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This study reproduced in a group of infants with acute diarrhea the conditions under which systemic acidosis usually ensues in infantile diarrheal disease. These conditions were achieved in order to assess changes in stool composition and the influence of milk intake on the composition of the stools and on the acid-base equilibrium; these changes were compared with similar observations during fasting and intravenous therapy. Also specific challenges with individual sugars were done in some patients and the changes induced in stool composition were studied. 9 infants were studied during consecutive periods of milk feeding and intravenous therapy. During milk administration the stools were abundant and markedly acidic and contained large quantities of lactate and other organic acids of low pKa. With fasting all parameters decreased significantly. When sugar loads were administered orally increased fecal excretion of carbohydrate occurred along with compositional changes qualitatively identical to those observed after milk ingestion. It is concluded that the high lactate content and high content of other inorganic anions in diarrheal stools in infants are related to carbohydrate ingestion. Therefore increased fecal excretion of endogenously produced organic acid anions in their neutralized dissociated form probably has a role in the genesis of the metabolic acidosis found in diarrhea.

the journal of clinical investigation/the journal of clinical investigation

Studies on infant diarrhea. I. A comparison of the effects of milk feeding and intravenous therapy upon the composition and volume of the stool and urine.