Nitrogen balance during recovery from secretory diarrhea of cholera in children.

This study describes nitrogen balance in children during recovery from severe cholera (bacteriologically confirmed). The subjects were six male children aged 12 to 24 months and weighing 6.29 to 9.86 kg (on recovery). They initially presented with dehydration and base deficit acidosis due to acute watery diarrhea. Nitrogen balance promptly improved with milk feeding even before diarrhea was fully controlled and irrespective of the clinical severity of the disease. There was no increase in stool volume and systemic acid base status remained unaffected when milk feeding was introduced. There was little nitrogen loss in the stool and the apparent absorption of protein was substantial. The negative nitrogen balance that occurred was largely due to the lack of intake. Early feeding and liberal intake appears to produce a more favorable impact than the cautious introduction of food. The common practice of restricting food during recovery from acute diarrhea is inappropriate in cholera.