DIARRHEA

Paper
To fulfill assignments in English courses
Who was coached by Mr. Yulius Irham, S.Pd., MM

By :
1. Septiana Dwi Anggaraini (P17220192023)
2. Khilda Habsyiyyah (P17220192024)
3. Amelia Danyswara (P17220193025)
4. Farhah Nahdia Kamilah (P17220193026)
5. Mella Nur Sabillah (P17220193028)
6. Sevia Kurnia Fitri (P17220193029)
7. Sumikatul Zanah (P17220193030)

POLITEKNIK KESEHATAN KEMENKES MALANG

NURSING MAJOR
D III KEPERAWATAN LAWANG
January 202
 i

PREFACE

First of all, thanks to Allah SWT because of the help of Allah, writer
finished writing the paper entitled “Diarrhea” right in the calculated time. The
purpose in writing this paper is to fulfill the assignment that given by Mr. Yulius
Irham, S.Pd., MM as lecturer in English lessons. 
In arranging this paper, the writer trully get lots challenges and
obstructions but with help of many indiviuals, those obstructions could passed.
writer also realized there are still many mistakes in process of writing this paper.
Because of that, the writer says thank you to all individuals who helps in
the process of writing this paper. Hopefully Allah replies all helps and bless you
all. The writer realized tha this paper still imperfect in arrangment and the content.
then the writer hope the criticism From the readers can help the writer in
perfecting the next paper. Last but not the least Hopefully, this paper can helps the
readers to gain more knowledge about English language.

Author
 ii

TABLE OF CONTENTS

PREFACE...............................................................................................i
TABLE OF CONTENTS........................................................................ii

CHAPTER I INTRODUCTION
1.1 Issue Background..............................................................................1
1.2 Problem Formulation.........................................................................1
1.3 Purpose Of The Paper.......................................................................2
CHAPTER II THEORY
2.1 Definition Of Diarrhea......................................................................3
2.2 Pathophysiology ...............................................................................3
2.3 Etiology.............................................................................................5
2.4 Types Of Diarrhea.............................................................................7
2.5 Symptoms Of Diarrhea......................................................................8
2.6 Due To Diarrhea................................................................................8
2.7 Diagnosis Of Diarrhea.......................................................................10
2.8 Management Of Diarrhea..................................................................11
2.9 Age Grouping....................................................................................12
2.10 The Rasionality Of Treatment.........................................................13
2.11 Treatment........................................................................................13
CHAPTER III CONCLUSION
3.1 Conclusion.........................................................................................19

BIBLIOGRAPHY...................................................................................21
 CHAPTER I
INTRODUCTION

1.1 Issue Background

Diarrheal disease or gastroenteritis is an important disease around the

community which is still the main cause of illness and death for a person,
especially in children. This is reflected by many people suffering from diarrhea or
gastroenteritis who come out of the hospital. As a result of diarrhea, many factors
include environmental health. , personal hygiene, nutritional status, socio-
economic factors, determine the attack of diarrheal disease, although many cases
of diarrhea suffer from dehydration, many people die if the right actions are not
taken.
People in general always consider a diarrheal disease to be trivial, whereas if
they know what happened, many diarrhea sufferers have died. Gastrointeritis is a
disease that must be treated as soon as possible because severe dehydration can
lead to hypovolemic shock and death.

1.2 Problem Formulation

1. what is the definition of diarrhea?
2. what is the pathophysiology of diarrhea?
3. what causes diarrhea?
4. what are the types of diarrhea?
5. what are the symptoms of diarrhea?
6. what is the result of diarrhea?
7. how is diarrhea diagnosed?
8. what is the treatment for diarrhea?
9. how is the age grouped for diarrhea?
10. what is the rationality for diarrhea?
11. how is diarrhea treated?

1.3 Purpose of the paper

1
 2

1. To know the definition of diarrhea

2. To know the pathophysiology of diarrhea
3. To know the causes of diarrhea
4. To know the types of diarrhea
5. To know the symptoms of diarrhea
6. To know the result of diarrhea
7. To know the diagnosed of diarrhea
8. To know the treatment of diarrhea
9. To know the age grouped for diarrhea
10. To know the rationality of diarrhea
11. To know how diarrhea treated
 CHAPTER II
THEORY

2.1 Definition of diarrhea  
 
Diarrhea (derived from Greek and Latin: dia, meaning to
pass, and rheein, meaning to flow or run) is a common problem for
people who suffer from “ passing too fast or too thin stool”
(Goodman and Gilman, 2003).
Diarrhea is the increasing frequency and decreasing the
consistency of bowel
movements large (BAB) compared with patterns CHAPTER normal
. The occurrence CHAPTER 3 times or more in a day with the
consistency of soft or liquid that is not as usual, which is usually
only two or three times a week (Yulinah, 2008).

