Anti-Diarrheal Effects of Diosmectite in the Treatment of Acute Diarrhea in Children

Abstract

Acute diarrhea caused by an infectious organism is highly prevalent, particularly in developing countries, and is usually self-limiting. The condition is a major contributor to the global disease burden and is associated with a significant economic cost. The disease is common in children aged <5 years. It occurs as the result of exposure to a diarrheogenic agent that alters intestinal absorption and/or secretion, resulting in an increase in the volume of water that enters the colon beyond that which can be absorbed. Diarrhea almost always occurs by one or more of four mechanisms: disruption of osmotic forces in the intestine; disruption of normal secretory processes; disruption of epithelial cells or the epithelial tight junctions; or motility disorders. Oral rehydration therapy (ORT) is central to the management of acute diarrhea, and is sufficient to prevent complications due to dehydration in most patients while the disease runs its course. However, ORT has no effect on the duration of the disease or frequency of bowel motions, and any agent that could meet these needs would therefore be a useful addition to ORT. Diosmectite is a natural aluminomagnesium silicate clay with a lamellar, non-fibrous crystalline structure that gives it strong adsorbent properties. Its mechanisms of action are not yet fully understood, but are probably multiple. Diosmectite reduces inflammation, modifies mucus rheologic properties, inhibits mucolysis, and adsorbs bacteria, bacterial enterotoxins, viruses and other potentially diarrheogenic substances. A number of studies have shown that diosmectite reduces the duration of diarrhea and decreases the frequency of bowel motions after 2 days of treatment in children with mild-to-moderate acute diarrhea. Two recent trials have indicated a reduction in stool output with diosmectite. Because of its very favorable safety profile, with no serious adverse effects, diosmectite is frequently used, mainly in European countries but also in Asia and Africa. Diosmectite should be used as an adjunct, not an alternative, to ORT and, when needed, to antibacterial therapy.

Management of traveller’s diarrhoea with a combination of sodium butyrate, organic acids, and A-300 silicon dioxide

“…It lacks direct bactericidal or bacteriostatic properties and acts by creating a protective layer in the intestine by interacting with mucosal glycoproteins, improving mucosal layer durability against irritants [22, 32]. It can increase its resorptive surface and eradicate harmful substances, which is particularly efficient when used with simultaneous administration of substances providing nutrition to natural bacterial flora of the intestine [16–19].…”

Geophagy by brown bears in the Russian Far East

“…This conclusion was also reached by Mattson et al (1999) in their study of brown bears in North America. The ability of smectite-or kaolinite-based clay minerals to curb diarrhea is widely known (Carretero 2002, Dupont and Vernisse 2009, Williams and Haydel 2010. As a result of these properties, such minerals have been utilized in traditional medicine and have been recently used extensively in modern medical practice as well.…”

Consensus Guideline on Acute Gastroenteritis in the Emergency Department. Emergency Medicine Committee of SLACIP (Latin American Society of Pediatric Intensive Care)

“…Evidencia B. Los resultados muestran que la esmectita disminuyó significativamente la cantidad de heces en niños con diarrea acuosa aguda, especialmente en aquellos que habían dado positivo (3,5,36,37,38,39). en rotavirus.…”