Childhood diarrhea (pediatric diarrhea) is the major cause of morbidity, undernourishment and mortality in newborns, infants, toddlers and children in developing countries.
Role of zinc in treatment of pediatric diarrhea
Zinc is being assessed for more than twenty years for efficacy in treatment of pediatric diarrhea. Most of the studies have proved its usefulness as adjunct to ORS (oral rehydration solution) in treatment of acute diarrhea and reduction in its severity and duration. However it is to be noted that ORS remains the mainstay of diarrhea therapy as the rehydration is the top most priority. Zinc gives the added benefits of reduced stool volume, reduced stool frequency and reduced duration of the episode. Further, this trace mineral has been found to reduce the recurrent incidences of pediatric diarrhea in treated patients. WHO recommends that, in addition to reduced osmolarity ORS, zinc at the rate of 10-20 mg/day be given for 10 - 14 days for all children suffering from diarrhea.Sadly, there is very slow progress in implementation of these revised guidelines by the world nations.
For example, although the Government of India, under the National Rural Health Mission, has provided for low osmolarity ORS and zinc through the public health system, a UNICEF survey in India documented less than 1% zinc prescriptions for pediatric diarrhea.
The main reason is lack of awareness about the efficacy and cost-effectiveness in these diarrhea treatment methods, even among the health care providers.
Reduced low osmolarity WHO-ORS
WHO is its latest recommendations has advised oral rehydration therapy (ORT) with ORS developed for global use in pediatric diarrhea. This improved hypotonic WHO-ORS is more effective and has lower osmolarity with reduced sodium and glucose concentrations. In comparison with earlier standard ORS, there is less vomiting, less stool output and reduced need for intravenous infusions on using this reduced osmolarity ORS.Oral rehydration solution (ORS) constituents - Composition by weight
| Reduced osmolarity ORS | grams/liter |
| Sodium chloride | 2.6 |
| Glucose, anhydrous | 13.5 |
| Potassium chloride | 1.5 |
| Trisodium citrate, dihydrate | 2.9 |
Oral rehydration solution (ORS) constituents - Composition by molar concentrations
| Reduced osmolarity ORS | mmol/litre |
| Sodium | 75 |
| Chloride | 65 |
| Glucose, anhydrous | 75 |
| Potassium | 20 |
| Citrate | 10 |
| Total Osmolarity | 245 |
Mechanism of Action of zinc in Pediatric diarrhea
It is a well known fact that this trace mineral is required in many metabolic activities in the human body.It is a critical component of many metallo-enzymes and mediates in gene transcription.
It has a central role in cellular and immune functions.
It is found to improve the absorption water and electrolytes.
As it improves the cell division and cell growth, it has positive effects on the repair and regeneration of intestinal epithelium.
Brush border is the microvilli covered surface of small intestine and has enzymes helping absorption. This trace mineral helps in the production of these brush border enzymes.
By the immunity enhancing activity of this trace mineral, the pathogens responsible for diarrhea are resisted and there is better clearance of these harmful organisms from the digestive tract.
Thus many studies evaluating the efficacy of zinc supplementation have established that it has a preventive, protective and lasting impact on pediatric diarrhea.
Related topics:
Zinc health benefits
Food sources
Signs and symptoms of deficiency
Role in immunity
Current topic : Zinc for diarrhea - pediatric diarrhea
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