2.2 Pathophysiology  
 
Diarrhea outbreaks in infants, children and adults are usually
caused by microorganisms that are spread through water or food
contaminated with infected feces . Infection can also be passed from 
person to person, that is , if a person with diarrhea does not wash
their hands thoroughly after defecating (Setiawan, 2005)
Acute diarrhea can be caused by infections , allergies, drug
reactions, and also psychological factors. Classification and
pathophysology of acute diarrhea caused by an infectious process in
the intestine or enteric infection.  Approaches Clinical are simple
and easy is a division of acute diarrhea by pathophysiological
processes enteric infection  , acute diarrhea that is split over the
mechanism inflammatory, non-inflammatory ,
and Penetrating (Zein A , 2004)

3
 4

Inflammatory diarrhea as a result of the process

of invasion and cytotoxin in colonic manifestations of the
syndrome dysentery with diarrhea were accompanied
by mucus and blood (also called Bloody diarrhea ). Usually the
clinical symptoms that accompany are abdominal complaints such as
heartburn to pain such as colic, nausea, vomiting, fever, and symptoms
and signs of dehydration (Zein a , 2004).
Non- inflammatory diarrhea with abnormalities that are
found in the intestinal smooth proximal portion. Abdominal
complaints are usually minimal or absent, but symptoms and signs
of dehydration can appear quickly, especially in cases where fluids
are not immediately replaced.

Penetrating diarrhea location in the distal part of
the small intestine. This disease is also called Enteric fever,
Chronic Septicemia , with clinical symptoms of fever
accompanied by diarrhea.
Table 1. Characteristics of 3 Types of Acute
Diarrhea
 
  Non-inflammatory Inflam Penetrating
atory
Stool i Water , excess volume        Blood Mucus,
mage                      Mucus, Low volume ,
Leukocytes modera Leukocyte MN 
te             
volume
, PMN
leukoc
ytes
Fever (-) (+) (+)
Abdomin (-) (+) (+) / (-)
al pain
Dehydrat (+++) (+) (+) / (-)
 5

ion
Complic Hypovolemic Toxic Sepsis
ations
(Zein a , 2004).
 
Description: -: Not found
+: Found
 
 
Acute diarrhea results in:
 
2.3 The loss of water and electrolytes as well as disturbance of
acid -base which causes dehydration, metabolic acidosis
and hypokalaemic.             
2.4 Impaired blood circulation can be in the form of hypovolemic
shock or shock as a result of diarrhea with or without
dehydration with vomiting, cerebral hemorrhage may occur,
decreased consciousness and if not treated quickly the patient
may die.             
2.5 Disorder nutrition that occurs as a result of the discharge of
liquid that excessive due to diarrhea and vomiting           
  
2.3 Etiology                              
 
Acute diarrhea can be caused by several factors:
1. Infection   
a) Viruses  

Is the most common cause of acute diarrhea in childre
n (70 - 80%). Rotavirus serotype 1, 2, 8, and 9: in
humans. Serotypes 3 and 4 were found in animals and
humans, and serotypes 5, 6, and 7 were found only in
animals. Norwalk virus : present at all ages, generally due
 6

to fool borne or water borne transmission , and can also

occur person to person transmission .
b) Bacteria :    
Enterotoxigenic E. coli (ETEC). Has 2 important
virulence factors, namely the colonization factor that causes
these bacteria to adhere to enterocytes in the small intestine
and enterotoxins ( heat labile (HL)
and heat stabile (ST) which cause secretion
of fluids and electrolytes that produce watery diarrhea .
ETEC does not cause brush border damage or invade
the mucosa.
Enterophatogenic E. coli (EPEC). The mechanism of
diarrhea is not clear. He found the process of attachment of
EPEC to intestinal epithelium
caused damage of membrane micro- villi, which would interf
ere with the absorption and activity level disakaridase.
Shigella invades and multiplies colonic epithelial
cells, causing mucosal cell death and ulcers. Shigella rarely
gets into the bloodstream. Virulence factors include: smooth
lipopolysaccharide cell-wall antigen which has endotoxin ac
tivity and helps the invasion process and toxins that are
cytotoxic and
neurotoxic and may cause watery diarrhea (Zeinª, 2004).

