Treatment Of Acute Diarrhea Research Articles

Correlation Between the Transient Elevation of Peripheral Eosinophil Count During Radiotherapy and Acute Diarrhea.

This study aimed to evaluate the association between the change in peripheral eosinophil count during postoperative pelvic radiotherapy and gastrointestinal (GI) toxicities in patients with cervical cancer. The medical records of 163 patients with cervical cancer who underwent postoperative concurrent chemoradiotherapy between 2000 and 2016 were analyzed. Among the peripheral blood cell counts, transient elevation of the eosinophil count was observed during radiotherapy. Of the 163 patients, 117 developed grade ≥2 diarrhea during radiotherapy, and 25 patients developed grade ≥2 late GI toxicities. In multivariate analysis, the maximum eosinophil count and age emerged as independent predictors of grade ≥2 acute diarrhea during radiotherapy, while bowel bag V 40 Gy and age were predictive of grade ≥2 late GI toxicities. Early detection of transient elevation of eosinophil may facilitate early treatment of acute diarrhea during radiotherapy.

To Determine Outcome of Probiotics in Treatment of Acute Diarrhea in Children

Aim: To determine outcome of probiotics in treatment of acute diarrhea in children aged 6 months to 5 years as compared to control Setting: Department of Pediatrics, Khyber Teaching Hospital, Peshawar Duration: From 23 May, 2019 to 23 Nov, 2019 Study design: Randomized Control Trial Methodology: 200 children were divided in two equal groups. Group A were given Probiotics (Saccharomyces boulardii) in a dose of 250-500 mg daily in two divided doses for 5 days, in addition to oral rehydration solution 50-100ml and 100-200ml after each loose stool in child aged <2 years and >5 years respectively. Group B were given only oral rehydration solution in same amount as prescribed to Group A. All the children were followed up at day 4. Outcome was assessed in terms of duration of diarrhea and improvement in number of stools per day at the 5th day of presentation. Results: In Group A, 92(92%) patients showed improvement while in Group B, 71(71%) patients showed improvement. Conclusion: Probiotics are found to be significantly more effective in reducing the stool frequency in ac. diarrhea. Keywords: Acute diarrhea, Probiotic, Saccharomyces boulardii (SB)

Role of Racecadotril in Children with Acute Diarrhea

Background: Diarrhea is a leading cause of illness and death among children in developing countries. Racecadotril (acetorphan), an enkephalinase inhibitor with antisecretory and anti-diarrheal actions, is an effective and safe treatment for acute diarrhea in adults and children.
 Objectives: The objective of this study is to evaluate the efficacy and tolerability of racecadotril as a treatment of acute diarrhea in children.
 Methods: This double-blind, randomized controlled clinical trial was conducted in Dr. MR Khan Children Hospital & Institute of Child Health over 1 year (June 2017- May 2018). The study was approved by the ethical committee of the institute. The efficacy and tolerability of racecadotril (1.5 mg/kg) administered orally 3 times daily) as adjuvant therapy to oral rehydration or intravenous fluid were compared with those of placebo in 40 children aged 3 months to 60 months of children who had acute diarrhea.
 Results: During the first 72 hours of treatment, patients receiving racecadotril had a significantly lower stool output (grams per hour) than those receiving placebo. The mean (±SE) 72-hours stool output was 54.75± 12.92 g per kilogram in the racecadotril group and 152.50±37.64 g per kilogram in the placebo group (p<0.001). The number of purging is significantly reduced in the racecadotril group than the placebo group (11.95±2.41 Vs 14.85±1.95, p= 0.000) on third day of admission. The duration of hospital stay is significantly lower in the racecadotril group than the placebo group (73.30±23.44 vs. 177.30±25.8. p= 0.000) group. Racecadotril was well tolerated; only 3 patients taking racecadotril had adverse effects like vomiting and 2 patients had hypokalaemia and 3 patients in the placebo group developed vomiting and 1patient developed hypokalaemia which all are mild and transient.
 Conclusion: In young children with acute watery diarrhea, racecadotril is an effective and safe treatment along with rehydration therapy.
 DS (Child) H J 2020; 36(1) : 8-13

