7/25/2019 9_Diarrea Cronica Optimized

1/10

DMALNL[LINM

Cg dlgrrmg jrinljg un dlsirdlnm dmccgcvi jgrgttmrlzzgti dgc armqumntm

pgssgeeli dl amjl clquldm smjindgrli gd un gu`mnti dmc vicu`m dmccmamjl stmssm jbm pmrslstm pmr pl dl trm smttl`gnm. Nmc cgttgntm, un vicu`mdl amjl supmrlirm g 7= e/oe/dlm dg jinsldmrgrm dlgrrmg. Nmc hg`hlnipl ergndm, jis ji`m nmccgducti, sl pgrcg dl dlgrrmg ln prmsmnzg dl unvicu`m amjgcm supmrlirm g 866 e/dlm.

MVLDM@LICIELG

Ninistgntm jinsldmrmvicl pgssl gvgntl nmccg ji`prmnslinm m nmccg emstlinmdmccm pgticielm dlgrriljbm, mssm sini gnjirg rmspinsghlcl dl jlrjg 8.8 l-clinl dl irtl ln mt pmdlgtrljg nmc indi. Ztudl puhhcljgtl nmecl uctl`l 76gnnl lndljgni jbm clnjldmnzg ecihgcm rl`gnm l``idljgtg, gssmstgndisl

ln jlrjg :.8 mplsidl pmr hg`hlni pmr gnni, ninistgntm sl slg vmrljgtg

ung rlduzlinm dmccg irtgclt. Clnjldmnzg prmjlsg dl dlgrrmg jrinljg nin nitg. Ln gjjirdi gl dgtl dmccg UBI, cg prmvgcmnzg dl dlgrrmg jrinljg lnmt pmdlgtrljg nmc `indi sl gssmstg trg lc : m lc 86%.Hg`hlnl nin gccgttgtl gc smni sini g rlsjbli gu`mntgti dl dlgrrmg pmrsl-stmntm, `mntrm cgccgttg`mnti pricunegti gc smni rgpprmsmntg un agttirmpritmttlvi.

M[LICIELG M ALZLIVGTICIELG

Lc prlnjlpgcm mjjgnls`i slipgticielji dl tuttl l tlpl dl dlgrrmg clnji`-pcmti gssirhl`mnti dl gjqug dgc cu`m lntmstlngcm i g jgusg dl ung nmttgrlduzlinm dmc rlgssirhl`mnti dl gjqug (divuti gd un rlditti gssirhl`mntidmecl mcmttricltl i gd un gu`mnti dmccg ciri smjrmzlinm) i pmr ung rltmnzlinmis`itljg`mntm `mdlgtg dl gjqug nmc cu`m lntmstlngcm. Cg sm`pcljm rldu-zlinm dmc rlgssirhl`mnti dl `mni dmcc7% dmccgjqug lntrgcu`lngcm elsuajlmntm g jgusgrm dlgrrmg, pmrtgnti gnjbm ung idmstg ji`pri`lsslinm

dmccg aunzlinm gssirhltlvg pu dmtmr`lngrm amjl `iccl. Zl jgplsjm pmrtgntiji`m dlvmrsm jindlzlinl pissgni mssmrm rmspinsghlcl dl dlgrrmg (Tghmccg 7).

DLGXXMG JXINLJG

Jbrinlj dlgrrbimgZgcvgtirm Jujjblgrg, @grlng Gcil

7/25/2019 9_Diarrea Cronica Optimized

2/10

Tgh. 7- Dlgenisl dlaamrmnzlgcm dmccg dlgrrmg jrinljg (> : smtt)

LNAGN[LG DIVI CLNAGN[LG

Dlgrrmg jrinljg gspmjlaljg Dlgrrmg jrinljg gspmjlaljg

Mjjmsslvg gcl`mntgzlinm Zlndri`m dmcclntmstlni lrrltghlcm

Lnamzlinm lntmstlngcm Jmclgjblg

Lnamzlinm mxtrglntmstlngcm (itltl, LQ]) Alhrisl jlstljg

Alhrisl jlstljg Dmaljlt dl dlsgjjgrldgsl

Jmclgjblg @gcgttlg lnalg``gtirlg lntmstlngcm

Egstrimntmrltm mislnialcg Jicltm ucjmrisg

Lpmrtlrildls`i @irhi dl Jribn

Dmaljlt jinemnlti dl cgttgsl Vsmudi-istruzlinm

Zlndri`l dg l``unidmaljlmnzg @gcnutrlzlinm pritmlji-jgcirljg

@gcnutrlzlinm pritmlji-jgcirljg Zjcmridmr`lg

@gcgttlg dl Blrsjbsprune Clnai`g

Dlamttl jinemnltl dl trgspirti (pmrdltg dl Jc, Zprum tripljgcm

pmrdltg dl Ng)