c) Protozoa    
Entamoeba histolytica prevalence. Amoebic
dysentery varies, but spread throughout the world. The
incidence increases with age, and especially in adult
males. Approximately 90% of asymptomatic infections are
due to non-pathogenic E.histolytica . Symptomatic amobiasis
can range from mild and persistent diarrhea
to fulminant  dysentery (Zein b , 2004).
 7

Cryptosporidium.  In developing countries ,

cryptosporidiosis 5
 
–15% of cases of diarrhea in children. Infection is usually
symptomatic in infants and asymptomatic in older children
and adults. Clinical symptoms include acute diarrhea with
a watery diarrhea type , mild and usually self-limited . In
patients with immune system disorders such as those with
AIDS, cryptosporidiosis is a reemerging disease with more
severe diarrhea and is resistant to several types of antibiotics
(Zeinª, 2004).
2. Malabsorption of carbohydrates, fats and proteins   
3. Stale, poisonous, spicy food .   
4. Psychological for example fear and anxiety (Arif et al, 2000).   
 
2.4 Types of diarrhea
 
1) Diarrhea according to its nature  
a. Acute diarrhea    

Defecation with increased frequency and consistency

of stools that are more soft and runny, are sudden onset and
last less than 2 weeks.
b. Chronic diarrhea  
Diarrhea that lasts more than 2 weeks (Suharyono, 2008).
 
2) Diarrhea according to the mechanism     
a. Secretory diarrhea    
Diarrhea which generally occurs when an injury has o
ccurred in the intestine and there is secretion of fluids and
electrolytes into the intestinal lumen.
b. Osmotic diarrhea  
 8

Diarrhea which is usually caused by a solute that

is difficult to absorb in the intestines. The cause is
intolerance to lactose and ingestion of asmotic laxatives .

2.5 Symptoms of diarrhea      
                              
The type and severity of symptoms depend on the
type and number of microorganisms or toxins
ingested. Symptoms also vary depending on the power hold
the body of a person. Symptoms usually occur suddenly namely
nausea, vomiting, headache, fever, cold, uncomfortable body,
often waste water is great, without the
blood and eventually happen dehydration.

2.6 Due to diarrhea         
                        
a. Dehydration  
Most patients with acute diarrhea will become
dehydrated. This is because a lot of body fluids are released
during diarrhea.

Dehydration is a condition where the body lacks fluids that may

result death ,
especially in infants and children if not immediately addressed
(Anonimª, 2008).
Dehydration will cause metabolic disorders to the
body. This disorder can result in death in infants. This death was
caused by depletion of body fluids, because fluid intake was not
balanced with expenditure through vomiting and defecation even
though it took place little by little. Dehydration is divided into
three types, namely mild dehydration, moderate dehydration and
severe dehydration (Andrianto, 1995).
b. Growth disorders  
 9

 
This disorder occurs because food intake has stopped
while iron expenditure continues (Andrianto, 1995).
Table 2. Assessment of the degree of dehydration
in patients with diarrhea
 
Assessment Without Mild / Severe dehydration
dehydration moderate
dehydration
General Good Restless, Sluggish,
condition of Normal cranky unconscious
the eye There Concave Very concave
Mouth Wet None None Very
tears, Drink regularly Dry. dry
tongue   Very Lazy / ca n't drin
Thirst Normal thirsty k             
    Coming back very
Skin Come back slowly
elasticity slow
(Anonymous a , 2008)
 

Table 3. Standard Fluid Therapy (Iso Hyponatremia) For All Ages

except neonates
  Degree of Needs Type of Old way
Plan dehydration fluids liquid usage

C WEIGHT +30 ml / kg RL TIV / 3

/ 1 hour hours or
  faster

= 10 tts /
kg / min
*) MEDIUM +70 ml / ½ Dextrose TIV / 3
kg / 1 hour hours
B 6-9% = 5 tts / Or Or
 10

  kg / min    
    ORS TIG / 3
  +50 ml / kg   Hours
LIGHT // 3 hours ½ Dextrose o  
  r Oral 3
= 3- 4 tts / ORS hours
kg / min  
TIV / 3
hours
 
