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digestive system
diarrhea
Nutrition

dietary guidelines

eating principles :

» acute:

• maintain fluids, electrolyte balance, especially in children

• short juice fast

• slowly reintroduce easily digested, hypoallergenic foods: broths, grated apples, steamed carrots, etc.

» chronic:

• elimination/rotation diet, rotation diet, rotation diet expanded, especially if alternating constipation with diarrhea

» acute diarrhea:

fresh juices:

• carrot and blackberry (Jensen, p 51)

• tea from guava peel (Ni, p. 123)

• fresh guava twice daily (Butt and Bloomfield, p. 132)

• tea from pomegranate inner rind (Shefi)

• tea from ginger, fennel, basil and Chinese black dates (Ni, p. 123)

• tea from unripe prunes (Ni, p. 123)

• tea from dried lychee and Chinese black date (Ni, p. 123)

• miso soup (Shefi)

• radish (Lu, p. 158)

• carrot (Walker, p. 134)

• Potassium broth (carrot, spinach, celery, and parsley)/Bieler Broth (Walker, p. 134)

• cabbage and tomato

therapeutic foods:

• grated raw apple, rice water or rice porridge, tapioca, barley broth, boiled milk, potato soup with boiled milk, bananas, carob powder tea, charcoaled bread, unripe prunes (Shefi)

• congee

• miso soup

• psyllium seed powder, bentonite clay

• applesauce

• black tea

specific remedies:

diarrhea in small children: take 3-15 g of hazelnut kernels and stir-fry until outer surface is black. Crush to a fine powder, cover with water and simmer. Serve three times daily (Yin-fang and Cheng-jun, p. 114)

specific remedies:

» Hot-type Diarrhea:

• bamboo shoots cooked with rice (Ni, p. 28)

• eggplant (Ni, p. 37)

• green beans with rice (Ni, p. 38)

• snow peas cooked in sweet rice (Ni, p. 48)

• Deficient Spleen/Stomach, anorexia:

take 30 g hazelnut kernels, 9 g dried orange peel, add water, steam and serve three times daily (Yin-fang and Cheng-jun, p. 114)

» Cold-type Diarrhea:

• garlic (Ni, p. 123)

• rice porridge cooked with ginger and black pepper (Ni, p. 123)

• crush 2 cloves garlic, add 2 tsp. brown sugar, boil in 1/2 c. water and drink three times daily

(Lu, p. 158)

• cook ginger without oil until dry and burned on outside, grind into powder. Take 8 g each time, three times daily with warm water (Lu, p. 158)

• toast one clove of raw garlic in a dry pan until brown and eat it three times daily (Butt and Bloomfield, p. 132)

• mix together l oz. dried, powdered apples and 5 oz. warm water and drink before eating three times daily (Butt and Bloomfield, p. 132)

• toast 6 oz. buckwheat and when dry grind into powder. Mix with 1/2 oz. warm water and swallow, twice daily (Butt and Bloomfield, p. 132)

Chronic diarrhea: boil 4 oz. carrots and 2 oz. brown sugar in 1 1/2 pt. water until reduced by half. Eat and drink all. (Butt and Bloomfield, p. 133)

Chronic diarrhea: Take a fresh pomegranate, including the skin, crush, add table salt, then steam in water and serve three times daily (Yin-fang and Cheng-jun, p. 26)

• pour boiling water over 15 g dried powdered apple and serve twice daily (Yin-fang and Cheng-jun, p. 45)

• juice from a fresh coconut with 30 g sugar and a dash salt dissolved in it, drink one cup three times daily for 3 days (Yin-fang and Cheng-jun, p. 86)

colic with vomiting and diarrhea: take 100 g sweet potato vine, cut into small pieces, add salt and stir-fry until it begins to scorch. Add water and simmer until cooked. (Chao-liang, Qing-rong, Bao-zhen, p. 15)

Cold pain in stomach with vomiting and diarrhea:

• drink the juice of 30 g ginger and 120 g garlic (Chao-liang, Qing-rong, Bao-zhen, p. 82)

avoid:

• Food intolerances

• Cold, raw foods, most fruits, juices, and overeating (Ni, p. 123)

• Meat, alcohol, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, coffee, caffeine, sweet foods and sugar

» Osmotic diarrhea:

• The general concerns with osmotic diarrhea are removal of active solutes and the replacement of fluids and electrolytes.

