Diarrhea in young children: clinical picture, diagnosis, principles of therapy

Many diseases in infants and young children are accompanied by the development of diarrheal syndrome. As a result, there are organic lesions and functional disorders in the intestine. It is well known fact that 1.4 billion children under 5 years in the world suffer from acute diarrhea, and 123 million of them are forced to seek medical help urgently, 9 million require inpatient care, and 1.8 million children die from dehydration. In this connection, the choice of therapeutic regimen remains urgent. Medications that slow intestinal motility (loperamide) are contraindicated in acute diarrhea in children, since the risk of side effects including ileus, drowsiness, nausea (mortality to 1 %) is high. Probiotics are living microbial drugs commonly used to prevent acute diarrhea. A large number of researches have been conducted, and results of meta-analyzes have been published that have revealed the effect of Escherichia coli strain Nissle 1917 (Mutaflor) in reducing the duration of diarrhea in children with acute gastroenteritis. Escherichia coli strain Nissle 1917 is one of the three bacteria in the world, which is better characterized at the molecular-biological level, the most investigated non-pathogenic and genetically stable strain in the world with 100-year history, having a genetic map, the genome of which is completely sequenced, genetic loci are deterministic. The product is included into the German Collection of Microorganisms and Cell Cultures (DSMZ). The purpose of our study was to improve the therapeutic approaches to the correction of diarrheal syndrome using Escherichia coli strain Nissle 1917 (Mutaflor) in the main treatment regimens. Seventy four children were examined and divided into two groups: the first group — children with diarrheal syndrome, who additionally received Mutaflor from the first day, the second group — children with diarrheal syndrome, who received traditional therapy. As a result of the study, the data were obtained proving the effectiveness of Escherichia coli strain Nissle 1917 (Mutaflor) in the treatment of diarrhea in young children, its beneficial effect not only on intestinal microflora and normalization of intestinal kinetics, but also on faster improvement of clinical symptoms, which allows recommending it to children from the first months of life