Analisar o uso de cepas probióticas no tratamento da diarreia aguda

As cepas probióticas são microorganismos geralmente vivos que apresentam pouca ou inexistência de patogenicidade, adicionadas a alimentos, remédios e suplementos alimentares. O objetivo desta revisão é analisar o uso de cepas probióticas no tratamento de diarreia aguda. Os dados foram obtidos por meio de uma busca nas bases de dados Pubmed, Scielo e Lilacs em inglês, português e espanhol. Todos os artigos foram selecionados a partir da leitura do titulo e do resumo que analisaram cepas probióticas no tratamento da diarreia aguda. Para recuparar as informações desejadas aplicaram-se os descritores e a lógica booleana utilizando os seguintes termos de interesse: (“Probiotic”) AND (Saccharomyces boulardii) OR (Lactobacillus rhamnosus) OR (Lactobacillus reuterii) AND ("acute diarrhea") NOT (review). Inicialmente foram encontrados 184 estudos sobre uso de probóticos no tratamento da diarreia aguda dos quais 163 foram encontrados na base de dados da Pubmed, 11 na Scilelo e 10 na Lilacs. Após os critérios de seleção de exclusão e inclusão rertaram 7 estudos na Pubmed, 1 estudo na Scielo e nenhum estudo na Lilacs, totalizndo 8 estudos incluidos na revisão. Os resultados apontaram que os probióticos quando administrados em doses adequadas, podem reduzir tempo de duração e frequência das evacuações ao paciente com diarreias agudas.

The Use of Activated Micronized Zeolite Clinoptilolite as a Possible Alternative to Antibiotics and Chestnut Extract for the Control of Undifferentiated Calf Diarrhea: An In Vitro and In Vivo Study.

Simple SummaryToday, zeolite has appeared as an interesting alternative for the symptomatic treatment of acute diarrhea. Therefore, this study aimed to investigate the properties of activated micronized (five microns) zeolite clinoptilolite (MZC) from Transylvania, Romania, first by testing it in vitro and then in vivo on calves with diarrhea. To assess the toxic potential of MZC, we performed a cell cytotoxicity assay on cells of bovine origin, while its antimicrobial activity was investigated on Escherichia coli. The uncontrolled in vivo study was carried out over 8 days on a fattening farm, with some 650 calves. Selected calves were randomly assigned to 4 groups of 20 individuals. Several combinations between activated MZC, chestnut extract, and oxytetracycline were tested. At the beginning of the study, all calves had diarrhea, while at the end of the study, the prevalence of diarrhea was significantly lower in all four groups (p < 0.001), including the ones treated with MZC. Due to its low cytotoxicity on the intestinal cells and with regards to the results we obtained in vivo, MZC could represent an alternative method to reducing the amount of antimicrobials needed for the symptomatic treatment of diarrhea in calves, therefore contributing to the reduction of the antimicrobial resistance phenomenon.Today, zeolite appears as an interesting alternative for the symptomatic treatment of acute diarrhea. Therefore, this study aimed to investigate the properties of activated micronized (5 microns) zeolite clinoptilolite (MZC) from Transylvania, Romania, first by testing it in vitro and then in vivo on calves with diarrhea. To assess the toxic potential of the MZC, we performed a cell cytotoxicity assay using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) technique on primary bovine intestinal epithelial cells (BIECs). The antimicrobial activity of MZC was investigated by measuring the minimal inhibitory concentration (MIC) on Escherichia coli (ATCC 25922). The uncontrolled in vivo study was carried out over 8 days on a fattening farm, with some 650 calves. Selected calves were randomly assigned to four groups of 20 individuals. Several combinations between MZC, chestnut extract, and oxytetracycline were tested. At the beginning of the study, all calves had diarrhea, while at the end of the study, the prevalence of diarrhea was significantly lower in all four groups (p < 0.001), including the ones treated with MZC. Due to its low cytotoxicity on the intestinal cells and with regards to the results we obtained in vivo, MZC may be considered an alternative for the symptomatic treatment of undifferentiated diarrhea in calves.

