Diarrhea – more effective and safer in accordance with WHO and ESPGHAN guidelines Review article

Abstract

Diarrhea, especially acute diarrhea, is one of the most common reasons for medical consultations, both in children and adults. According to the WHO, there are 2 billion episodes of acute diarrhea worldwide each year. Diarrhea requires treatment that is appropriate to the patient’s condition – primarily symptomatic therapy, such as rehydration – because regardless of the cause, it can lead to dehydration, electrolyte imbalances (hypokalemia, hypernatremia, hyponatremia), acid-base disturbances (most commonly metabolic acidosis), wasting, and in some cases even death. The most frequent causes of acute diarrhea are infectious agents, most of which resolve spontaneously with proper hydration. Chronic diarrhea has many causes, but these are not the primary focus of this paper. In cases where dehydration is classified as mild to moderate (body weight loss <9%), rehydration can usually be managed with oral rehydration solutions. Despite their simplicity, oral rehydration solutions are considered one of the greatest achievements in medicine. The correct ratio of sodium to glucose enables the use of the sodium-glucose cotransport mechanism to promote the absorption of water and electrolytes, compensating for losses even in the most severe cases of diarrhea – such as cholera. Studies have shown that the effectiveness of oral rehydration solutions can be enhanced by the addition of diosmectite, which may reduce the duration of diarrhea by up to two days.