Current management of acute diarrhoeas. Use and abuse of drug therapy.

Acute diarrhoeas in infants and children should be regarded as a protective physiological response of the gastrointestinal tract to flush out harmful organisms and toxins, thus limiting the morbidity from this illness. The approach to therapy of acute diarrhoeas must be physiological rather than pharmacological. Prevention and early correction of acute dehydration with oral rehydration is the most physiological approach to the successful management of acute diarrhoeas, which generally have a self-limited course. The use of antidiarrhoeal drugs is limited to a few isolated cases. These may include the short term administration of antimicrobials in selected cases of acute diarrhoea caused by entero-pathogens where antimicrobials are proven to be efficacious. Antisecretory drugs which are devoid of unwanted side effects may be tried in persistent cases of acute diarrhoeas, but kaolin-pectin mixtures and antimotility drugs should be avoided for infants and children. Generally, the management of acute diarrhoea is simply to stop the dehydration rather than the diarrhoea, not with drug therapy but with oral rehydration therapy.