Literatur review: Peran selenium pada diare akut anak

Acute diarrhea is a manifestation of gastrointestinal dysfunction. If it lasts more than 14 days is called persistent diarrhea. Diarrhea is a leading cause of death in infants and children in Indonesia. Acute diarrhea is a gastrointestinal disease that is considered oxidative stress. Selenium is also thought to be involved in the acute diarrhea process because it contains the gastrointestinal glutathione peroxidase (GPx2 / GPx GI) enzyme which is most commonly found in the epithelial mucosa of the gastrointestinal tract. The aim of this review is to study and analyze the role of selenium in the treatment of pediatric acute diarrhea. This study is a literature review with a narrative method that analyzes research related to the role of selenium in the treatment of acute diarrhea. The results of this study indicate that the administration of selenium reduces the duration of diarrhea. The conclusion of this study is selenium functions in the process of healing acute diarrhea

Randomized, placebo-controlled trial of xyloglucan and gelose for the treatment of acute diarrhea in children

ABSTRACT Background Oral rehydration is the main treatment of acute diarrhea in children. This study was undertaken to evaluate the efficacy and safety of xyloglucan and gelose (agar-agar) plus oral rehydration solution (ORS) compared with placebo and ORS for reduction of acute diarrhea symptoms in children. Methods In a randomized, double-blind, placebo-controlled trial, children with acute gastroenteritis received xyloglucan/gelose plus ORS (n = 50) or placebo plus ORS (n = 50) for 5 days. Demographic, clinical, anthropometric and laboratory parameters were recorded and analyzed. Results Xyloglucan/gelose plus ORS reduced the total number of type 7 and 6 stools on the Bristol Stool Form scale (p = 0.040 and p = 0.015, respectively, compared to placebo plus ORS), and had a rapid onset of action, evident 6 hours post-treatment. Xyloglucan/gelose plus ORS also improved associated clinical symptoms (apathy, vomiting, flatulence, and blood in stool). compared with placebo plus ORS. Except for a generalized rash of unknown causality in a patient receiving placebo plus ORS, all other adverse events (dehydration, n = 7, cough, n = 1, exacerbation of vomiting, n = 1) were deemed unrelated to study medication. Conclusions Xyloglucan/gelose plus ORS was effective and safe in treating acute diarrhea in children.

A combination of three probiotic strains for treatment of acute diarrhoea in hospitalised children: an open label, randomised controlled trial.

Acute diarrhoea continues to be a leading cause of morbidity, hospitalisation, and mortality worldwide, and probiotics have been proposed as a complementary therapy in the treatment of acute diarrhoea. The goal of this study is to assess the efficacy and safety of three combined probiotic strains, Bifidobacterium lactis Bi-07, Lactobacillus rhamnosus HN001, and Lactobacillus acidophilus NCFM, as an adjunct to rehydration therapy in treatment of acute watery diarrhoea in hospitalised children. Eligible diarrheal children were randomised into intervention group (IG, n=96, conventional treatment for diarrhoea in combination with probiotics) and control group (CG, n=98, conventional treatment for diarrhoea without probiotics). The primary assessments of this study were duration of diarrhoea and hospital stay and improvement in diarrhoea symptoms. Significantly more children in the IG showed improvements in diarrhoea (defined as a decrease of stool frequency to no more than four times per day and an improved stool consistency within 24-48 h after the treatment) than those in the CG (96.9 vs 79.6%, P<0.05). Children supplemented with the mixed strains had a 22.5 h shorter (121.4±13.7 h vs 143.9±19.8 h) mean duration of diarrhoea and 1.2 d shorter hospital stays (5.1±1.2 d vs 6.3±1.4 d) than children only receiving the rehydration therapy (P<0.05). The prevalence of constipation of children in the IG (3.1%) was markedly lower (P<0.05) than that of children in the CG (13.3%) after treatment. In conclusion, the mixture of three probiotic strains given to children aged 1-3 years resulted in shorter durations of diarrhoea and hospitalisation and a higher percentage of improved children.

