patients undergoing radiation in the pelvic and abdominal regions. This study aimed to report the effect of probiotics on radiation enteritis in endometrial cancer patients. Case presentation: A 57-year-old morbidly obese woman diagnosed with endometrial cancer underwent chemoradiation therapy. On the 21st out of 25 radiation sessions and the 2nd chemotherapy session, the patient visited the nutrition clinic at the Radiation Oncology Therapy Center with a complaint of diarrhea for the past 5 days. The diarrhea occurred approximately 10 times a day, with each bowel movement being approximately 50 ml and yellow in color. The patient was then treated with anti-diarrheal therapy, probiotics (Lactobacillus acidophilus, Bifidobacterium longum, and Streptococcus thermophilus) 2 times a day, zinc 20 mg once a day, and prescribed a low-fat and lactose-free diet. After monitoring on the 21st day, the frequency of liquid bowel movements decreased to 2 times a day, and the appetite improved. Conclusion: Patients with radiation enteritis who are given probiotics may experience a reduction in symptoms of acute diarrhea. Direct administration of probiotics increases beneficial bacteria in the digestive tract.

Diversity of Rotavirus Strains among Children with Acute Diarrhea in Karachi, Pakistan.

One of the common viral pathogens in infectious diarrhea is Rotavirus; in developing countries, it is a primary cause of deaths in children less than five years of age. This study was planned to find out the etiologic agents of acute watery diarrhea. In this study, 1465 stool samples were analyzed with the symptoms of acute diarrhea. Demographic data analysis showed no. of episodes of diarrhea, vomiting, and fever. All samples were checked by ELISA technique for the presence of Rotavirus circulating strains. More than 6% patients were found to be positive with Rotavirus. Common Rotavirus genotypes, including G2P4, G2P6, G3P4, G8P4, G8P6, G9P4, and G10P4, were detected in patients through RT-PCR. This study concluded that detection of rotavirus strain diversity and management of diarrheal patients may identify assortment of emerging strains and reduce emergence of antimicrobial resistance and repeated episodes of diarrhea, which may also help to avoid and manage the essential nutrients lost leading to malnutrition and stunted growth, as well as to reduce high mortality rate in young children less than five years.

Magnitude of Rotavirus A and Campylobacter jejuni infections in children with diarrhea in Twin cities of Rawalpindi and Islamabad, Pakistan

BackgroundAcute diarrhea is a leading cause of morbidity and mortality in children particularly in developing countries of Asia and Africa. The present study was conducted to detect the two most important pathogens, rotavirus and Campylobacter Jejuni in children suffering with diarrhea in Rawalpindi and Islamabad, Pakistan in 2014. The clinical and epidemiological aspects of the disease were also investigated.MethodsA total of 500 stool samples were collected from children presented with clinical signs and symptoms of acute diarrhea. The samples were initially screened for the presence of rotavirus A (RVA) via ELISA (Enzyme-linked immunosorbent assay) and RT-PCR (Reverse Transcriptase PCR) and then were analysed for C. jejuni by using species specific PCR assay.ResultsThe detection rate of RVA was 26.4% (132/500) while, Campylobacter was detected in 52% (260/500) of samples with C. jejuni accounted for 48.2% (241/500) of all study cases. Co-infection of C. jejuni with RVA was identified in 21.8% of all cases. Children with RVA and C. jejuni co-infection showed a higher probability (p = 0.01) to be dehydrated. A significant association (p = 0.02) was found between C. jejuni positive status and fever in children. The median age of children with both RVA and C. jejuni infection was 6–11 months. The RVA detection rate was high in winter months of the year while, C. jejuni infections were documented high in summer over 1 year study period.ConclusionsThe overall results have demonstrated the high prevalence of C. jejuni in Rawalpindi, Islamabad, Pakistan in 2014. The results of present study will not only help to calculate disease burden caused by C. jejuni and rotavirus but also will provide critical information to health authorities in planning public health care strategies against these pathogens.

