Chronic Diarrhea in Children

Zella, Garrett C.; Israel, Esther J.

doi:10.1542/pir.33-5-207

Cited by 18 publications

(30 citation statements)

References 40 publications

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“…Large epidemiological studies worldwide have indicated a diarrhea rate of ~ 3.2 episodes per child and it has been estimated that between 3% to 20% of these episodes correspond to persistent diarrhea (> 14 days) [51]. Since the first association of EAEC with persistent diarrhea in Indian children, this bacterium has been identified as a cause of chronic diarrhea in children from less developed areas of the world as well as from Europe and the United States, (as revised by 10•).…”

Section: Eaec History and Epidemiologymentioning

confidence: 99%

Enteroaggregative Escherichia coli: A Pathogen Bridging the North and South

et al. 2014

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Enteroaggregative Escherichia coli (EAEC) is a heterogeneous emerging enteric pathogen. Identified during the 1980’s when EAEC strains where isolated from cases of acute and persistent diarrhea among infants from developing countries and of traveler’s diarrhea. Subsequently, EAEC strains were linked with foodborne outbreaks and diarrhea illness in adults and children from industrialized countries, HIV-infected subjects and stunting of malnourished poor children. Nowadays, EAEC is increasingly recognized as a major cause of acute diarrhea in children recurring hospitalization and of traveler’s diarrhea worldwide. EAEC strains defining phenotype is the aggregative adherence (AA) pattern on epithelial cells. AggR a transcriptional regulator of several EAEC virulence genes has been a key factor in both understanding EAEC pathogenesis and defining typical EAEC (tEAEC) strains. EAEC virulence genes distribution among these strains is highly variable. Present challenges are the identification of key virulence genes and how they coordinately function in the setting of enteric disease.

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Section: Eaec History and Epidemiologymentioning

confidence: 99%

Enteroaggregative Escherichia coli: A Pathogen Bridging the North and South

et al. 2014

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“…Persistent diarrhea is included in a big category of chronic diarrhea. Although others use a diagnostic cut off of 4 weeks, most physicians agree that 14 days of diarrhea duration meets a diagnosis criteria for chronic diarrhea [6]. Chronic diarrhea, lasting more than 14 days, is sure to bring about weight loss, dehydration, and nutritional impairment.…”

Section: The Concepts Of Chronic Diarrheamentioning

confidence: 99%

“…According to an announcement of WHO, 13.2% of all childhood deaths were caused by diarrhea and the worldwide prevalence of chronic diarrhea ranges from 3 to 20% [6]. Though worldwide incidence of diarrhea has not decreased, the mortality due to diarrhea is decreasing.…”

Section: Epidemiology and Cause Of Chronic Diarrheamentioning

confidence: 99%

How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

Lee

Kang

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the vicious cycle of chronic diarrhea and is one of the main one thing among treatments. We should know the exact concept of chronic diarrhea and provide appropriate treatments according to etiologies of chronic diarrhea.

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Section: Introductionmentioning

confidence: 99%

“…The generally accepted definition is diarrhea lasting at least two weeks [1-4]. The causes of CD can be divided into four principal pathophysiologic mechanisms: osmotic, secretory, dysmotility-associated and inflammatory [4]. There is little data to indicate that the incidence of CD is decreasing, however, Bhutta et al [1] noted that there has been a significant reduction in the number of publications on the topic.…”

Section: Introductionmentioning

confidence: 99%

Two single group, prospective, baseline-controlled feeding studies in infants and children with chronic diarrhea fed a hypoallergenic free amino acid-based formula

Borschel

Antonson

Murray³

et al. 2014

BMC Pediatr

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BackgroundInfants and children with chronic diarrhea (CD) often require specialized foods or parenteral nutrition (PN) to achieve adequate nutrient intakes to support growth and development. We assessed the efficacy of an amino acid-based formula (AAF) in supporting growth and improving symptoms in infants and children with CD from multiple etiologies.MethodsTwo studies were conducted: CD study in children (CD-C) and CD study in infants (CD-I). Each was a single group, baseline-controlled study in which each subject served as his/her own control. At enrollment, all subjects had CD lasting > 2 weeks and had ≥ 4 stools/day. Subjects were fed an AAF for 80 days starting at SD5, and were assessed at SD 28 and 84.ResultsCD-C: 18 of 19 subjects completed the study. At enrollment, the mean age was 5.6 ± 0.7 years, the most common diagnosis was short bowel syndrome (SBS) (n = 13), and 5 subjects with SBS were on PN. Subjects achieved significant increases in weight-for-age z-scores (p = 0.026). Over 50% of subjects achieved improvements in clinical outcomes targeted most frequently by their physicians. Of the five subjects on PN at enrollment, four had substantial weight gain and four had their PN requirements decreased. CD-I: 22 of 27 subjects completed the study. At enrollment, the mean age was 3.3 ± 0.3 months, the most common diagnosis was food allergy (n = 20), and no subjects were on PN. Subjects achieved significant increases in weight-for-age z-scores (p = 0.0023), significant decreases in the number of stools/day (p = 0.0012), and improvements in stool consistency (p = 0.0024). Over 80% of subjects achieved improvements in the clinical outcomes targeted most frequently by their physicians.ConclusionsInfants and children with CD fed an AAF for three months displayed significant improvements in weight-for-age z-scores and clinical symptoms. Children dependent on PN also grew well and four of five decreased their dependence on PN.Trial registrationBoth trials were registered on ClinTrials.gov (CD-C, NCT01812629; CD-I, NCT01820494).

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Chronic Diarrhea in Children

Cited by 18 publications

References 40 publications

Enteroaggregative Escherichia coli: A Pathogen Bridging the North and South

Enteroaggregative Escherichia coli: A Pathogen Bridging the North and South

How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

Two single group, prospective, baseline-controlled feeding studies in infants and children with chronic diarrhea fed a hypoallergenic free amino acid-based formula

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