Spectrum of chronic diarrhoeal diseases - A cross sectional study
Journal Title: Medpulse International Journal of Pediatrics - Year 2019, Vol 9, Issue 3
Abstract
Protracted diarrhoea is the most severe form of diarrhoea in infancy and has also been defined as intractable diarrhoea. Its etiology is poorly defined. We have retrospectively evaluated the etiology, the outcome, and the risk factors of 38 children, admitted with protracted diarrhoea and need for hospitalization from 5 January 2013 to 10 January 2016. Children with anatomic abnormalities and/or primary immunodeficiency were excluded. There was an inverse relationship between the number of patients and the age of diarrheal onset (mean age, 2.9 ± 3.5 months). Etiology of protracted diarrhoea was an enteric infection in 18 cased (eight Salmonell, there Staphylococcus, five rotavirus, one adenovirus, one Cryptosporidium), multiple alimentary intolerance (eight cases), familial microvillour atrophy (two), autoimmune enteropathy (two), celiac disease, lymphangectasia, eosinophilic enteropathy, intestinal pseudoobstructiopn, and intestinal neurodysplasia (1 case each). Etiology was not detected in three cases. Overall, 12 children died, five are presently being treated, and 21 had full remission. Comparative evaluation of risk factors between children with protracted diarrhoea and a control population of children with diarrhoea but without the need for hospitalization showed that low birth weight, no breast feeding, history of fatal diarrhoea in a relative and early onset of diarrhoea had a significantly higher incidence in the former. Social background was similar in the two populations. We conclude that at specific etiology can be identified in the majority of cases of chronic diarrhoea. The etiologic spectrum of chronic diarrhoea is broad, but an enteric infection is the most common cause of chronic diarrhoea. The severity of this condition is related, at least in part, to establish risk factors.
Authors and Affiliations
V K Tandon, B K Papnai
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