Malabsorption associated with diarrhea.pdf

1248 The American Journal of Clinical Nutrition 30: AUGUST 1977, pp. 1248-1253. Printed in U.S.A. Malabsorption associated with diarrhea and intestinal infections13 Irwin H. Rosenberg,4 M.D., Noel W. Solomons,5 M.D., and Roberto E. Schneider,6 M.D. ABSTRACT An episode of diarrhea causes weight loss and a temporary cessation of growth in infants and children. Diarrhea is accompanied by malabsorption of sugars, nitrogen, fats, and micronutrients. The mechanisms by which acute diarrheal disease produce malabsorption have not been studied carefully. The nutritional costs of malabsorption may pose a major threat if diarrhea becomes chronic or recurrent. The hydrogen breath test for carbohydrate malabsorption does not require intubation or blood drawing and can be used in children to help clarify the importance of carbohydrate intolerance in the duration and perpetuation of acute diarrhea and intestinal bacterial overgrowth. Am. J. Clin. Nutr. 30: 1248-1253, 1977. Diarrhea may well be the commonest dis- ease/symptom in the world. In Central America a majority of childhood deaths are associated with diarrhea (1). Morbidity from diarrheal disease must be measured not only in terms of the life-threatening ef- fects of water and electrolyte loss, dehydra- tion, and sepsis but also in terms of the impact on growth and nutrition in children under the age of 5. It is well documented that an episode of acute diarrhea results in a drop in weight and a temporary cessation of growth in infants and children (2). Several factors are involved in this detrimental ef- fect on nutritional status of the child. These factors include withdrawal of food, shift of food from a more nutritious diet to one of starchy gruels, the nutritional costs of infec- tion, and the impact of diarrheal disease on the absorption and utilization of nutrients. We will examine the evidence for the tem- porary malabsorption syndrome which oc- curs in association with diarrheal disease and evaluate the scope of thi