Diarrheal syndrome in children and adolescents: the features of pathogenetic therapy

The article presents modern data on syndrome of acute, prolonged and chronic diarrhea in children, its etiology and mechanisms of development of different types of this di­sease and its clinical symptoms. Prolonged diarrhea is usually defined as acute-onset diarrhea lasting for 7 days or more, but less than 14 days. There is a trend towards its decline in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. Prolonged diarrhea is more difficult to treat than acute diarrhea, it often leads to nutritional and metabolic complications. The pathogenesis of prolonged diarrhea is multifactorial and is essentially based on persistent mucosal damage due to specific infections, host-related factors including micronutrient and/or vitamin deficiency, undernutrition, high mucosal permeability caused by previous infectious processes and nutrient deficiency with consequential malabsorption and microbiota disruption. The рathogenetic therapy of prolonged diarrhea is comprehensive and should include an assessment of the intestinal microbiome, evaluation of the enzymatic function of the child’s body, the presence of functional gastrointestinal disorders.