Starvation.—The entire digestive tract requires absolute rest for a certain period; no food and very little water, the latter in the form of bits of ice only, are given for a period lasting from twelve to thirty-six hours or more, depending upon the violence of the attack and the condition of the patient. This is to allow the toxic substances which are probably causing the disturbance to pass out of the body, either in the feces or in the urine. When the acute symptoms subside, that is, when the pain and distention of the intestines have disappeared, and the bowel movements become more normal in number and character, the dietetic treatment suitable to the condition is instituted.
Dietetic Treatment.—The first day the patient is given a small cup of weak tea, half a glass of buttermilk or peptonized milk, or a cup of well-skimmed meat broth, every three or four hours. If the patient is weak, the nourishment may be given oftener, and in those cases it is often found advisable to give a small amount of alcohol in the form of brandy in albumen water, or panopepton or liquid peptonoids. These may be administered in tablespoonful doses every two hours. Whole milk, unless it is peptonized, and at times even then, is not advisable in diarrheal conditions on account of its liability to form curds which decompose with the production of toxic substances, known to be exceedingly irritating to the already inflamed mucous membranes lining the intestinal walls.
Increasing the Diet.—As the diarrhea and inflammation subside, the following foods are gradually introduced into the dietary, keeping in mind always that a return of the acute symptoms is apt to occur. Hence the patient must never be overfed. It is better to err on the side of too little than too much food during the early convalescent period.
Diet.—Soft-cooked eggs, toast (slightly buttered), cocoa made with water instead of milk, chicken, calf’s-foot or wine jelly; later, well-cooked rice, junket, and soft custard; still later, lightly broiled beefsteak, lamb chops, chicken, squab or quail, sweetbreads or brains. Not until the patient is entirely free from all symptoms of diarrhea or intestinal disturbance may the following foods be given: cream or cream dishes such as cream toast, cream chicken, or cream soup, raw or stewed fruit, green vegetables, salt foods, spiced foods of any description; pastries, confectionery and desserts in general, unless they are simple in character and are sweetened with saccharin instead of sugar, as the latter substance is particularly susceptible to fermentation.
Anemia as a Result.—Anemia is one of the most common results of prolonged diarrheal attacks, especially in those toxic diarrheas resulting from infectious diseases, dysentery, etc. The blood-making tissues suffer from a lack of nourishment and are in consequence incapable of producing blood of the best quality. Hence the starvation treatment cannot be carried on over a very extended period or the resulting anemia may be more difficult to overcome than the original trouble.
Selecting and Regulating the Diet.—The following points must be kept in view when regulating the diets of individuals who are prone to develop diarrhea:
Preparing the Diet.—Only such foods as are known to agree with the individual, and these prepared in the simplest manner possible, must have a place in the dietary.
Fermentation.—All foods that are subject to fermentation either in the stomach or intestines must be withheld, at least until the attack is well over. Sugar is an example of such foods; saccharin may be substituted when necessary.
Avoidable Foods.—Pork, veal, and shellfish must be left out of the dietary, possibly for months, since they have been found frequently not only to bring about a return attack of diarrhea but also to have been the cause of the original one.
Fatty foods of all sorts had best be avoided as long as there are symptoms of diarrhea; these foods are handled with difficulty by the digestive apparatus and impose extra work upon the intestine, which is already taxed by the disease.