Detection and Molecular Typing of Campylobacter Isolates from Human and Animal Faeces in Coastal Belt of Odisha, India

AbstractIntroduction:Campylobacter-mediated diarrhoea is one of the major causes of gastroenteritis globally. A majority of the Campylobacter spp. that cause disease in humans have been isolated from animals. Faecal contamination of food and water is the identified frequent cause of human campylobacteriosis. Methodology: In the present study, faecal samples from patients with symptoms of acute diarrhoea (n = 310) and domestic animals including cows (n = 60), sheep (n = 45) and goats (n = 45) were collected from the same localities in the peri-urban Bhubaneswar city. Genomic DNA isolation followed by polymerase chain reaction and sequencing was employed to analyse Campylobacter spp.-positive samples. Results: Of the 460 faecal samples, 16.77% of human samples and 25.33% of animal samples were found to be positive for Campylobacter spp. Among animals, the isolation rate was highest in sheep followed by cows and goats with 9.33%, 8.66% and 7.33%, respectively. The highest number of Campylobacter-positive cases was diagnosed in infants of 2–5 years age. Concurrent infection of other pathogens in addition to Campylobacter spp. was frequently detected in the samples. Conclusion: The present study showed the incidence of Campylobacter infections in human and different animal species in and around Bhubaneswar, Odisha. The analysis suggested that domestic animals can be the potential sources for human campylobacteriosis in the region.

Evaluation of Gelatin Tannate Against Symptoms of Acute Diarrhea in Pediatric Patients

BackgroundAcute diarrhea is the second most common cause of morbidity and mortality worldwide, especially in children aged ≤3 years. Some drugs (e.g., the mucoprotector gelatin tannate) plus a reduced osmolality oral rehydration solution (ORS) may effectively reduce symptom duration and severity. The current trial was therefore designed to assess the efficacy and safety of gelatin tannate in pediatric patients with acute diarrhea.Material/MethodsThis was a randomized, controlled, double-blind, parallel-group, single-center study comparing gelatin tannate plus ORS (103 patients) with ORS plus placebo (100 patients) in children aged 3 months to 12 years with infectious or noninfectious acute diarrhea. Details about stool consistency and total time to resolution of diarrhea comprised the primary study endpoints. Secondary study endpoints included symptoms of diarrhea at 12, 24, 36, 48, and 72 hours after the first dose of study medication.ResultsFrom 12 hours onwards, the incidence of watery stools was significantly lower in the gelatin tannate group than in the ORS group (at 12 hours: 59.2% vs. 77.0%; p=0.01). The same was true for stool frequency (at 12 hours: mean 2 vs. 3 stool productions in the previous 12 hours; p<0.01). At all timepoints during the study, the proportion of patients with Stool Decrease Index improvement was significantly greater (p<0.01) in the gelatin tannate group than in the placebo group (at 12 hours: 66.6% vs. 33.3%; p<0.01).ConclusionsGelatin tannate plus ORS is an effective and safe option for the treatment of acute diarrhea in children. Significant symptom relief is evident 12 hours after starting treatment.

Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India

BackgroundThere are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. Also acute diarrhea is one of the major causes of morbidity and mortality among children less than 5 years of age.MethodsIn our study, fecal samples (n = 130) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies. Rotavirus and Adenovirus were screened by immunochromatographic tests. Diarrheagenic Escherichia coli (EPEC, EHEC, STEC, EAEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. were detected by gene-specific polymerase chain reaction.ResultsEscherichia coli was detected to be the major etiological agent (30.07%) followed by Rotavirus (26.15%), Shigella (23.84%), Adenovirus (4.61%), Cryptosporidium (3.07%), and Giardia (0.77%). Concurrent infections with two or more pathogens were observed in 44 of 130 (33.84%) cases with a predominant incidence particularly in <2-year-old children (65.90%) compared to children of 2–5 years age group (34.09%). An overall result showed significantly higher detection rates among children with diarrhea in both combinations of two as well as three infections concurrently (p = 0.004915 and 0.03917, respectively).ConclusionSuspecting possible multiple infectious etiologies and diagnosis of the right causative agent(s) can aid in a better pharmacological management of acute childhood diarrhea. It is hypothesized that in cases with concurrent infections the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea that could be studied better in experimental infections.

