Diet: a key factor
Viruses, bacteria, parasites: causes behind gastrointestinal infections are varied. The main associated symptom is diarrhea, which dehydrates your body. In most cases, these infections are acute, resolve spontaneously within five days with symptomatic treatment, and do not relapse. However, in other cases, they can be severe from the start or they can last longer, and thus require a specific treatment. This may be due to the virulence of some microorganisms or their toxic substances, but also to their interactions with the gut microbiota1, which is unique to each individual. What can we do then? Acting on our gut microbiota could open the way to effective preventive and curative treatments and help us face the public health issue posed by infectious diarrhea.
About this article
The primary step in the treatment of any acute diarrhea is to counterbalance water and sodium losses, and slow down the intestinal transit (except in case of hemorrhagic diarrhea or high fever). It is also important to make sure that the amount of protein and calorie intake as well as micronutrient supplements are adequate.
Drink salty fluids2,3 !
This rehydration process can be carried out either through diet, combining an increased consumption of drinks containing glucose, sodium, potassium and bicarbonates (still or sparkling water, some soft drinks) and salty high-glucose food (rice, pasta…), or through the intake of commercially available oral rehydration solutions (ORS) in case of nausea. Tap water should be avoided, as well as chicken broth, apple juice and most soft drinks. Special caution should be paid with older people who are less sensitive to thirst: in case of severe dehydration, intravenous rehydration may be required. In newborns, breastfeeding should be encouraged whenever possible. For formula-fed babies, the use of lactose-free milk is not recommended because it could jeopardize treatment effectiveness once an antibiotic is given.
DIARRHEA IN A NUTSHELL
In practice, diarrhea is defined as the passage of three or more loose or liquid stools per day. According to the WHO, there are three clinical types of diarrhea:
- Acute watery diarrhea (lasts several hours or days, and includes cholera-induced diarrhea)
- Acute bloody diarrhea (also called dysentery)
- Persistent diarrhea (last 14 days or longer)
Zinc for malnourished children
The World Health Organization recommends the daily use of zinc supplements for two weeks in malnourished children over six months; unfortunately, this recommendation is seldom applied in low-income countries where meat consumption (source of zinc)is low4. In the GI tract, zinc restores the integrity of the gut barrier and stimulates immunity against microorganisms responsible for gastrointestinal infections.
This twofold benefit has been confirmed in animal studies concluding that a chronic zinc deficit alters the composition and function of the gut microbiota and increases the risk of gastrointestinal infections. More specifically, giving zinc dietary supplements to children with severe diarrhea decreases the duration of the episode. However, according to scientists, this approach is of little use in children under five years old with severe diarrhea but no zinc deficit, especially considering that this supplementation may increase the risk of vomiting following the initial dose.
2nd leading cause of death in children under five years old (525,000 deaths per year)
1.7 billion children affected every year
> 90% of lethal infections occur in poor countries
1 Non-pathogenic microorganisms (bacteria, viruses, fungi, parasites) living in our intestines.
2 Beaugerie L, Sokol H. Acute infectious diarrhea in adults: epidemiology and management. Presse Med. 2013 Jan
3 Crawford SE et al. Rotavirus infection. Nat Rev Dis Primers. 2017 Nov 9
4 Lazzerini M. Oral zinc provision in acute diarrhea. Curr Opin Clin Nutr Metab Care. 2016 Ma