Persistent diarrhea

 Acute diarrhea persists for > 14 days

 Mainly comes in < 1 year old.
 It can occurs in toddlers& preschool age
 When it comes to <3 months old, it is called Intractable diarrhea of infancy
Management of persistent diarrhea:
Nutritional therapy:
 Continue breast feeding.
 Decrease artificial milk to milk-cereal or replace with yoghurt.
 Total stop of artificial milk if large amounts of stool
 Second line dietary therapy: specialized milk-free diets e.g. diet e.g. rice-lentil
formulations, green banana or mashed potato
 If diarrhea persists, so the patient has disaccharide intolerance.
 The patient should receive comminuted chicken+ glucose+KCl+NAHCO3
Rehydration with ReSoMal.
Correct electrolyte imbalance.
Screen& treat any other infection.
Supplementation with Zn, Vit. A& Folate.
 Maintain catch up growth in convalescence.
Antibiotic for:
 E.coli or Shigella
 Bloody diarrhea
 Septicemia
 Oral Gentamicin 5 mg/kg/day 4 hourly for 3 days
 Oral cholestyramine 1 g 6 hourly for 5 days
 Antiamebic: in giardiasis or amebiasis or anaerobic infection