Dmaljlt dl sgjjgrgsl-lsi`gctgsl

@gcgssirhl`mnti dl ecujisli-egcgttisli

Gjridmr`gtltm mntmripgtljg

QLVi`gGtrialg ldlipgtljg dml vlccl

Mntmripgtlg gutil``unm

Ghmtgclpipritmlnm`lg

Clnagnemjtgslg prl`grlg

Jicmstgsl nmingtgcm

Lntmstlni jirti jinemnlti (`gcritgzlinm)

Dlgrrmg agjtltlg

Cg dlgrrmg sl dlstlneum ln smjrmtirlg i is`itljg, smhhmnm mntrg`hl l`mjjgnls`l pissgni jimslstmrm ln pgzlmntl jin ergvl mntmripgtlm. Cgprl`g pl rgrg md jgrgttmrlzzgtg dg erissl qugntltgtlvl dl amjl clquldm,jin sjgrljbm `icti armqumntl, slg dlurng jbm nitturng, md un dlgrrmgjbm pmrslstm gnjbm g dleluni. Jcgssljl msm`pl sini cg dlgrrmg lndittg dgcQlhrli jbicmrgm m dg M. Jicl mntmritisslemnlji.

Gc jintrgrli, cg dlgrrmg is`itljg dlpmndm dgccgcl`mntgzlinm m lc vicu`mdmccm amjl nin emnmrgc`mntm jis `gsslvi ji`m nmccg dlgrrmg smjrmtirlg.Jgusm sini cg prmsmnzg dl nutrlmntl nin gssirhlhlcl g clvmcci egstrilntmstl-ngcm md emnmrgc`mntm gssijlgtg g dgnni dmccg `ujisg. Mssl msmrjltgniun rljblg`i is`itlji dl clquldl nmc cu`m lntmstlngcm, jin rlduzlinm dmccgjinslstmnzg dmccm amjl. Jcgsslji msm`pli cg dlgrrmg nmcclnticcmrgnzg gccgttisli. Lc cgttisli nin gssirhlti rgeelunem lc jicin nmccg sug air`g lntgttg,divm cg irg hgttmrljg amr`mntg ci zujjbmri ln gjldl iregnljl g jirtg jgtmng,

emnmrgndi un ussi is`itlji dl gjqug nmc cu`m.

Cg prmsmnzg dl uji m sgneum nmccm amjl sl vmrljg ln prmsmnzg dl lng`-`gzlinm lntmstlngcm, cg ujisg vlmnm lnvgsg m dlstruttg dgcclnctrgti jmccu-

7/25/2019 9_Diarrea Cronica Optimized

3/10

cgrm dl tlpi lng``gtirli m vmneini pridittm jltijblnm prilng``gtirlm.

L prijmssl gssirhltlvl vmneini gctmrgtl, l gtmrlgcl mssudgtl (`uji, sgneum)vmneini mcl`lngtl m cg itlclt lntmstlngcm gctmrgtg. Clng``gzlinm lntm-

stlngcm pu mssmrm divutg g rmgzlinl gccmreljbm, lnamzlinl, prijmssl dl tlpil``unltgrli, jis ji`m gvvlmnm nmccm gcgttlm lng``gtirlm lntmstlngcl.Cm prlnjlpgcl jgusm dl dlgrrmg jrinljg sm`hrgni dlpmndmrm dgccg sltugzli-nm sijlimjini`ljg dmccg pipicgzlinm. Nmccm ngzlinl lndustrlgclzzgtm, cmdlgenisl pl armqumntl ln pgzlmntl jin dlgrrmg jrinljg sini cg slndri`mdmcclntmstlni lrrltghlcm, cm `gcgttlm lng``gtirlm jrinljbm dmcclntmstl-ni, cm slndri`l dg `gcgssirhl`mnti, cm lnamzlinl jrinljbm m cg dlgrrmg

smjrmtirlg ldlipgtljg. Nmccm ngzlinl mni svlcuppgtm, lnamzlinl hgttmrljbmm pgrgssltgrlm rgpprmsmntgni cm mzlicielm pl armqumntl.

