Prolonged diarrhea causes dehydration and cellular depletion in the gastrointestinal lumen. Sodium-rich liquids and functional foods help restore gut balance.
Pediatricians, during residency, will learn how to manage acute diarrhea and rehydration in young patients. However, once in practice, they will probably see many children whose parents have brought them to the office only after 1 or 2 days of diarrhea. These children aren’t usually dangerously dehydrated but can become so if fluid intake doesn’t keep up with ongoing loss.
There are quite a few dietary tactics you can recommend that are simple for most parents to use and provide replenishment and comfort for the child.
First, remind the parent that diarrhea often takes about a week and a half to resolve. This is because the intestinal tract needs time to replace the many cells lost during the acute illness. During the recuperation phase, nutrients will not be as well absorbed so careful attention to a child’s diet is helpful. Partially digested foods, particularly sugars, will act like osmotic stool softeners so should be avoided. On the other hand, an overly restrictive diet that avoids, for example, fats and protein, can prolong recovery. Without fat in the intestinal lumen, it will take much longer for the intestinal brush border to reestablish its enzymatic machinery.
Dietary tricks to support rehydration
A recipe for homemade rehydration fluid:
• 1 liter of water
• One-half teaspoon of salt
• 8 teaspoons of sugar
This solution lacks potassium, so the child should have some banana, potato, or carrots. Some parents turn this into an orange smoothie by mixing the salt/sugar/water solution in a blender with a quarter cup of orange juice and half a banana.
Homemade chicken or vegetable soup makes excellent rehydration fluid:
• Place unboned chicken thighs in a pot of water; bring to a boil.
• Add one-third teaspoon of salt per 1 liter of water (some of the water will evaporate).
• Add carrots, peas, or squash; all contain natural sugar and potassium.
Dietary tricks to help support gut recuperation
Brown rice. Taken as a soup, helps by “blotting” up bacterial by-products and cellular debris. Rice bran has a spiral structure that acts like a cotton mop as it travels down the GI tract.
Steel cut oatmeal. Has the same beneficial effect of mopping up cellular debris. It can be cooked to a soupy consistency and bananas can be added for flavor, texture, and potassium.
Plaintains. Their fibrous structure also is a good bacterial “blotter” and will help decrease the osmotic load of contents in the lower intestine.
Lentils. Another good blotter for extra bacteria and their toxins.
Sweet potatoes, carrots, squash. The yellow vegetables are thought to be good for intestinal healing.
Potatoes, parsnips, turnips. All are great sources of potassium and trace elements and can be sprinkled with salt.
Remember to add some fat to the broths and the vegetable dishes.
Yogurt and kefir. Lactobacillus, a “friendly” bacteria added to some commercial yogurt products, is thought to be particularly helpful in children with diarrhea because it competes with other intestinal bacteria. It is thought to float to the periphery of the intestinal stream and help crowd away the more pathogenic Escherichia coli from mucosal receptors.
As long as an infant can tolerate cow’s milk protein, he or she can be given yogurt as early as 6 months of age. It’s not necessary to purchase the commercial “baby yogurt” brands; any reputable pasteurized brand that claims on the label to contain “active cultures” can be used.
For children who don't like yogurt or milk, there are several pediatric probiotic products available without a doctor’s prescription (ie, pediatric Culturelle and Florastor). The products are made to be sprinkled on and mixed into cold soft foods.