Chemotherapy-induced diarrhoea in dogs and its management with smectite: Results of a monocentric open-label randomized clinical trial.

Chemotherapy-induced diarrhoea (CID) is a frequent chemotherapy adverse event in dogs. Yet, there is currently no consensus regarding its management. Smectite is a natural medical clay, widely used in the treatment of acute diarrhoea in humans. The objectives of this study were to assess the efficacy of smectite in the management of CID in dogs, and to collect epidemiological data on CID. For each episode of diarrhoea, dogs were randomized into two management groups: Smectite group, receiving smectite at 0.5 g/kg PO per day divided in two to three doses initiated at the start of CID; control group, without initial medication. In both groups, rescue metronidazole was prescribed if CID progressed or was not improved within 48 hours. Sixty dogs were recruited and received 426 chemotherapy administrations between June 2017 and March 2019. The incidence rate of CID was 110/426 (25.8%, 95% CI: 21.7%-30.2%), and significantly differed between the chemotherapeutic drugs administered (P < .001). Metronidazole was administered in 5/54 events (9.3%, 95% CI: 3.1%-20.3%) in the smectite group and in 40/56 events (71.4%, 95% CI: 57.5%-82.3%) in the control group (P < .001). The time to resolution of diarrhoea was shorter (P < .001) in the smectite group (median: 19.5 hours, interquartile range [IQR]: 13.5-32 hours) compared with the control group (median: 53 hours, IQR: 31.5-113.5 hours). The results of this study support the administration of smectite in the first-line management of CID in dogs.

Treatment outcome of Diarrhea with or without Probiotics among Children aged 12-60 months

Background: High mortality rate around the globe has been reported due to diarrheal disease among all fewer than five years of age. Many studies show their utilization in the treatment of diarrheal disease especially among children of under-five. Objective: To assess the treatment outcome of diarrhea with and without probiotics among children aged 12-60 months. Methodology: This comparative cross-sectional study was undertaken from July to December 2017. A pre-designed questionnaire was used to collect the information in terms of antibiotics, rehydrating agents, antipyretic agents, and probiotics. A total of 109 patients were selected randomly and then divided into two groups as having 55 children and Non-Probiotic, having 54 children. Guardians of patients were contacted telephonically after 48 hours and 72 hours to ask about the time frame of relief from symptoms, diarrheal episodes, and cure from disease. Data were analyzed by using SPSS 20. Results: Out of 109 patients, 54 patients were in the non-probiotic group and 55 in the probiotic group. The overall age of patients remained 31±12 months. Saccharomyces boulardii (56.4%) and Lactobacillus GG (43.6%) were probiotics prescribed by pediatric physicians. A significant difference (p=0.000) was observed in terms of treatment outcome showing early relief (12 hrs) 43 (78%) vs 22 (41%) in probiotic vs non-probiotic group and early cure (<48 hrs) from diarrhea in probiotic group 48 (87%) vs 35 (65%) as compared to the non-probiotic group. (p=0.00) Conclusion: The use of probiotics during the treatment of acute diarrhea among children below five years shortens the duration of symptoms and helps the cure as early as one day before the patients' not using probiotics.