Or TIG / 3
Hours
A NO + 10-20 RT or ORS Oral until
DEHYDRATION ml / kg / solution diarrhea
each time stops
diarrhea
 
(Zeinª, 2004)
 
Description: TIV: intravenous drops
TIG: intra-gastric drops
 
2.7 Diagnosis of diarrhea             
                    
In diarrheal disease, to diagnose diarrheal disease by:
a. Examination of feces: macroscopic and microcopic, pH and
sugar levels if sugar intolerance is suspected ,  culture of
bacteria to look for causative germs and test for resistance to
various antibiotics (in persistent diarrhea )      
b. Examination of the blood: the blood of
peripheral complete, analysis of gases of
blood and electrolytes
 11

(especially Na, K, Ca, and P serum on diarrhea that
is accompanied with seizures)     
c. Examination
of blood urea and creatinine levels to determine kidney function 
d. Duodenol icubation , to know germs cause disease diarrhea.     
 

2.8 Management of diarrhea                         

        
Knowledge and understanding of the processes that
cause diarrhea to occur enables the clinician to develop the most
effective drug therapy . A balanced mixture of glucose and
electrolytes in a volume equivalent to lost fluids can prevent
dehydration (Goodman and Gilman, 2003).
Treatment of diarrhea is based on the proper diagnosis
and replacement of fluid and electrolytes are lost and also the use
of drugs antidiarrheal specific, and also avoid foods and
medications that can cause diarrhea, such as drug laxatives,
antacids and medications that affect motility intestines
(Watts, 1984).
Acute diarrhea in adults always occurs briefly without
complications, and sometimes resolves on its own even without
treatment. It is not uncommon for sufferers to seek self-
medication or self-medicate with over-the-counter anti-diarrhea
drugs. Usually, patients only seek medical help when acute
diarrhea has been more than 24 hours since there has been no
improvement in the frequency of bowel movements or the
number of stools passed. The principle of treatment is to
eliminate the causes of diarrhea by providing antimicrobials
according to etiology, supportive or fluid
replacement therapy with adequate fluid intake or with Oral
Rehydration Solution (ORS) known as ORS,
and symptomatic drugs are often needed to stop or reduce
 12

the frequency of diarrhea. . To determine the microorganisms that

cause acute diarrhea , routine fecal examination is carried out and
in a situation where routine feces does not show any
microorganisms, it is necessary to examine fecal culture with a
certain medium according to the microorganisms suspected
clinically and routine laboratory examinations. Indications for
fecal culture examination include severe diarrhea, body
temperature> 38.5 ° C, presence of blood and / or mucus in
the stool, found leukocytes in
the stool, lactoferrin, and persistent diarrhea that has not received
antibiotics (Zein b , 2004).

2.9 Age grouping        
                      
Age is also known as a factor in determining therapy
using drugs. Acute diarrhea can affect men and women in various
age groups and sufferers' daily habits. Patients with acute
diarrheal disease were divided into 3 age groups, namely the
pediatric group (children and
adolescents), the adult age group , and the geriatric age group ( el
derly).
The British Paediatrics Association (BPA) divides childhood
into several groups, namely neonates (early birth to month old),
infants (1 month to 2 years), children (2 to 12 years), adolescents
(12 to 18 years) . Therefore, the pediatrics group includes patients
aged 0-2 years. The age group of children is patients aged 2-18
years. The adult age group is patients aged 18 to 64
years. Patients were aged 65 years to above included in
the group aged geriatric (elderly) (Shetty and Woodhouse, 2003).

2.10 The rationality of treatment   

                              
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According to the definition of the WHO, the treatment of

rational drug means requires that patients receive medications
appropriate to the needs of their clinics, in doses that meet the
individual needs of their own, for a period of time that
is adequate, and the price of the lowest to the public (Siregar and
Endang, 2006).
Rational therapy is expected to provide maximum
results. Rational therapy includes :.
a. Correct drug selection      
b. Appropriate indication: the reason for writing a prescription
based on medical considerations.     
c. The right medicine: consider the efficacy, safety, suitability
for the patient, and price      
d. Right dose, method of administration, and duration
of administration of the right.     
e. Right patient: right on the condition
of patients respectively, in the sense that there are
no contraindications and the possibility of going
on reactions that harm is minimal.     
f. Patient adherence to treatment (Siregar and Endang, 2006).       
 