JCLNLJG

Lc qugdri dl prmsmntgzlinm dmc hg`hlni jin dlgrrmg jrinljg jirrmcgti

gccmzlicielg dmc dlsirdlnm (Tghmccg 8), gnjbm sm cm jinsmeumnzm dl ungdlgrrmg pmrslstmntm jin pmrdltg dl nutrlmntl mssmnzlgcl sini ji`unl gtuttm cm jgusm. Lc hg`hlni pitr prmsmntgrm dlvmrsl ergdl dl dlsldrgtg-zlinm m, nmccm air`m pl smvmrm m pricunegtm, un qugdri jinjcg`gti dl`gcnutrlzlinm. Zpmjljbm pgticielm dmc pljjici lntmstlni, dmc amegti m

dmc pgnjrmgs dmtmr`lngni cgctmrgzlinm dmccg jinslstmnzg dmccm amjl. Nmcjgsi dmc pljjici lntmstlni, lc dgnni dmccg `ujisg divuti g dlvmrsm jgusm

sl gnlamstg jin dlgrrmg m `gcgssirhl`mnti (gd msm`pli nmccg jmclgjblg,nmccg egstrimntmrltm mislnicg m nmccg slndri`m dmcclntmstlni jirti).Cg jindlzlinm jbm pl armqumntm`mntm dmtmr`lng dlgrrmg jrinljg cgtri-g dml vlccl lntmstlngcl smjindgrlg gd un dgnni dmccg ujisg dmtmr`lngti

dg gemntl lnamttlvl i gccmremnl. Ln tgc jgsi lc qugdri jclnlji sl jgrgttmrlzzgpmr ung dlgrrmg smjrmtlvg (divutg gc `gcgssirhl`mnti dl mcmttricltl mnutrlmntl). Ln prmsmnzg dl lnticcmrgnzm gcl`mntgrl sl vmrljg ung mntmri-

jicltm gccmreljg jin dlgrrmg, spmssi sgneulnicmntg, m vi`lti jbm smeuinil``mdlgtg`mntm i mntri qugcjbm smttl`gng clnemstlinm dmccgccmremnm.Nml jgsl pmrslstmntl m nin rljinisjlutl sl gssijlg ung ji`pri`lsslinmdmccgjjrmsjl`mnti pindmri-stgturgcm. Cg jmclgjblg sl prmsmntg tlpljg`mntmjin dlgrrmg, sjgrsi gjjrmsjl`mnti, gnirmsslg m dlstmnslinm gddi`lngcm(gnjbm sm lc qugdri jclnlji mstrm`g`mntm picl`irai m l slnti`l eg-strilntmstlngcl pissini gnjgrm).

Cg egstrimntmrltm mislnicg sl `gnlamstg jin dicirl gddi`lngcl, ngusmg,vi`lti m pmrdltg dl pmsi jin dlgrrmg. Nmc 5=% dml jgsl sl gssijlg unglpmrmislniclg pmrlamrljg.

7/25/2019 9_Diarrea Cronica Optimized

4/10

Tgh. 8-Dlgenisl dlaamrmnzlgcm dmccg dlgrrmg jrinljg succg hgsm dmccm jgrgttm-rlstljbm dmccm amjl

Dlgrrmg gjquisg Ztmgtirrmg

Dlgrrmg Is`itljg Zlndri`l dg gcgssirhl`mntiLnemstlinm dl @e, ZI4, VI4 Vgticielm dmccg ujisg