Effect of Lactobacillus rhamnosus LGG and Bifidobacterium animalis subspecies lactis BB-12 combination on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey

Background Acute diarrhea continues to be a leading cause of morbidity and mortality worldwide. The main therapy for all individuals with dehydration caused by diarrhea is oral rehydration. Probiotics have been proposed as a complementary therapy in the treatment of acute diarrhea. We aim to evaluate the effect of a combination of Lactobacillus rhamnosus GG (LGG) with Bifidobacterium animalis subspecies lactis BB-12 (BB-12) on the duration of diarrhea and length of hospital stay in children with acute diarrhea.Methods A multicenter, randomized (240 children, 2:1 randomized for probiotic vs. control), single blind, hospital based clinical trial was performed in children (6 to 60 months) with acute watery diarrhea lasting more than 24 but less than 72 hours, requiring hospitalization. We enrolled children with clinical signs of mild to moderate dehydration. The children received conventional therapy with or without the combination of LGG and BB-12 (1 × 109 colony forming units for each) for 5 days. The primary endpoint was the duration of diarrhea (in hours), defined as the first normal stool according to the Bristol stool score (score &amp;lt; 5). Secondary outcome measures were duration of hospitalization (days) and percentage of children without diarrhea at 72 hours of intervention.Results In total, data from 218 of 240 children could be evaluated (150 in the probiotic group and 68 in the control group). The duration of diarrhea was significantly reduced in the LGG and BB-12 group compared to the control group (74.5 ± 40.8 hours vs. 98.4 ± 22.9 hours, P&amp;lt;0.001). The percentage of diarrhea-free children was significantly larger in the LGG and BB-12 group at 72 hours compared to the control (60% vs. 33.8%, P&amp;lt;0.001). Mean length of hospital stay was similar for both groups (5.03 ± 2.3 days vs. 5.25 ± 1.3 days, P&amp;gt;0.05).Conclusion This is the first clinical trial to test the combination of LGG and BB-12, and show its effects on diarrhea duration in children with acute infectious diarrhea. The duration of diarrhea was reduced by approximately 24 hours in the hospitalized children. Further randomized controlled clinical trials including outpatient cases with acute infectious diarrhea in addition to hospitalized cases should be conducted to assess the potential effects of the combination in more detail.

Randomized, Placebo-Controlled, Double-Blind and Open-Label Studies in the Treatment and Prevention of Acute Diarrhea With Enterococcus faecium SF68.

Enterococcus faecium SF68® (SF68) is a licensed pharmaceutical for treatment and prevention of diarrhea in Austria, Italy and Switzerland. However, as for other probiotics, evidence for its efficacy is based on small to medium-sized studies. Four unpublished studies on the treatment of acute diarrhea and the prevention of antibiotic-associated diarrhea were analyzed: one randomized, double blind, placebo-controlled trial (RCT) for treatment (n = 1,143), one open-label study for treatment (n = 5,093), one RCT for prevention (n = 1,397) and one open-label study for prevention (n = 4,340). Patients in the treatment-arm and the open-label studies received SF68 (b.i.d. for the prevention studies, t.i.d. for the treatment trials) for 7 days. Primary end points were time to resolution of diarrhea (treatment) and percentage of development of diarrhea (prevention). The primary endpoint of the treatment study was met with a decreased time to resolution of diarrhea in SF68-treated patients compared to controls (median 3 vs. 4 days, p < 0.001). Time to resolution of secondary symptoms was also significantly reduced. Preventive treatment with SF68 was more effective than placebo with development of diarrhea in 8.6 vs. 16.2% (p < 0.001). Results from the open-label studies were consistent with the RCTs. The incidence of adverse events were low (1.1 and 1.4% in the RCT and 4.7 and 7.4% in the open-label studies). SF68 is effective and safe in the treatment of acute diarrhea and prevention of antibiotic-associated diarrhea.

Potency of Oral Rehydration Solution in Inducing Fluid Absorption is Related to Glucose Concentration

