Management of infectious diarrhoea

Infectious diarrhoea is the most common cause of diarrhoea worldwide and is the leading cause of death in childhood.Gastrointestinal infections have their major impact in the developing world.In the developed world, despite improvements in public health and economic wealth, the incidence of intestinal infection remains high and continues to be an important clinical problem.During the past 10 years there have been some major improvements in our knowledge base regarding the treatment of infectious diarrhoea.Oral rehydration therapy (ORT) remains central to case management but advances have been made by the introduction of hypotonic solutions and there is early evidence that resistant starch may be the substrate of the future.The search for antisecretory drugs continues, with real progress having been made by the introduction of a new class of drugs, the enkephalinase inhibitors.Other new drugs are in the early phases of development.The role of antimicrobial agents in the management of infective diarrhoea continues to be clarified with the emergence of new agents and simplified treatment regimens.Probiotics are popular with diarrhoea sufferers and have been shown to have some efficacy but further scrutiny is required to determine the magnitude of their effects.www.gutjnl.com