@gcgssirhl`mnti dl jgrhildrgtl Zlndri`m dmcclntmstlni jirti

Dlgrrmg smjrmtlvg Dlgrrmg pistrmsmzlinm

Ghusi dl cgssgtlvl (nin-is`itljl) @gcdlemstlinm

Zlndri`l jinemnltm Lnsuaaljlmnzg pgnjrmgtljg

Tisslnm hgttmrljbm Dmaljlt gjldl hlclgrl

@gcgssirhl`mnti lcmgcm dmecl gjldl hlclgrl Dlgrrmg lnalg``gtirlg

@gcgttlm lnalg``gtirlm jrinljbm dmcclntmstlni @gcgttlm lnalg``gtirlm jrinljbm

Jicltm ucjmrisg Jicltm ucjmrisg

@gcgttlg dl Jribn @gcgttlg dl Jribn

Jicltm ljrisjipljg Dlvmrtljicltm

Dlvmrtljicltm Dlelunilcmltm ucjmrgtlvg

Qgsjucltl Lnamzlinl

Driebm m vmcmnl Lnamzlinl vlrgcl ucjmrgtlvm

Dlsirdlnl dmccg itlclt J@Q

Dlgrrmg pistvgeiti`lg BZQ

Dlgrrmg pistsl`pgtmjti lg

Lpmrtlrildls`i

Zlndri`m dmcclntmstlni lrrltghlcm

Tu`irl nmurimndijrlnl

Egstrlni`g

QLVi`g

@gcgttlg dl Gddlsin

Dlgrrmg smjrmtlvg ldlipgtljg

Cg dlgrrmg lntrgttghlcm dmcclnagnzlg, jinisjlutg gnjbm ji`m dmjltsmjindgrli dmccm dlsgjjgrldgsl, sl vmrljg ln smeulti gd ung lnamzlinm

lntmstlngcm jbm dmtmr`lng ung vgrlghlcm rlduzlinm dmccm jgpgjlt dlemstlvmmd gssirhltlvm dmc cgttgntm. Clnticcmrgnzg trgnsltirlg gc cgttisli nm rgpprm-smntg cg air`g pl clmvm. Nmccg vgrlgntm pl smvmrg (dlgrrmg lntrgttghlcm) tgcvictg nmjmssgrli rljirrmrm printg`mntm gccg nutrlzlinm pgrmntmrgcm.Mplsidl rljirrmntl dl dlgrrmg m sjgrsg jrmsjltg nmc prl`i sm`mstrm dl vltgsueemrlsjini tgcm dlgenisl. Cg dlgenisl sl hgsg succg jinisjmnzg dgpgrtm dmc `mdlji dmccg `gcgttlg, succmsjcuslinm dl gctrm pisslhlcl jgusmmd, mvmntugc`mntm, succg rlspistg gccg tmrgplg nutrlzlingcm (mntmrgcm ipgrmntmrgcm smjindi cg ergvlt dmc qugdri).Mrrirl jinemnltl dmc `mtghicls`i sl pissini prmsmntgrm jin ungdlgrrmg prmjijm pmrslstmntm nmc jintmsti dl gctrl slnti`l jclnljl, jl qugnti gvvlmnm nmccg egcgttism`lg, nmccg tlrislnm`lg, nmccg jcirldirrmg

ag`lclgrm.]ng jindlzlinm armqumntm m hmnleng dl dlgrrmg jrinljg durgntm cg Lgm cg LLglnagnzlg rgpprmsmntgtg dgccg DLGXXMG JXINLJG NIN-ZVMJLALJGLNAGNTLCM. Lc hg`hlni prmsmntg 1-78 mvgjugzlinl quitldlgnm, mspcislvm

7/25/2019 9_Diarrea Cronica Optimized

5/10

dl amjl iccl, spmssi jintmnmntl jlhi lndlemrlti smnzg gctmrgzlinl dmccg jrm-sjltg (g mni jbm nin slg pisti g dlmtg rmstrlttlvg) i slnti`l jclnljl. Zpmssisl vmrljg g smeulti dl un mplsidli dl egstrimntmrltm gjutg (Tghmccg :).

Tgh. :-Dlgrrmg jrinljg nin spmjlajg

ZLNTI@L

Lnlzli; 1-72 `msl dl vltg

Amjl `iccl, `ivl`mntl lntmstlngcl mspcislvl jintmnmntl jlhi lndlemrltl

Armqumnzg dml `ivl`mntl lntmstlngcl; 1-78 vv/dlm

Jrmsjltg; nir`gcm (sm nin g dlmtg rmstrlttlvg)

XMD ACGEZ

M`gtijbmzlg/`mcmng

Amhhrm pmrslstmntm

Vmrdltg dl pmsi i grrmsti dmccg jrmsjltg

Gnm`lg

DLMTG

Tmntgtlvi dl msjcuslinm dl cgttisli m sujjbl dl aruttg

MZG@L DL CGHIXGTIXLI

M@G m gntl-tTE

Gntlemnm amjgcm dl Elgrdlg

TMXGVLG

Xgssljurgzlinm

Jg`hlg`mntl dmcci stlcm dl vltg

Mvltgrm dlmtm rmstrlttlvm

Cm jindlzlinl lng``gtirlm dmc pljjici lntmstlni i dmc jicin sl `gnl-amstgni jin ung dlgrrmg `uji-sgneulnicmntg. Cm `gcgttlm lng``gtirlm

jrinljbm pl armqumntl sini cg gcgttlg dl Jribn m cg Xmttijicltm ]cjmrisg.Nmccm `gcgttlm lng``gtirlm jrinljbm dmcclntmstlni cg dlgrrmg nin

ghhindgntm, sl `gnlamstg spmssi slg dl elirni jbm dl nittm md emnmrgc-`mntm `uji-sgneulnicmntg.

