Saccharomyces Boulardii Pak Armed Forces Med J 2021; 71 (2): 686-89 686 EFFICACY OF SACCHAROMYCES BOULARDII IN THE MANAGEMENT OF ACUTE WATERY DIARRHEA Misbah Munir, Sajid Ali Shah*, Saeed Zaman**, Lutfullah Goheer***, Sana Bushra****, Sajjad Ahmad Khan***** Mekran Medical College Turbat Pakistan, *Combined Military Hospital Skardu/National University of Medical Sciences (NUMS) Pakistan, **Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan, ***Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan, ****Civil Hospital Quetta Pakistan, *****Fauji Foundation Hospital Peshawar Pakistan ABSTRACT Objective: To determine the Efficacy of probiotic (saccharomyces boulardii) in children (2 months to 5 years) with acute watery diarrhea. Study Design: Comparative cross sectional study. Place and Duration of Study: This study was carried out in the department of pediatrics, Combined Military Hospital, Quetta, from Jan 2017 to Jun 2018. Methodology: All children (2 months to 5 years) with acute watery diarrhea presenting within 24 hour of illness with no dehydration and some dehydration were enrolled and divided into two groups, study group and control group. Efficacy was assessed by reduced frequency of stools(less than 3 per day) and duration during the study period. Results: Mean age of the children in probiotic saccharomyces boulardii group was 3.42 ± 1.36 years, while mean age in control group was 3.91 ± 1.16 years (p-value 0.002). Significant difference was also observed in duration of stool and frequency of stool at day 1-5 (p-value <0.05). Statistically significant difference was observed among children in probiotic sacchramyces boulardii group 114 (53%) as compared to controls 101 (47%) (p-value 0.021). Conclusion: The Efficacy of probiotic (saccrharomyces boulardii) was found satisfactory in children (2 months to 5 years) with acute watery diarrhea. In children with acute watery diarrhea saccrharomyces boulardii may be recommended for better outcome. Keywords: Acute watery diarrhea, Children, Dehydration, Probiotics, Saccrharomyces boulardii. INTRODUCTION As per World Health Organization (WHO) defini- tion, stool emission with a frequency of 3 or more loose stool per day is termed as diarrhea. Quantification of stool in children especially in diaper babies may be difficult 1,2 . Different mechanisms have been presumed for diarrhea. The final result of all the mechanisms is either increase in the volume of stool or there may be increase in stool frequency. Multiple factors are invol- ved in water balance across the intestine mucosal me- mbrane 3-5 . Diarrheal diseases are considered the fifth most leading cause of mortality in under 5 years chil- dren and the 8 th leading cause of death among all ages, worldwide 6 . It is also the main cause of childhood mortality and morbidity in Pakistan: highest mortality from moderate to severe diarrhea reported from some part of Pakistan among south Asian countries 7,8 . Different etiological factors are involved in cau- sing diarrhea. The most common cause of diarrhea is infection, with viruses top of the list. About 20% of infectious diarrhea is due to bacteria. Common strain of bacteria responsible for diarrhea are E.Coli, Salmo- nella and campylobacter species etc. Besides bacterial infections, diarrhea may be caused by parasites and fungal infections. There are non-infectious causes of diarrhea as well like antibiotic associated diarrhea, diarrhea caused by toxins and some non-organic me- tals (Magnesium) ets. At time diarrhea may be a mani- festation of systemic illness, particularly in children. Children with otitis media, encephalitis and pneumo- nia may present with loose motion. Route of transmis- sion in most cases is oro-fecal. The spread of infections is due to unhygienic environment 9 . Infection may spread from person to person by direct contact or by taking contaminated food and water. The infection may remain localize to the intestine or may spread to other organs. The sign and symptoms then depend on the pathogenicity of the bacteria and the organ invol- ved. The patients may present only with loose motion and vomiting or sometime may be having systemic symptoms as well like fever, malaise, respiratory and renal symptoms. Some organisms may result in fatal outcome, like Clostridium difficile, which may lead to life threatening colitis 10 . We carried out our study with the aim to prove whether probiotics are efficacious in acute watery diarrhea or not. If proved to be efficacious, then This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Dr Sajid Ali Shah, Department of Peads, Combined Military Hospital Skardu Pakistan Received: 16 Jan 2020; revised received: 04 Nov 2020; accepted: 01 Apr 2021 Sajid_theone@yahoo.com Original Article Open Access