Persistent diarrhoea: management in algorithmic approach using a low-cost rice-based diet in severely malnourished Bangladeshi children

J Trop Pediatr. 1993 Dec;39(6):332-7. doi: 10.1093/tropej/39.6.332.

Abstract

Easy and successful dietary management of persistent diarrhoea has been a long desired goal. Finding an efficient diet which is economically feasible, and easy to prepare in poor homes of developing countries, has not been easy. A dietary algorithm was followed to test the clinical efficacy of an inexpensive and easy to prepare diet made up with rice powder, egg white, glucose, and soya oil. We studied a cohort of 100 severely malnourished children aged between 3 and 36 months with persistent diarrhoea in Dhaka Shisu (children's) Hospital, Bangladesh, during 1990. Initially on a milk-based diet, 26 children (26 per cent) improved while on a subsequent rice-based diet; 65 (88 per cent) of the remaining 74 children improved within a week, with a mean recovery period of 4 days. Patients who did not improve with the rice-based diet were weaned earlier than those who improved. Nine patients failed to improve on the rice-based diet. They were given a soya formula, and only two improved. The remaining seven patients finally improved when a comminuted chicken diet was given. Eight patients died in the hospital with secondary infections of septicaemia and bronchopneumonia. This study offers a simple and effective algorithm on the management of persistent diarrhoea and also demonstrates the success of a rice-based diet, showing promising and feasible means of management of persistent diarrhoea in patients with severe malnutrition.

MeSH terms

  • Algorithms*
  • Bangladesh
  • Child, Preschool
  • Chronic Disease
  • Dehydration / diagnosis
  • Diarrhea, Infantile / complications*
  • Diarrhea, Infantile / therapy*
  • Diet Therapy* / economics
  • Female
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Male
  • Nutrition Disorders / complications*
  • Oryza*
  • Treatment Outcome