Remove all simple carbohydrates (especially in children)

• Make sure all solutes are being broken down so they may be absorbed

• Supplement digestive and pancreatic enzymes

• Eat cultured foods such as yogurt and kefir if the patient has no sensitivity: Lactobacillus acidophilus (from ages 1-7, L. bifidus) (Lerebours, Ndam, Lavoine, Hellot, Antoine, et al. AJCN 49 p. 823-27, 1989 )

Charcoal

• Miso soup

• Rice water and rice

• Psyllium seed powder or bentonite clay

• Pectin

• Carob powder

• Avoid coffee

(Marz, p. 384, 1997)

» Secretory diarrhea:

• Bring about a balanced bacterial flora by replacing lost beneficial bacteria and inhibiting the growth of harmful bacteria. Replace electrolytes.

Lactobacillus acidophilus contains antibacterial, antiviral, and antifungal properties. It also acidifies the colon. Use enterically coated L. acidophilus or give with meals.

Garlic inhibits the growth of yeast as well as other pathogens.

Hydrastis canadensis is an anti-bacterial used for the treatment of infectious processes.

Charcoal adsorbs toxins.

Note: Parasites must be suspected if there is no improvement and the patient has a suspicious history. Investigate thoroughly because parasites can be difficult to diagnose.

(Marz, p. 384, 1997)

» Exudative diarrhea:

• Try to remove the source of the irritation if possible. Always rule out allergies (this goes for any type of diarrhea). Heal the inflamed tissues. Check for excess permeability. Replace electrolytes.

• Consider a short fast to avoid physically irritating the tissues

• Consider a hypoallergenic diet

Ulmus fulvus

• Vitamin C 1-2 g per day, divided dose, buffered

• Zinc picolinate 30 mg per day

• Vitamin A 25,000 IU

• Apple sauce

(Marz, p. 384, 1997)

supplements

lactobacillus acidophilus

(Guarino A, et al. J Pediatr Gastroenterol Nutr 1997 Nov;25(5):516-519.

» if due to irritant:

Vitamin C 1-2 g per day

Zinc 30 mg per day

Vitamin A 25,000 IU per day (Marz, 1989)

Vitamin B-complex

lactobacillus acidophilus

» if due to parasites:

bromelain 550 mg 3 caps three times daily (Marz)

oxyquinolin sulfate 5 caps four times per day (Marz)

digestive enzymes

footnotes

Guarino A, Canani RB, Spagnuolo MI, Albano F, Di Benedetto L. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J Pediatr Gastroenterol Nutr 1997 Nov;25(5):516-519.

Abstract: BACKGROUND: Oral administration of live Lactobacillus casei strain GG is associated with the reduction of duration of diarrhea in children admitted to the hospital because of diarrhea. The purposes of this work were to investigate the clinical efficacy of oral administration of Lactobacillus in children with mild diarrhea who were observed as outpatients, and to see whether Lactobacillus GG can reduce the duration of rotavirus excretion. METHODS: Duration of diarrhea was recorded in 100 children seen by family pediatricians and randomly assigned to receive oral rehydration or oral rehydration followed by the administration of lyophilized Lactobacillus casei, strain GG. Rotavirus was looked for in the stools of all children and in those in whom results were positive, stools were examined again 6 days after the onset of diarrhea. RESULTS: In 61 children results were positive for rotavirus and in 39 results were negative. Duration of diarrhea was reduced from 6 to 3 days in children receiving Lactobacillus GG, with a similar pattern in rotavirus-positive and -negative children. Six days after the onset of diarrhea, stools in only 4 out of 31 children that received Lactobacillus

Isolauri, E, Juntumen, M, Rautanen, T, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics 1991;88:90-97.

Kirchhelle, A, Fruhwein, N, Toburen, D. Treatment of persistent diarrhea with S. boulardii in returning travelers. Results of a prospective study. Fortschr Med 1996;114:136-140.

Kollaritsch, H, Holst, H, Grobara, P, Wiedermann, G. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med 1993;111:152-156.

Lerebours, Ndam, Lavoine, Hellot, Antoine, et al. Yogurt and fermented, then pasteurized milk effects of short term and long term ingestion on lactose absorption and mucosal lactase activity in lactase deficient subjects. AJCN 49 p. 823-27, 1989

Abstract: In 16 lactase deficient individuals, lactose digestion was enhanced by ingestion of yogurt. This beneficial effect was destroyed by pasteurization. Long term ingestion of yogurt did not increase lactase activity of the duodenal mucosa. The increase in lactose absorption associated with yogurt ingestion must therefore be primarily related to an intraluminal process.

Okasanen, PJ. Prevention of traveler's diarrhea by Lactobacillus GG. Ann Med 1990;22(1):53-56.

Pant, AR, Graham, SM, Allen, SJ, et al. Lactobacillus GG and acute diarrhoea in young children in the tropics. J Trop Pediatr 1996;42:162-165.