Today's Clinical Pearl

Oxidative stress is involved in childhood malnutrition and diarrheal diseases. Because of nutritional depletion intestinal cell growth is suppressed as well as the absorptive capacity of the colonic mucosa. In severe malnutrition such as kwashiorkor, childhood diarrhea can be attributed to mucosal malnutrition. Childhood diarrhea could in such cases be termed malnutritional diarrhea. The gastrointestinal tract in such situations becomes vulnerable to various enteropathic antigens. Oxidative stress occurs from the dietary intake of certain pathogens which can activate local phagocytic action. Arachidonic acid metabolites such as leukotrienes, neutrophils and cytokines are responsible as well for creating such a state of the gastrointestinal tract. Infective diarrheas are likely to cause a healthy subject to become malnourished unless the compromised nutritional status is replenished. Amino acids have been shown to restore the nutritional status of the intestinal mucosa. Protein energy supplementation has been found to enhance the nutritional state of children recovering from shigellosis which facilitates the absorption of many other micronutrients, particularly vitamin A. A large dose of vitamin A at 100,000 to 200,000 I.U. to severely protein energy malnourished children may not produce the desired benefits until mucosal nutrition has been restored. 22020 [gas, inf, nut]


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