Oral rehydration solutions (ORSs) is the key treatment of acute diarrhea in children, as it restores the electrolyte balance by stimulating the intestinal sodium/glucose transporter SGLT1 to induce fluid absorption. The World Health Organization (WHO) and The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) proposed ORSs with different chemical compositions. The main agent of childhood acute gastroenteritis is rotavirus (RV). We evaluate the effects of ORS with different concentration of glucose and sodium on RV induced secretion. Ussing chambers technique was used for electophysiology experiments to evaluate ion fluid flux. ESPGHAN ORS (sodium 60 mmol/L and glucose 111 mmol/L) induced a more potent proabsorptive effect in Caco-2 cells than WHO ORS, and this effect depended on the sodium/glucose ratio. Titration experiments showed that RV-induced fluid secretion can be reverted to a proabsorptive direction when sodium and glucose concentration fall in specific ranges, specifically 45–60 mEq/L and 80–110 mM respectively. The results were confirmed by testing commercial ORSs. These findings indicated that ORS proabsorptive potency depends on sodium and glucose concentrations. Optimal ORS composition should be tailored to reduce RV-induced ion secretion by also considering palatability. These in vitro data should be confirmed by clinical trials.

Lactobacillus acidophilus LB: a useful pharmabiotic for the treatment of digestive disorders.

Dysbiosis, a loss of balance between resident bacterial communities and their host, is associated with multiple diseases, including inflammatory bowel diseases (nonspecific chronic ulcerative colitis and Crohn’s disease), and digestive functional disorders. Probiotics, prebiotics, synbiotic organisms and, more recently, pharmabiotics, have been shown to modulate the human microbiota. In this review, we provide an overview of the key concepts relating to probiotics, prebiotics, synbiotic organisms, and pharmabiotics, with a focus on available clinical evidence regarding the specific use of a unique pharmabiotic, the strain Lactobacillus acidophilus LB (Lactobacillus boucardii), for the management of gastrointestinal disorders. Since it does not contain living organisms, the administration of L. acidophilus LB is effective and safe as an adjuvant in the treatment of acute diarrhea, chronic diarrhea, and antibiotic-associated diarrhea, even in the presence of immunosuppression.

Silver-based drug effect on the body of calves with diarrhea

Diarrhea of newborn calves is a globally common disease that causes significant damage to livestock. Economic losses from diarrhea in young cattle are directly related to the cost of long-term treatment of animals and their mortality, as well as the projected decrease in productivity, which negatively affects the efficiency of maintaining the entire herd. Currently, it is an established fact that diarrhea of newborn calves has a polyethological nature, which has an interaction in pathogenesis between the calf’s body, enteropathogens and the technology of keeping animals. For the treatment of calves with diarrhea caused by enteropathogenic Escherichia coli, many methods and schemes using various antibiotics have been proposed. The need for fast and efficient treatment for acute diarrhea of calves in many cases leads to an empirical selection of the drug without taking into account the spectrum of its activity. This approach leads to the appearance and rapid spread of antibiotic resistant strains of microorganisms and as a result reduces the effectiveness of veterinary measures. The article presents the results of a study of the effect of a new complex drug containing stabilized silver particles, an immunostimulator and an antioxidant on the body of calves with diarrhea, as an alternative to the antibiotics. Studies were conducted on calves of the first week of life with a diagnosis of diarrhea, with enteropathogenic Escherichia coli confirmation.

Metronidazole treatment of acute diarrhea in dogs: A randomized double blinded placebo-controlled clinical trial.

BackgroundMetronidazole is commonly administered to dogs with acute diarrhea, but there is limited evidence to support this practice.ObjectiveTo investigate the effects of metronidazole administration on dogs with acute nonspecific diarrhea.AnimalsThirty‐one dogs, including 14 test population dogs and 17 controls.MethodsRandomized controlled clinical trial. Dogs with acute diarrhea in which causation was not determined by routine fecal diagnostic testing were randomly assigned to metronidazole treatment (10‐15 mg/kg PO q12h for 7 days) or placebo. Fecal cultures and characterization of Clostridium perfringens isolates also were performed. Owners maintained medication and fecal scoring logs, and fecal diagnostic tests were repeated on day 7.ResultsThe mean ± SD time to resolution of diarrhea for test population dogs (2.1 ± 1.6 days) was less than that for controls (3.6 ± 2.1 days, P = .04). Potential relationships of C. perfringens with acute diarrhea pathogenesis were not investigated, but only 3 of 13 (23.1%) test population dogs had persistent C. perfringens carriage at day 7, which was less than the 11 of 14 (78.6%) controls with persistent growth (P = .007).Conclusions and Clinical ImportanceOur results suggest that metronidazole treatment can shorten duration of diarrhea and decrease fecal culture detection of C. perfringens in some dogs with acute nonspecific diarrhea. Additional studies are needed to assess the benefits and risks of routine use of metronidazole for this purpose because most dogs achieve resolution of diarrhea within several days regardless of treatment.