Gnjbm mrrirl dlmtmtljl pissini mssmrm cg jgusg dl dlgrrmg jrinljg nmc hg`-hlni. Ln pgrtljicgrm, l`pirtgntm msjcudmrm unmjjmsslvg lnemstlinm dlerissm qugntlt dl jgrhildrgtl nin dlemrlhlcl, ji`m lc sirhltici dmccg aruttg.Cg slndri`m dmcclntmstlni lrrltghlcm ung jindlzlinm icti dlaausg nmccgpipicgzlinm pmdlgtrljg m nmccgducti. Zl rltlmnm jbm lc 76-86% dmccm vlsltmegstrimntmricieljbm spmjlgclstljbm slgni divutm g tgcm qugdri jclnlji. Lslnti`l sini rgpprmsmntgtl dg dicirl gddi`lngcl gssijlgtl emnmrgc`mntm

gd ung gctmrngnzg dmccgcvi.Tuttm cm jindlzlinl jbm jgusgni ung lnsuajlmnzg pgnjrmgtljg msijrlngjgusgni stmgtirrmg. Cg jindlzlinm pl armqumntm cg hrisl jlstljg, gctrmsini cg slndri`m dl Zbwgjb`gn i cg pgnjrmgtltm jrinljg.

7/25/2019 9_Diarrea Cronica Optimized

6/10

Ln prmsmnzg dl jicmstgsl mpgtljg sl vmrljg uni sjgrsi gssirhl`mnti dlergssl pmr lc dmjlt dl sgcl hlclgrl (gtrmslg hlclgrm, stmnisl hlclgrm jinemnltg,

mjj) jin dlgrrmg jrinljg.

Nml dmjlt l``unltgrl, ji`m cg slndri`m dl l``unidmjlmnzg ji`hl-ngtg smvmrg (ZJLDZ) i cGLDZ, cg dlgrrmg spmssi un lnlzlgcm slnti`idl gccgr`m.

DLGENIZL

Cgpprijjli gd un hg`hlni jin dlgrrmg jrinljg jinslstm lnngnzltutti lnungjjurgtg rgjjictg dmccgng`nmsl gssijlgtg gd un gttmntg vgcutgzlinmjclnljg (Tghmccg 4).

Tgh. 4- Qgcutgzlinm lnlzlgcm dmccg dlgrrmg jrinljg

DLGENIZL DLAAMXMN[LGCM

Zmjrmtirlg is`itljg lnalg``gtirlg

Dlamttl jinemnltl dmccgssirhl`mnti stmg-

tirrmg lnalg``gzlinm dlgrrmg jrinljg

gspmjlaljg

@gcgssirhl`mnti dl jgrhildrgtl - @LJL

Aunzlingcm, dlmtmtljg

@gcgssirhl`mnti

@LJL

L`pgtti amjgcm, lnalg``gzlinm

@LJL tu`irl l`pgtti amjgcm

@LJL

Alhrisl jlstljg, @LJL, jmclgjblg

@LJL

Jindlzlinl lpmrsmjrmtlvm

Jmclgjblg, @LJL

Ztmgtirrmg; alhrisl jlstljg, gcaghmtg clpipri-

tmlnm`lg, jmclgjblg, @LJL

@LJL

Mntmripgtlg pritmlni-dlspmrdmntm, @LJL

Gcaghmtg clpipritmlnm`lg

Jmclgjblg

Lnamzlinl hgttmrljbm i pgrgssltgrlm

DGTL

Ztmp 7; stirlg jclnljg Armqumnzg dmamjgtirlg pgttmrn

(nitturng9 `idlaljgtg dgc dleluni9)

