Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Review Article Volume 4 Issue 8

Chronic Diarrhoea: Scenario in Indian Vis-à-Vis Western Children

Suraj Gupte*

Professor and Head (Emeritus), Postgraduate Department of Paediatrics, MMC and Hospitals, Khammam, Telangana, India

*Corresponding Author: Suraj Gupte, Professor and Head (Emeritus), Postgraduate Department of Paediatrics, MMC and Hospitals, Khammam, Telangana, India.

Received: June 29, 2021; Published: July 20, 2021


Background: Chronic diarrhoea, defined as diarrhoea of 2 weeks or more duration, is a common problem in Indian children. Until recently, this remained ambiguous if the approach to its diagnostic evaluation and management warranted to be the same as followed in the western countries.

Objective: To focus on the current etiologic profile of chronic diarrhoea in childhood in India and highlight the major differences between the profile encountered in Western children.

Design: The review is based on author’s extensive experience in chronic diarrhoea in children in India spread over the past four decades and the information available in the English medical literature.

Salient Features: Aetiology of chronic diarrhoea in resource-limited settings is exhaustive. Nonetheless, only a few conditions such as protein-energy malnutrition (PEM), iron-deficiency anaemia (IDA), intestinal parasitosis (giardiasis, ancylostomiasis), and excessive consumption of soft drinks monopolise the situation. Coeliac disease, inflammatory bowel disease, and cystic fibrosis do occur but less frequently. This picture sharply contrasts with the pattern dominated by celiac disease, cystic fibrosis and inflammatory bowel disease in the Western children.

Conclusion: A good idea about the pattern of aetiology of chronic diarrhoea in different regions together with an individualised approach and an adequate follow-up is likely to resolve a large majority of the diagnostic problems in chronic diarrhoea in paediatric practice. Treatment depends on the aetiological condition. With the evolving socioeconomic and living conditions, futuristic changes in the aetiological pattern in India are expected in future. As the nutritional status improves and gut parasitic infestations get controlled, the pattern may slowly move towards the one that is seen in the western countries.

Keywords: Ancylostomiasis; Chronic Diarrhoea; Coeliac Disease; Cystic Fibrosis; Endemic Tropical Sprue; Giardiasis; Intestinal Parasitosis; Iron Deficiency Anaemia; Protein-Energy Malnutrition


  1. Wilson E. “Chronic diarrhea in childgood: International scenario”. In: David CE (edition). Chronic Diarrhea-cum- Malabsorption Syndrome in Pediatri Practice, London: Smithson (2017): 123-139.
  2. Gupte S. “Diarrhoeal diseases”. Prof. JR Srivastava Oration, Indian Academy of Paediatrics, Kanpur, India (2017).
  3. Patwari A., et al. “Gastroenterologyy”. In: Gupte S (edition): The Short Textbook of Pediatrics, 13th edition. (2020): 467-505.
  4. Gupte S. “Chronic diarrhea: Four decades experience in resource-limited settings”. International Journal of Gastroenteroly, Hepatoogyl, Transplantatio and Nutrition 1 (2016): 78-84.
  5. Gupte S., et al. “Diarrheal diseases”. In: Gupte S , Gupte SB, Gupte M (eds). Recent Advances in Pediatrics (Special Vol 23: Pediatric Gastroenterology, Hepatology and Nutrition). New Delhi: Jaypee (2013): 57-81.
  6. Walia BNS., et al. “Chronic diarrhoea in north Indian children”. Indian Journal of Medical Research 59 (1971): 1448-1453.
  7. Gupte S., et al. “Tropical malabsorption: Experience in north Indian children”. In: Gupte S (ed). Newer Horizons in Tropical Paediatrics. New Delhi: Jaypee (1977): 270-278.
  8. Indian Academy of Paediatrics. “Paediatric Gastroenterology Chapter: “Chronic and persistent diarrhea in infants and young children: Status statement”. Indian Paediatrics 48 (2011): 37-42.
  9. Mittal SK. “Chronic diarrhea in tropics”. Indian Journal of Paediatrics 66 (1999): S4-15.
  10. Gupte S and Gupte N. “Giardasis: A neglected disease”. EC Paediatrics 3 (2016): 279-280.
  11. Walia BNS., et al. “Celiac disease”. Indian Paediatrics 8 (1972): 620-625.
  12. Gupte S. “Editorial: Changing Concepts in celiac disease”. JK Science 3 (2001): 11-13.
  13. Yachha SK. “Coeliac disease on the global map”. Journal of Gastroenterology and Hepatology 21 (2006): 1622-1625.
  14. Pipaliya N., et al. “Spectrum of chronic small bowel diarrhea with malabsorption in Indian subcontinent: is the trend really changing?” Intestinal Research 14 (2016): 75-82.
  15. Mehta S., et al. “Fibrocystic disease of pancreas in India”. Indian Paediatrics 5 (1968): 185-191.
  16. Gupte S and Mehta S. “Chronic diarrhoea- an etiological study”. Indian Pediatrics 7(1970): 625-627.
  17. Maya PP., et al. “Cystic fibrosis in South India”. Tropical and Geographical Medicine 32 (1980): 45-49.
  18. Gupte S and Pal M. “Cystic fibrosis in Indian Subcontinent: Yes or no?” European Chronicle of Gastroenterology 3 (1981): 412-413.
  19. Gupte S. “Comments on cystic fibrosis in India”. Indian Journal of Paediatrics 67 (2000): 475-476.
  20. Mandal A., et al. “Cystic fibrosis in India: Past, Present and Future”. Journal of Pulmonary Medicine and Respiratory Research (2015).
  21. Gupte S. “Paediatric chronic diarrhea: Approach in resource-limited settings”. EC Paediatrics 9 (2020): 1-5.


Citation: Suraj Gupte. “Chronic Diarrhoea: Scenario in Indian Vis-à-Vis Western Children”. Acta Scientific Gastrointestinal Disorders 4.8 (2021): 40-43.


Copyright: © 2021 Suraj Gupte. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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