Efficacy of zinc supplementation in the management of acute diarrhoea: a randomised controlled trial

ABSTRACTBackground: Zinc has been recommended for the treatment of acute diarrhoea; however, there are heterogeneous reports regarding its efficacy.Aim: This study investigated the efficacy of zinc supplementation on the treatment outcomes of children admitted to hospital with acute diarrhoea.Methods: A double-blind, randomised, placebo-controlled trial was conducted in the Srinakharinwirot University Hospital’s Paediatric Department, Thailand. Eligible children were randomly allocated to receive either zinc bisglycinate (15 mg elemental zinc) or a placebo. The study protocol was registered in the Thai Clinical Trials Registry (TCTR20190423004).Results: Of 86 patients, 50 (58.1%) were male and the mean age (range) was 2.5 years (6 months to 9.3 years). The median (IQR) number of hours to recovery from diarrhoea was significantly less in the zinc group than in the controls [44 (24–48) vs 52 (36–80) hours, respectively, p < 0.01]. The median (IQR) number of stools was significantly lower in the zinc group [5 (3–12)] than in the controls [7 (4–17), p = 0.02]. The median (IQR) duration of intravenous fluid therapy was 40 (24–56) hours in the zinc group and 56 (40–73) in the control group (p < 0.01). The duration of hospitalisation was 60 (44–72) hours in the zinc group and 84 (56–136) hours in the controls (p < 0.01). There was good compliance by all participants in both groups.Conclusion: Zinc supplementation can reduce the time to resolution of acute diarrhoea, the length of hospital stay and the frequency of stools. Zinc supplementation is recommended as a routine strategy for Thai children with acute diarrhoea.

Trehalose Protects the Probiotic Yeast Saccharomyces boulardii against Oxidative Stress-Induced Cell Death.

Saccharomyces boulardii is the only probiotic yeast with US Food and Drug Administration approval. It is routinely used to prevent or treat acute diarrhea and other gastrointestinal disorders, including the antibiotic-associated diarrhea caused by Clostridium difficile infections. The formation of reactive oxygen species (ROS), specifically H2O2 during normal aerobic metabolism, contributes to programmed cell death and represents a risk to the viability of the probiotic microbe. Moreover, a loss of viability reduces the efficacy of the probiotic treatment. Therefore, inhibiting the accumulation of ROS in the oxidant environment could improve the viability of the probiotic yeast and lead to more efficacious treatment. Here, we provide evidence that supplementation with a non-reducing disaccharide, namely trehalose, enhanced the viability of S. boulardii exposed to an oxidative environment by preventing metacaspase YCA1-mediated programmed cell death through inhibition of intracellular ROS production. Our results suggest that supplementation with S. boulardii together with trehalose could increase the viability of the organism, and thus improve its effectiveness as a probiotic and as a treatment for acute diarrhea and other gastrointestinal disorders.

Double Blind, Randomized, Controlled With Placebo Clinical Trial in Children Between 3 Months and 14 Years Old to Evaluate the Efficacy and Safety of Gelatin Tannate in the Treatment of Acute Diarrhea (INDIGO)

Double Blind, Randomized, Controlled With Placebo Clinical Trial in Children Between 3 Months and 14 Years Old to Evaluate the Efficacy and Safety of Gelatin Tannate in the Treatment of Acute Diarrhea (INDIGO)

Bovine colostrum in the treatment of acute diarrhea in Egyptian children: a randomised double-blinded, placebo-controlled trial

Bovine colostrum in the treatment of acute diarrhea in Egyptian children: a randomised double-blinded, placebo-controlled trial