Gspmtti dmccm amjl; gjquism, sjblu`i-

sm, untuism ujism, sgneulnicmntm, jlhi

lndlemrlti

Zlnti`l gssijlgtl; jrg`pl gddi`lngcl,

acgtucmnzg, amhhrm, slnti`l mxtrglntmstl-

ngcl

Ztirlg dlmtmtljgZtmp 8; vgcutgzlinm jclnljg

Jrmsjltg nir`gcm

Zjgrsg jrmsjltg

Gatm irgcl

Gddi`m dlstmsi

@gssm gddi`lngcl

Gni`gclm rmttgcl

Zlnti`l mxtrglntmstlngcl; pic`ingrl, gr-

tljicgrl, ijucgrl, jutgnmlZtmp :; tmsts dl cghirgtirli

Lnjrm`mnti lndljl dl acieisl

Gctmrgzlinl mcmttricltljbm

Gnm`lg

Xlduzlinm vltg`lnm clpisicuhlcl

Lnjrm`mnti mnzl l pgnjrmgtljl

Xlduzlinm gchu`lng

Xlduzlinm jicmstmrici, trlecljmrldl Gu`mnti gntl tTE i M@G

Jiprijicturg

7/25/2019 9_Diarrea Cronica Optimized

7/10

Cm lndgelnl sujjmsslvm dmvini qulndl mssmrm hgsgtm su tgcm vgcutgzlinm,succmt dmc hg`hlni m succg durgtg dmccg dlgrrmg. Dgtl gng`nmstljl l`-pirtgntl sini qumccl pmrlngtgcl (jistlpgzlinm, hrisl jlstljg), prmjmdmntl

lntmrvmntl jblrureljl (slndri`m dmcclntmstlni jirti) m cg stirlg ag`lclgrm(jmclgjblg, @LJL). l`pirtgntm vgcutgrm cg smvmrlt dmccg dlgrrmg, lc tlpidl amjl g cg prmsmnzg dl slnti`l gssijlgtl. l`pirtgntm maamttugrm ung gdm-eugtg vgcutgzlinm nutrlzlingcm, ldmntljgndi un mvmntugcm jgci pindmrgcm

i un rldittg jrmsjltg, md msg`lngrm un jg`plinm dl amjl.]ng dlgrrmg msirdltg ln pmrlidi nmingtgcm, ung victg msjcusm pisslhlcl lnam-zlinl, sueemrlsjm ung mntmrijicltm dg gccmrelg gccm pritmlnm dmc cgttm vgjjl-ni, ung hrisl jlstljg, ung clnagnemjtgslg, dlamttl jinemnltl dmc trgspirti dl

mcmttricltl (ji`m cg jcirldirrmg jinemnltg). ]ng dlgrrmg sgneulnicmntg nmcpmrlidi nmingtgcm sueemrlsjm ung mntmrijicltm nmjritlzzgntm, nmc hg`hlnipl ergndm ung `gcgttlg lng``gtirlg jrinljg lntmstlngcm. Nmc rgnem dl

mt ji`prmsg trg sml `msl m dum gnnl, cm jindlzlinl dg jinsldmrgrm sinicg dlgrrmg jrinljg gspmjljg dmc cgttgntm, ung slndri`m pistmntmrltljg, cg

jmclgjblg. Lnamzlinl rmsplrgtirlm gssijlgtm dmvini sueemrlrm ung hrisl

jlstljg i ung l``unidmjlmnzg jinemnltg. Ln pgmsl divm vl ungctg

prmvgcmnzg dmccBLQ, qumstg dmvm mssmrm msjcusg prmjijm`mntm.Cmsg`m ihlmttlvi pmr`mttmr dl vgcutgrm gttmntg`mntm cg jrmsjltg m cisvlcuppi. Ci stgdli dmcci svlcuppi puhmrgcm utlcm pmr vgcutgrm ung`gcnutrlzlinm gssijlgtg g puhmrt rltgrdgtg.Zuccg hgsm dmccg stirlg jclnljg m dmccg vgcutgzlinm jclnljg sl pitr gvmrm unprl`i irlmntg`mnti su un dlsturhi aunzlingcm i iregnlji, pmr dlstlneumrmun gcgssirhl`mnti dg air`m dl lng``gzlinm jicinljg m pmr ldmntljgrm

cg nmjmsslt dl sujjmsslvm lndgelnl (Tghmccg =).Xmd ges, ji`m dlgrrmg jintlnug smvmrg m nitturng, sgneum m uji nmccmamjl, amjl `icti gjldm, pmrdltg dl pmsi i sjgrsi gjjrmsjl`mnti m slnti`lgssijlgtl pripmndini pmr ung air`g iregnljg.

TMXGVLG

Cg dlgrrmg jrinljg gssijlgtg gd uni stgti dl `gcnutrlzlinm dmvm mssmrmsm`prm jinsldmrgtg ji`m ung pgticielg smrlg m dmvm mssmrm printg`mntmgvvlgtg ung tmrgplg. Lc trgttg`mnti jinslstm sjbm`gtljg`mntm ln lsurm dlsuppirti emnmrgcm, rlghlcltgzlinm nutrlzlingcm m tmrgplg mdljg/jblrureljgln hgsm gccm dlvmrsm mzlicielm (cg tmrgplg dmccm spmjljbm jgusm nin dl

pmrtlnmnzg dl qumsti jgpltici).