Oral consumption of potential probiotic Saccharomyces boulardii strain Unique 28 in patients with acute diarrhoea: a clinical report

This study was conducted to evaluate the efficacy and safety of Saccharomyces boulardii strain Unique 28 in patients suffering from acute diarrhoea. A total of 25 patients (average age 30.72±4.38 years) with symptoms of acute diarrhoea (≥3 loose motion in last 24 hours for <7 days) were included upon informed consent and ethical committee approval. All subjects were assigned to consume S. boulardii strain Unique 28 (5×109 cfu/capsule) twice a day for a duration of 10 days. Primary outcome measures such as duration of diarrhoea, frequency of defaecation, abdominal pain and consistency of stool were analysed on day 1, 3, 6 and 10 of the study. Secondary outcome measures were evaluated by assessment of incidence and type of adverse events (blood pressure and pulse rate), physical examination and clinical laboratory tests (complete blood count, glutamic-pyruvic transaminase, serum creatinine, stool examination and microscopy and these tests were performed on day 1 and 10 of the study. The results of the present study indicate that the mean duration of diarrhoea decreased from 34.20±4.25 to 9.40±3.00 (P<0.0001) min per day, frequency of defaecation decreased from 7.04±0.84 to 1.76±0.52 (P<0.0001) times a day, abdominal pain decreased from 3.28±1.06 (severe) to 0.72±0.50 (absent) (P<0.0001) and consistency of stool improved from 3.80±0.50 (watery) to 1.32±0.47 (soft) (P<0.0001). In addition, no significant changes in safety parameters were observed during treatment. Therefore, the present study concludes that S. boulardii strain Unique-28 might be useful in alleviating the symptoms of diarrhoea without any adverse effects.

Empiric antimicrobial therapy and infectious diarrhea. Do we need local guidelines?

Background In the management of acute diarrhea, administration of antibiotics may be indicated. Appropriate antimicrobial therapy can shorten illness, reduce morbidity and can be life-saving in invasive infections. Emergence of microbial strains resistant to commonly used antibiotics means that treatment failures may become common. Because of changing patterns of resistance, knowledge of recent local patterns of susceptibility can guide the initial choice of antibiotics. Methods A retrospective study was conducted to investigate the epidemiology of infective gastroenteritis in patients over 14 years old in the region of Chania (Crete). We reviewed all positive stool cultures and susceptibilities of the pathogens recovered from patients with symptoms of acute diarrhea, from 2003 until October 2010. Results Out of 194 positive stool cultures, we observed 139 cases of Salmonella enterica and 48 cases of Campylobacter jejuni. During the last 3 years of observation there was an increased incidence of C. jejuni, especially after the tap water outbreak that occurred in our region in 2009. Discussion In the vast majority of acute diarrhea in adults, antibiotics are of no benefit and overprescription may confer to side effects, costs and emergence of resistance. Antibiotics are initiated in cases of febrile diarrheas especially those believed to have moderate to severe disease. Considering the increased incidence of C. jejuni and the resistance of the great majority of isolated strains to quinolones as well as the sensitivity of Salmonella spp. to azithromycin, administration of azithromycin empirically for acute diarrhea, when indicated, could be appropriate in our region.

Mixed viral infections in children with acute diarrhoea

To the editor: Respiratory infections (RI) and acute diarrhoea (AD) are the main causes of morbidity and mortality among Mexican children. A retrospective analysis of rotavirus (RV) epidemics in Merida, Mexico from 2003 to 2008 indicates that 31.5% of children with diarrhoea also present respiratory symptoms. We hypothesized that the co-occurrence (mixed clinical symptoms) of RI and AD may also be a result of mixed diarrheal and respiratory viral infections in children. To address this possibility we evaluated the presence of different respiratory viruses in children diagnosed with acute diarrhoea in two slums with poor housing and health conditions in Merida. This prospective study involved a total of 127 children under 5 years of age with AD who received medical attention at the “Units of Social Insertion” (USIs) from July 2003 to June 2004. The selected USIs are health units serving people in the city who do not have social security. Faecal samples were collected to detect RV infection and a throat swab was collected from all children to detect influenza and/or other respiratory viruses. Clinical and epidemiological data were collected from all patients. Faecal samples were processed for rotavirus (RV) using polyacrylamide gel electrophoresis (PAGE).1 Throat swabs were processed for respiratory viruses, including influenza A M gene and respiratory syncityal virus (RSV) with nested RT-PCR, as previously described.2 RV was identified in 61 of the samples (48%) included in the study, of which 37 children (61%) showed at least one respiratory symptom. The most commonly referred symptoms were cough and nasal congestion (35% and 34%, respectively), followed by rhinorrea (33%). Respiratory viruses were detected in 9% of samples (10 influenza A, one RSV), including five mixed infections with RV and influenza A. The clinical features of patients positive for influenza were diarrhoea (10/10), fever (5/10), rhinorrea (6/10), nasal congestion (6/10), cough (5/10) and general malaise (5/10). Samples positive for respiratory viruses were detected in July and December 2003 (influenza A), and January-March 2004 (influenza A and RSV), coinciding with seasonal patterns of influenza circulation in Yucatan.3 Our findings suggest that respiratory viruses are present in children presenting mixed diarrheal and respiratory clinical symptoms, sometimes having mixed viral infections, as we have shown. Since other viruses (such as rhinoviruses or metapneumovirus) were not evaluated, the possibility of co-infection cannot be totally ruled out. Nevertheless, the recent influenza A H1N1 epidemic also showed that mixed diarrheal and respiratory clinical symptoms may occur in some cases;4 the accurate diagnosis of respiratory and/or diarrhoeal viruses should be considered.