The use of irrational drug can be found in daily
practice at home sick or where services health other things this
includes the writing of unnecessary drugs, drugs are wrong,
ineffective or drugs that are not safe, effective drug available is
less used, and the use of drugs that are
not true (Siregar and Endang, 2006).

2.11 Treatment    
a. Antibiotics      
Empiric administration of antibiotics is rarely indicated
in acute infectious diarrhea, because 40% of cases of infectious
 14

diarrhea recover in less than 3 days without giving

antibiotics. Administration of antibiotics is indicated in: Patients
with symptoms and signs of infectious diarrhea such
as fever, bloody stool , leukocytes in the stool, reduced excretion
and environmental contamination, persistent or life-saving in
infectious diarrhea, and traveler's diarrhea. Empiric
administration of antibiotics can be done but specific antibiotic
therapy is given based
on culture and germ resistance (Zein b , 2004).
In determining the antibiotics used, Jumono and
Prayitno (2003) argue that the choice of antibiotics must be
based on the sensitivity of the bacteria, clinical experience, place
of infection, tixicity, and price. In combination therapy, the
adverse effects, such as antagonism, increased side effects, and
increased costs, must be taken into account.
Antibiotics can only be given if pathogenic bacteria are
found in laboratory tests. Because the test to find bacteria is
sometimes difficult or the test results come late, antibiotics can
be given with regard to, among others: the age of the patient, and
the course of the disease.

Table 4. Antibiotics for Bacterial Infectious

Diarrhea
 
Organism First choice Second choice
Campylobacter, Ciprofloxacin 500 Salmonella /
Shigella  or Salmonella sp mg orally twice a Shigella:
p                day, 3-5 days Ceftriaxon 1gr
IM / IV daily
TMP-SMX DS
orally twice a
day, 3 days
Chylobacter
 15

spp:
Azithromycin,
500 mg orally
twice a day.
Erythromycin
500 mg orally
twice a day,
for 5 days
Vibrio Cholera Tetracycline 500 Tetracycline
mg orally 4 times a Resistant
day, 3 days Ciprofloxacin
Doxycycline 300 1gr orally once
mg orally, as a a day
single dose Erythromycin
250 mg orally
as a single dose
4 times a day, 3
days
Clostridium difficile Metronidazole Vancomycin,
250-500 mg 4 125 mg orally 4
times daily, 7-14 times a day 7-14
days orally or IV days,
Enterotoxigenic E. Coli Norfloxacin 400 Trimethoprim-
mg or ciprofloxacin sulfamethoxazol
500 mg 2 times e DS tablets
a day, 3 days every 12 hours

(Zein b , 2004)
 
b. Anti- diarrhea medicine     
 

Various drugs have been used to treat bouts
of diarrhea. These drugs are grouped into several categories:
 16

antimotility, adsorbents, antisecretory compounds, antibiotics,

enzymes and intestinal microflora.
i. Opiates and their derivatives  
Opiates and their derivatives can increase intestinal
capacity, prolong contact and absorption. Endogenous
opioids, regulate fluid movement in the mucosa by
stimulating the absorption process. Opiate use is limited due
to the potential for addiction (with long-term use) and
worsening diarrhea.

ii. Adsorbent     
Adsorbents are used to reduce symptoms. These
products, most do not require a prescription, which
is nontoxic  , but e fektivitas this drug remains
unproven. Specific adsorbents in medicine, namely drugs
absorb nutrients, toxins, drugs, in the digestive tract

iii. Antisecretory     
Bismuth subsalicylate
is used for anti- secretory, anti-inflammatory, and
antibacterial effects. So it is marketed to treat digestive tract
disorders, reduce stomach cramps, and control diarrhea
(Spruill and Wade, 2005).
Table 5. Anti-diarrheal drugs
 
Medicine name Packaged dosage Adult dosage
1. Antimotili 2.5 mg / tablet 5 mg, 4 times / day,
ty              2.5 mg / 5 ml no more than 20 mg /
Diphenocylat day
es
Loperamid 2 mg / capsule Initially 4 mg, then 2
mg after passing
stool, no more than
 17

