Chronic nonspecific diarrhea: the value of a preliminary observation period to assess diet therapy

Eighteen children with chronic, nonspecific diarrhea were evaluated prospectively to determine "basal" fat consumption and the response of their diarrhea to diets containing either 25% or 50% of total calories as fat. In the observation period, prior to initiating any alteration in dietary fat content, diarrhea subsided. Only five of the 18 patients had a low fat intake (less than 27% of total calories) at the outset of the study, and spontaneous resolution of the diarrhea precluded an assessment of the effect of altering fat intake on stool frequency. We are, therefore, impressed that a preliminary observation period, in which details of the diarrhea are documented, is essential to evaluate any treatment modality for this poorly defined condition.