Subtype prevalence, plasmid profiles and growing fluoroquinolone resistance in Shigella from Kolkata, India (2001-2007): a hospital-based study

Shigellosis is a major public health problem, and increasing antimicrobial resistance has complicated its treatment. We report isolation frequency, plasmid profiles and antimicrobial resistance of Shigella subtypes in Kolkata, India, from a prospective hospital-based study. Fresh stool or rectal swabs were collected from children (<5 years) attending the Diarrhea Treatment Unit of a governmental paediatric referral hospital in Kolkata. Samples were processed following standard methods over a 7-year period from January 2001 to December 2007. Of 4478 samples collected, 516 (11.5%) were positive for Shigella spp. S. flexneri (312; 6.9%) was the most frequently isolated serogroup, ranking before S. sonnei (123, 2.7%), S. dysenteriae (48, 1.1%) and S. boydii (33, 0.7%). Although 10 subtypes of S. flexneri were identified, the common ones circulating locally were S. flexneri 2a (179), S. flexneri 6 (38) and S. flexneri 3a (36). Knowledge of Shigella subtypes is important for vaccine development. The majority of Shigella isolates (81.0%) were multidrug (two or more antimicrobial classes) resistant and showed high minimum inhibitory concentration (MIC) with commonly used drugs like ampicillin, tetracycline, co-trimoxazole and nalidixic acid. Emergence of fluoroquinolone (FQ)-resistant S. dysenteriae type 1 (100.0%) in 2002-2003 was followed by frequent isolation (>25.0%) of FQ-resistant S. flexneri 2a, and S. flexneri 3a in 2004, which restricted use of fluoroquinolones for treatment. A number of smaller plasmids (<20 kb) with distinct patterns have been observed for several years in predominant subtypes. Long-term surveillance of Shigellae and their antimicrobial resistance are mandatory in endemic areas to formulate treatment policy until any suitable candidate vaccine is available to control the disease.

Diarrhea Caused by Rotavirus in Children Less than 5 Years of Age in Hanoi, Vietnam

Group A rotaviruses are the major cause of diarrhea in young children worldwide. From March 2001 to April 2002, 836 children less than 5 years of age were investigated in Hanoi, Vietnam. This included 587 children with diarrhea and 249 age-matched controls. Group A rotavirus was identified in 46.7% of the children with diarrhea and 3.6% of the controls, which was a significant difference. Within the diarrhea group, the highest prevalence was seen in children from 13 to 24 months of age, and the prevalence was higher in males than in females. The symptoms of acute diarrhea caused by rotavirus were watery diarrhea, vomiting, fever, and dehydration. A higher prevalence of rotavirus detection was obtained for children who had all of these symptoms, followed by those who had diarrhea with vomiting-dehydration, fever-dehydration, and dehydration. The high rates occurred from September to December, although the infection was encountered all year round. In 58 patients (21.2% of the rotavirus-infected children), rotavirus infection was detected in association with either diarrheagenic Escherichia coli or Shigella spp. The most frequent combinations were rotavirus-enteroaggregative E. coli and rotavirus-enteropathogenic E. coli. At least one enteropathogen was identified from about 64% percent of the samples. The bacterial infection may not have given rise to clinical symptoms of such severity. The present study demonstrates the burden of rotavirus diarrhea in Hanoi, Vietnam. Continuous surveillance of diarrhea caused by rotavirus in young children would play an important role in diagnosis, treatment, and prophylaxis in order to improve the health of children in Vietnam.

