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1. Role of Zinc
in Anti-
Diarrheal
Therapy in
Childhood
Diarrhea Samyek Napit
Roll no. 66
NAIHS-COM

2. • World Health Organization(WHO)
and United Nations Children’s
Emergency Fund recommends that
all children with acute diarrheal
illness should be treated with
Zinc, “regardless of etiology”.
Zinc reduces severity, duration and recurrence in
ensuing 2-3 months.

3. For children <6 months
of age
10 mg Zinc for 10-14
days should be given
daily
For children >6 months
of age up to 5 yrs
20 mg Zinc for 10-14
days daily

4. • Zinc tablets are available in the following forms :-
 Zinc Sulfate
 Zinc Acetate
 Zinc Gluconate

6. Role of Zinc
Zinc is an important
micro-nutrient.
Age Group Recommended Dietary
Allowance
0-6 months 2 mg
7-12 months 3 mg
1-3 yrs 3 mg
4-8 yrs 5 mg
Over 300 biological
9-13 yrs 8 mg
functions, functioning of
14-18 yrs 11 mg(m) 9 mg(f) more than 100 enzymes
Mother’s milk provides the
19+ 11 mg(m) required 2mg of zn

7. Role of Zinc
• for protein synthesis, cell growth and differentiation
• immune function
• maintaining cell membrane integrity (Bettger and
Odell 1993).
• intestinal transport of fluid and electrolyte??
• is component of enzymes like carbonic anhydrase,
alcohol dehydrogenase, etc

8. Zinc Deficiency
• Zinc deficiency is a common among children in
underdeveloped and developing countries.
Causes
o Low intake of diet rich in Zinc
o Lack of breast-feeding
o Excess intake of legumes and whole grains- rich in
phytates which inhibit Zinc absorption (among
vegetarians)

9. Causes..
o Chronic Diarrhoea
o Malabsorbtion
o Other Gastrointestinal diseases

10. Effects of Zinc deficiency
• impaired immune function
• diarrhea
• growth retardation
• Impairment of sexual development
• loss of appetite

11. • eye and skin lesions
• Weight loss
• delayed healing of wounds
• taste abnormalities/ impairment in development
of taste buds (gustin)
• mental lethargy

12. Effect of Zinc deficiency on immune
system
• rapid and extensive effect
• promotes production of glucocorticoids from adrenal
gland acting via hypothalamus and pituitary
• glucocorticoid mediated apoptosis
• results in loss of precursor lymphocytes( less bcl2 gene
expression)

13. • down regulation of Lymphopoiesis
• loss in antibody mediated response

14. How does Zinc help in diarrhoea?
• Zinc supplementation +
ORS stops diarrhoea
faster *
• Prevent reoccurrence of
diarrhoea in the
following months
*Clear beneficial effects
seen among infants > 6
• Prevents months
aforementioned
problems due to Zinc Applicable in both acute
deficiency and Chronic diarrhea

15. Mechanism
•Zinc inhibits cAMP induced, chlorine dependent fluid
secretion
•Zinc inhibits basolateral K+ channels
•Boosts the immune system
•Increases the absorption of water and electrolytes????

16. • Inhibits toxin induced cholera
• As an adjunct to antimicrobial (AM) treatment in
bloody dysentery showed increase in the
bactericidal antibody titers against Shigella
• Increases the levels of brush border enzymes
• Increases intestinal epithelium regeneration

17. Cost of Management
• Also, studies have shown
that the use of Zinc
therapy reduces the
overall cost of
management of diarrhea
• Make ORS therapy more
cost-effective

18. FOR 10-14 DAYS!
• http://www.youtube.com/watch?v=8cpzCPtZ
woU

19. References
• “Effectiveness of zinc supplementation plus oral rehydration salts
for diarrhoea in infants aged less than 6 months in Haryana state”
by Sarmila Mazumder a, Sunita Taneja a, Nita Bhandari a, Brinda
Dube a, RC Agarwal b, Dilip Mahalanabis c, Olivier Fontaine d &
Robert E Black e
Bulletin of the World Health Organization 2010;88:754-760. doi:
10.2471/BLT.10.075986
• The Dynamic Link between the Integrity of the Immune System
and Zinc Status by Pamela J. Fraker, Louis E. King, Tonya
Laako, Teresa L. Vollmer (American Society for Nutritional Sciences)
• Role of Zinc in pediatric diarrhea- Indian Journal of Pharmacology

20. Thank You!