Diet: a key factor

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 fluids^2,3 !

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.

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.