Medical and nutritional aspects of intractable diarrhea.

Diarrhea can be due to at least five pathogenetic mechanisms. Major examples of each are presented to better illustrate each type of diarrhea and to provide a springboard for discussion of the nutritional management of each class of diarrhea. Certainly, specific diseases require specific therapies, such as avoidance of gluten in adult coeliac disease, but the major dietary/nutritional alterations and subsequent treatment are similar for each class of disease. Nowhere in medicine and nutrition is an admonition to the health care team more important and more proper than in the treatment of chronic diarrheas: The feeding of healthy man, as well as the diet of the sick cannot be left to chance, guided by the appetite, or ruled by tradition, but can be safely directed only according to the laws of digestion and metabolism.