Vmr qugnti rleugrdg lc suppirti emnmrgcm dmc pgzlmntm, piljb cm jinsm-eumnzm jclnljbm pl ergvl pissini mssmrm maamtti dmccg dlsldrgtgzlinm, l`pirtgntm lnstgurgrm printg`mntm ungdmeugtg rmldrgtgzlinm dmc hg`hl-ni jin ung sicuzlinm pmr cg rmldrgtgzlinm irgcm (ZXI). Lc tlpi dl sicuzlinm

7/25/2019 9_Diarrea Cronica Optimized

8/10

dg utlclzzgrm nmc hg`hlni jin dlsldrgtgzlinm gnjirg dlhgttuti, lnagttl,smhhmnm slg niti jbm cm sicuzlinl lpitinljbm rlspmtti g qumccm lsitinl-jbm rldujgni cg durgtg m cg qugntlt dl mvgjugzlinl dl amjl clquldl, studl

rmjmntl sueemrlsjini cg pgrl majgjlg dl sicuzlinl mcmttricltljbm rlspmttigccg sicuzlinm slicieljg.

Tgh. =-Lndgelnl pmr cg dlgenisl mzlicieljg dl dlgrrmg jrinljg

Nin-lnvgslvl Lnvgslvl

Vgrg`mtrl dl cghirgtirli MEDZ jin hlipslm dmc pljjici

lntmstlniLnalg``gzlinm 0 QMZ, VJX, trgnsg`lngsl Lcmijicinsjiplg

Gccmrelg 0 LeM, XGZT

Nutrlzlinm 0 m`ijri`i, gzitm`lg, mcmttricltl, VT,

Qlt. G, M, D, H78, Jg, amrrltlng, trlecljmrldl, jicmstmrici

L``unlt 0 LeG, M@G, gntl tTE

Tissljicielg

Aunzlingclt tlrildmg

Amjl

JicturmZtmgtijrlti

Ergssl amjgcl

Mcgstgsl

Gcag-7-Gntltrlpslng

Egp is`itlji

Hrmgtb tmst pmr vgcutgrm cgssirhl`mnti

Hrmgtb tmst gc cgttisli

Tmst dmc sudirm

Xx dlrmttg gddi`m

Ln hg`hlnl gcnutrltl, cg rlghlcltgzlinm nutrlzlingcm mssmnzlgcm, gnjbmln prmsmnzg dl unlnamzlinm mntmrljg. Dlmtm dl msjcuslinm vmneinipripistm jin lc dippli pripislti dl trgttgrm mvmntugcl lnticcmrgnzmgcl`mntgrl, jbm pissini mssmrm ung jgusg prl`grlg dl dlgrrmg jrinljg i

dmccm sum ji`pcljgnzm. Cg smqumnzg dl mcl`lngzlinm divrmhhm mssmrmmaamttugtg pgrtmndi dg pijbl gcl`mntl, rmstrlnemndi mvmntugc`mntm cgdlmtg gd gctrl gcl`mntl, pgrtmndi qulndl dg un ldriclsgti pritmlji i dgung air`ucg hgsgtg su g`lnigjldl clhmrl, g smjindg dmccg ergvlt dmcqugdri jclnlji. Gnjbm sm un dmjlt dl dlsgjjgrldgsl nin ung jgusg

armqumntm dl dlgrrmg pmrslstmntm, armqumntm un dmjlt trgnsltirli dl

cgttgsl smjindgrli gc dgnni dmccg `ujisg lntmstlngcm md gccg `gcnu-

trlzlinm, pmr jul ung dlmtg smnzg cgttisli divrmhhm mssmrm gvvlgtg lnienl hg`hlni jin dlgrrmg pmrslstmntm md lnjcusg nmccgceirlt`itmrgpmutlji dmccg UBI.

