Etiology and risk factors of severe and protracted diarrhea

A. Guarino, M. I. Spagnuolo, S. Russo, F. Albano, S. Guandalini, G. Capano, S. Cucchiara, P. Vairano, R. Liguori, Antonella Casola, A. Rubino

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Severe and protracted diarrhea (SPD) is the most severe form of diarrhea in infancy and has also been defined a intractable diarrhea. Its etiology is poorly defined. We have retrospectively evaluated the etiology, the outcome, and the risk factors of 38 children, admitted with protracted diarrhea need for total parenteral nutrition (TPN) from 1977 to 1993. Children with anatomic abnormalities and/or primary immunodeficiency were excluded. There was an inverse relationship between the numbers of patients and the age of diarrheal onset (mean age, 2.9 ± 3.5 months). Etiology of SPD was an enteric infection in 18 cases (eight Salmonella, three Staphylococcus, five rotavirus, one adenovirus, one Cryptosporidium), multiple alimentary intolerance (eight cases), familial microvillous atrophy (two), autoimmune enteropathy (two), celiac disease, lymphangectasia, eosinophilic enteropathy, intestinal pseudoobstruction, 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 SPD and a control population of children with diarrhea but without the need for TPN showed that low birth weight, no breast feeding, history of fatal diarrhea in a relative, and early onset of diarrhea had a significantly higher incidence in the former. Social background was similar in the two populations. We conclude that a specific etiology can be identified in the majority of cases of SPD. The etiologic spectrum of SPD is broad, but an enteric infection is the most common cause of SPD. The severity of this condition is related, at least in part, to established risk factors.

Original languageEnglish (US)
Pages (from-to)173-178
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume20
Issue number2
StatePublished - 1995
Externally publishedYes

Fingerprint

etiology
Diarrhea
diarrhea
risk factors
Total Parenteral Nutrition
total parenteral nutrition
digestive system diseases
Intestinal Pseudo-Obstruction
Cryptosporidium
celiac disease
low birth weight
Rotavirus
immunosuppression
breast feeding
remission
Low Birth Weight Infant
Celiac Disease
infancy
Adenoviridae
Infection

Keywords

  • Congenital enteropathy
  • Enteric infection
  • Food intolerance
  • Intractable diarrhea
  • Parenteral nutrition

ASJC Scopus subject areas

  • Gastroenterology
  • Histology
  • Medicine (miscellaneous)
  • Food Science
  • Pediatrics, Perinatology, and Child Health

Cite this

Guarino, A., Spagnuolo, M. I., Russo, S., Albano, F., Guandalini, S., Capano, G., ... Rubino, A. (1995). Etiology and risk factors of severe and protracted diarrhea. Journal of Pediatric Gastroenterology and Nutrition, 20(2), 173-178.

Etiology and risk factors of severe and protracted diarrhea. / Guarino, A.; Spagnuolo, M. I.; Russo, S.; Albano, F.; Guandalini, S.; Capano, G.; Cucchiara, S.; Vairano, P.; Liguori, R.; Casola, Antonella; Rubino, A.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 20, No. 2, 1995, p. 173-178.

Research output: Contribution to journalArticle

Guarino, A, Spagnuolo, MI, Russo, S, Albano, F, Guandalini, S, Capano, G, Cucchiara, S, Vairano, P, Liguori, R, Casola, A & Rubino, A 1995, 'Etiology and risk factors of severe and protracted diarrhea', Journal of Pediatric Gastroenterology and Nutrition, vol. 20, no. 2, pp. 173-178.
Guarino A, Spagnuolo MI, Russo S, Albano F, Guandalini S, Capano G et al. Etiology and risk factors of severe and protracted diarrhea. Journal of Pediatric Gastroenterology and Nutrition. 1995;20(2):173-178.
Guarino, A. ; Spagnuolo, M. I. ; Russo, S. ; Albano, F. ; Guandalini, S. ; Capano, G. ; Cucchiara, S. ; Vairano, P. ; Liguori, R. ; Casola, Antonella ; Rubino, A. / Etiology and risk factors of severe and protracted diarrhea. In: Journal of Pediatric Gastroenterology and Nutrition. 1995 ; Vol. 20, No. 2. pp. 173-178.
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AU - Capano, G.

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