Diarrheal disease still kills millions of children every year. Most of these incidences
occur among the children of the developing countries. Because chronic diarrhea
originates from the episodes of acute diarrhea, it is important to consider the
causes, pathophysiology, and management of acute diarrhea.
Dehydration is the loss of fluids and electrolytes that, depending on extent, can
compromise the health and well-being of an individual and in extreme cases, prove
Nearly a century ago, Pavlov's experimental work confirmed the earlier independent,
clinical work by Beaumont and Cabanis demonstrating that the brain influences
gut function (1—3).
The regulation of energy homeostasis is an area that straddles neurobiology, classical
endocrinology, and metabolism. It is currently one of the most exciting and
rapidly advancing topics in biomedical research;
Oral rehydration therapy (ORT), using a solution of glucose and three salts (ORS)
is an elegant and deceptively simple therapeutic technology, to treat or prevent
dehydration from diarrhea, that stood the test of time over the past 25 years of use.
The control and prevention of undemutrition is an unfinished work in many countries.
At the same time nutrition-related chronic diseases are now the main causes
of disability and death, not only globally but also in most developing countries (1).
Near the end of the nineteenth century, Pavlov suggested that digestive secretions
including exocrine pancreatic secretion were exclusively controlled by neural reflex
As the epidemic of obesity has grown over the past 20 years, the need to understand
the elements of treatment has become more important. Along with this understanding
will come novel ideas about techniques, strategies, molecules, and procedures that
can be used to curtail the devastating effects of this epidemic.
Dehydration is a feature of many illnesses resulting either from increased fluid
losses from the gastrointestinal tract, urinary tract, skin, and respiratory tract; or
from inadequate fluid intake.
Maintenance of body water and electrolytes is the result of tightly regulated balances
of intakes and outputs mediated by elegant and complex physiologic mechanisms.
Total body water (TB W) consists of extracellular fluid (ECF) and intracellular
fluid (ICF) and, as a percentage of body weight, changes with age decreasing particularly
rapidly within the first year of life (1).
Anorexia is a common feature of many diseases. In the initial phase of systemic
infections, the anorexia is part of the generalized host defense reaction, which is
termed "acute phase response" (APR) (1).
Humans are continuous metabolizers but ingest food discontinuously. Although
energy expenditure determines the energy requirement, energy intake is indirectly
tuned to energy expenditure.
Weight loss is a common accompaniment to many chronic inflammatory conditions,
cancer and acquired immunodeficiency syndrome (AIDS). The potential
causes of weight loss include reduced energy intake secondary to loss of appetite
(anorexia), increased energy expenditure or in the case of gut inflammation, malabsorption
of nutrients from the inflamed gut.
Acute diarrhea is a common cause of childhood morbidity in both developed and
developing countries; it is the second most important cause of mortality in the latter.
Acute watery diarrhea causes water, electrolyte, and acid-base imbalance.
The colon is an organ that, for long, was considered to be responsible merely for
the storage of waste material, and its disposal at a convenient time as feces.
Dr. Dilip Mahalanabis: Now regarding oral rehydration solution (ORS) composition,
I'd like to add to whatever we discussed, the issue which we didn't mention
specifically here, that for ORS composition you'd recall that the World Health
Organization (WHO), apart from talking about the single solution,