7/25/2019 9_Diarrea Cronica Optimized

9/10

Divrmhhm mssmrm sm`prm airnlti un gdmeugti gppirti jgcirlji. Clntgomjgcirlji divrmhhm mssmrm priermsslvg`mntm gu`mntgti gc =6% i gc dlsiprg dmccm rgjji`gndgzlinl dlmtmtljbm pmr smssi md mt. Ln dlvmrsl jgsl,

nmjmssgrli nutrlrm lc hg`hlni pmr vlg mntmrgcm jin un sindlni ngsieg-strlji i jin ung egstristi`lg i pmr vlg pgrmntmrgcm.Vmr qugnti rleugrdg cg tmrgplg `mdljg rlvictg gccg rlduzlinm dmc trgnsltidl uldl gttrgvmrsi clntmstlni, sl pissini utlclzzgrm ecl ipplgjml md l

ciri dmrlvgtl. Cg cipmrg`ldm cgemntm dl sjmctg pmrjb bg cg spmjlgcltgntldlgrriljg `geelirm. Cg si`gtistgtlng rldujm airtm`mntm cg dlgrrmgsmjrmtirlg jgusgtg dg tu`irl nmurimndijrlnl md gtrig dml vlccl.

Cg tmrgplg g cunei tmr`lnm dmcclnticcmrgnzg gc cgttisli dmvm lnjcudmrmcg rmlntriduzlinm dml jlhl jintmnmntl cgttisli, `g gcjunl dl qumstl sini`mecli ticcmrgtl dl gctrl. Ci yieurt nin pgstirlzzgti jbm jintlmnm ungqugntlt pgrl i supmrlirm dl cgttisli rlspmtti gc cgttm lntmri jintlmnm gnjbmun hmtg-egcgttisldgsl `ljrihljg jbm glutg cg dlemstlinm lntrgcu`lngcmdmcci zujjbmri. L air`geel stgelingtl ji`m ergng, m``mntbgc,hrlm sini `mecli ticcmrgtl rlspmtti g qumccl mcghirgtl. L jlhl jin gcti

jintmnuti dl ergssl jbm rgccmntgni ci svuitg`mnti egstrlji m qulndl lctrgspirti dmc cgttisli gcclntmstlni tmnum, pissini mssmrm ticcmrgtl dggcjunl pgzlmntl lnticcmrgntl gc cgttisli. Wulndl lc emcgti m lc cgttm lntmrisini `mecli ticcmrgtl rlspmtti gc cgttm sjrm`gti. Cm gctmrngtlvm pmr lpgzlmntl jbm nin ticcmrgni lc cgttm sini rgpprmsmntgtm dgc cgttm prmldri-clzzgti trgttgti jin mnzl`l qugcl cg cgttgsl dl dmrlvgzlinm `ljrihljg icgssunzlinm dl qumsti mnzl`g ln ji`prmssm lnslm`m gl pridittl dmccgttm durgntm l pgstl.Ln jgsi dl dlgrrmg jrinljg gspmjljg, ictrm gd ung dlmtg rmeicgrm md gccm-vmntugcm rlduzlinm dmccgssunzlinm dl sujjbl dl aruttg, pu mssmrm utlcmsi``lnlstrgrm cg cipmrg`ldm irgcm (6,7-6,8 e/oe/dlm) ln dum i trm disl.Ln jgsi dl sispmtti dl sivrgjrmsjltg hgttmrljg dmcclntmstlni tmnum, sldivrgnni prmndmrm ln jinsldmrgzlinm `idgclt dl suppirti jblrurelji,`mdlji m nutrltlvi. Cg tmrgplg gntlhlitljg prmvmdm cusi lnlzlgcm dl gn-tlhlitljl g cgrei spmttri (ms. `mtrinldgzici, mrltri`ljlng md g`pljlcclngln ji`hlngzlinm jin nmi`ljlng)? sicltg`mntm vlmnm maamttugtg ln jljcldl dum smttl`gnm. Cg rlspistg jclnljg sl bg emnmrgc`mntm mntri cg prl`gsmttl`gng dl tmrgplg.

Hlhcliergag mssmnzlgcm

- @gtbgl K, Xgku H, Hgvdmogr G. Vmdlgtrlj Egstrimntmriciey Jbgptmr, LndlgnGjgdm`y ia Vmdlgtrljs. Jbrinlj gnd pmrslstmnt dlgrrbmg ln lnagnts gnd yiunejblcdrmn; stgtus stgtm`mnt. Lndlgn Vmdlgtr. 8677? 42;:5-48.

7/25/2019 9_Diarrea Cronica Optimized

10/10

- Cmm OZ, Ogne DZ, mt gc. Biw ti di ln pmrslstmnt dlgrrbmg ia jblcdrmn9; Jin-jmpts gnd trmgt`mnts ia jbrinlj dlgrrbmg. Vmdlgtr Egstrimntmric Bmpgtic Nutr.8678?7=;88