16 mg / day
Paregoric 1 mg / 5 mL  5-10 mL, 1-4 times /
Tincture 2 mg / 5 day
of mL (morphine)  0.6 mL, 4 times daily
Difenoxin 5 mg / mL 2 tablets, then 1
opium (morphine tablet after removing
) 1 mg / water up to
tablet 8 tablets / day
2. Adsorbent              5.7g kaolin +130 30-120 mL after
Koalin + pectin mg pectin / 30 mL defecating
mixture 500 mg / tablet
Polycarbopil   2 chewable tablets 4
times / day after
defecation, no more
than 12 tablets / day
Attapulgit 750 mg / 15 mL 1200-1500 mg after a
300 mg / 15 mL bowel movement or
750 mg / tablet 2 hours afterward, up
600 mg / tablet to 9000 mg / day
300 mg / tablet
3. Antisecret 1050 mg / 30 mL 2 tablets or 30 mL
ory 265 mg / 15 mL every 30 minutes for
Bismuth salic 524 mg / 15 mL up to 1 hour, up to
ylate 262 mg / tablet 8 doses / day if
needed
Enzym (lactose) 1250 units of pure 3-4 dos with milk or
lactose / 4 dos products
of milk
3300 FCC lactose 1 or 2 tablets
units / tablet
Addition   2 tablets or 1 packet
Bacteria ( Laktobasill of granules, 3 to 4
us  acidophilus, L.Bul times / day with milk,
garicus)              juice or water
4. Octreotid 0.05 mg / mL Initial: 50 mcg, 1-2
 18

0.1 mg / mL times / day and

0.5 mg / mL dropping dose for
indication up to 600
mcg / day 2-4 doses
(Spruill and Wade, 2005).

In acute diarrheal disease, supportive therapy is also needed t
o help patients recover their condition. During the period of
diarrhea, required intake of calories that
is enough for people who are useful to the energy and help the
recovery of damaged enterocytes. Anti-motility drugs are not
recommended in diarrhea with dysentery syndrome accompanied by
fever. Several classes of drugs that are symptomatic in acute
diarrhea can be given with careful clinical considerations for cost-
effectiveness .
 
 
 CHAPTER III
CONCLUSION

3.1 Conlusion

Diarrhea is the increasing frequency and decreasing the consistency of bowel

movements large (BAB) compared with patterns CHAPTER normal. The
occurrence CHAPTER 3 times or more in a day with the consistency
of soft or liquid that is not as usual, which is usually only two or three times a
week Acute diarrhea resulting in k ehilangan water and electrolytes as well
as disturbance of acid -base , Impaired blood circulation can be hypovolemic
shock or pre-shock and can cause Disorders nutrient that occurs due to
the discharge of liquid that excessive . Acute diarrheal diseases can be caused by
several factors , such as infections (viral, bacterial , protozoal), malabsorption of
carbohydrate, fat, and protein , food stale, non-toxic, food spicy , and p sikologis
example, fear and anxiety .
Based on the type of diarrhea is
classified into several types , namely the first diarrhea, according to its
nature ( diarrhea acute and diarrhea chronic ), diarrhea, according to the
mechanism ( diarrhea secretory and diarrhea osmotic), symptoms
of diarrhea usually occurs suddenly, namely nausea, vomiting, headache, fever,
cold, uncomfortable body, often waste water is great, without the
blood and eventually happen dehydration. Diarrhea can lead to problems
with dehydration and problems with growth . Enforcement diagnosis
of diarrhea able to do Fecal examination: macroscopic and microscopic, pH and
sugar levels , examination of blood: the blood of peripheral complete, analysis
of gases of blood and electrolytes , Inspection levels of urea and creatinine blood ,
and Duodenol  icubation  .
Treatment of diarrhea is based on the proper diagnosis and replacement of
fluid and electrolytes are lost and also the use of drugs antidiarrheal specific, and
also avoid foods and medications that can cause diarrhea, such as drug laxatives,
antacids and medications that affect motility intestines . Giving the

19
 20

drug on patients with diarrhea can
be with given antibiotics , Drug antidiarrheal ( Opiates
and derivatives , adsorbents , Antisektori ), In sickness diarrhea Acute also needed 
therapy supportive to help patients in recovering the patient's condition. During
the period of diarrhea, required intake of calories that
is enough for people who are useful to the energy and help the recovery of
damaged enterocytes.
 21

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