Diarrhea is characterized by frequent (more than three) watery to loose stools in a 24-h period. Diarrhea can be classified as acute or chronic.

Acute diarrhea is usually caused by an infection from a bacteria, virus, or parasite, which may be present in animal and human fecal matter or in contaminated food, milk, or water. Symptoms may persist for 1-2 days with or without serious consequences; however, persistent diarrhea lasting more than 3 days may lead to dehydration and electrolyte imbalance and can be fatal, particularly in children and the elderly. Other symptoms of diarrhea may include cramping, abdominal pain, bloating, nausea, fever, and bloody stools.

Prolonged diarrhea that lasts for a month or longer is chronic; it may be caused by a large number of diseases, some of which are related to nutrients, such as allergies to cow’s milk, lactose intolerance, celiac disease, or pancreatic insufficiency.

Nutritional therapy for diarrhea is aimed at replacing fluids and electrolytes through consumption of beverages, such as water, juices, or sports drinks, and eliminating the cause of diarrhea (contaminated foods). Juices and carbonated beverages should be diluted since they are often hyperosmolar and would otherwise aggravate the diarrhea. The optimal fluid replacement therapy has an osmolality at or below that of plasma (~280 mOsm/kg). If solid foods are tolerated, restricting insoluble fiber can assist in slowing gut transit time; yogurt intake may be helpful in replacing commensal gut flora; and increasing soluble dietary fiber intake may be helpful with chronic diarrhea; however, these suggestions are based more on belief than evidence [20].

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