Loperamide plus simethicone reduced the duration and symptoms of acute diarrhea

Loperamide plus simethicone reduced the duration and symptoms of acute diarrhea

Loperamide plus simethicone reduced the duration and symptoms of acute diarrhea

Source Citation Kaplan MA, Prior MJ, Ash RR, et al. Loperamide-simethicone vs loperamide alone, simethicone alone, and placebo in the treatment of acute diarrhea with gas-related abdominal discomfo...

A study of the importance of the enterotoxigenic E. coli in children with acute diarrhoea in Recife, Brazil.

Even today acute diarrhoea is a major cause of morbidity and mortality in young children. It is a serious public health problem in less-developed countries, primarily in households whose income is low. As such, it is one of the main causes of death, affecting the undernourished in particular. The potential enteropathogenic agents are distributed universally. However, there is a major difference in the prevalence, according to the areas and the characteristics of the population groups which were studied. In Brazil, since the 1970s, our attention has been drawn to the importance of the classic enteropathogenic strains of E. coli (EPEC) in the aetiology of diarrhoeal diseases, primarily those present in weaned infants in inner city neighbourhoods. On the other hand, Guerrant and co-workers, and Queiroz and co-workers found significant percentages of isolated colonies of enterotoxigenic coli (ETEC) in the stool material of children with symptoms of acute diarrhoea. In rural areas of less-developed countries the incidence of episodes of ETEC provoking diarrhoea is estimated to be between five and ten per person/year. Due to the social and medical gravity of acute diarrhoea, and to the lack of studies dealing with the aetiopathogenic role of the strains of ETEC in our area, we decided to analyse the frequency of isolation of ETEC in children with and without diarrhoea who were attending the out-patient department of the Instituto Materno Infantil de Pernambuco/IMIP.

Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome

We studied 388 homosexual or bisexual men from the Baltimore-Washington area to define the spectrum of enteric pathogen carriage in a population at high risk for “gay bowel syndrome” in association with human immunodeficiency virus infection. Seventy-seven patients with acquired immunodeficiency syndrome, 68 gay men with symptoms of acute diarrhea or proctitis, and 243 gay men without gastrointestinal symptoms and participating in a natural history study of human immunodeficiency virus infection were selected for study. Approximately 12% of the asymptomatic men harbored at least one enteric pathogen; the most frequently recovered were Chlamydia trachomatis, herpes simplex virus, and Giardia lamblia. Men carrying a pathogen were more likely to be human immunodeficiency virus seropositive (48%) than men without a pathogen (25%) (p = 0.018), more likely to have fewer T helper cells (p = 0.015), and more likely to have a mucopurulent exudate (p = 0.014). We recovered an agent of enteric disease from 68% of gay men presenting with diarrhea or proctitis. Campylobacter species, herpes simplex virus, Neisseria gonorrhoeae, C. trachomatis, G. Iamblia, and Shigella species were identified most frequently. The most common pathogen associated with diarrhea in acquired immunodeficiency syndrome was Cryptosporidium (16% of 49 cases). Other agents identified were Clostridium difficile, Vibrio parahemolyticus, Campylobacter species, G. lamblia, Isospora, and cytomegalovirus. Approximately half of the identifiable etiologic agents of diarrhea in acquired immunodeficiency syndrome patients were treatable With antibiotics, but these agents required special culture procedures for detection.

Observation on etiology of diarrheal diseases in Arizona.

SummaryA total of 630 persons with symptoms of acute diarrhea was studied to evaluate the association between recognized enteric pathogens and diarrhea. Approximately 67% of persons for whom treatment was sought were less than 1 year of age. Recognized bacterial pathogens were isolated by a single examination from 57% of the cases. Shigella were recovered from 26%, enteropathogenic Esch. coli from 31%, and Salmonella from 7%. About 90% of all enteropathogenic Esch. coli recovered were from infants less than 1 year old; about 40% of the Shigella isolations were from this group. The cases from which etiologic agents were not recovered showed no characteristic distribution with respect to age of patients or month of occurrence.Results differ from earlier studies in the southwest in that the rate of association of Shigella with acute diarrhea was lower and relatively few persons other than infants were found with acute enteric symptoms.