DISEASES OF THE INTESTINAL TRACT
ACUTE AND CHRONIC DIARRHEA (CATARRH), ENTEROCOLITIS, DYSENTERY,
CONSTIPATION, APPENDICITIS, CHRONIC CONSTIPATION, AUTO-INTOXICATION
Diarrhea, like gastritis, may be a symptom of many diseases and a
result of many digestional disturbances. Enteritis, enterocolitis,
dysentery, typhoid fever, and certain cases of tuberculosis and
syphilis are all accompanied by an inflamed condition of the mucous
lining of the intestinal walls, and in each of these pathological
conditions we may find diarrhea as a resulting symptom.
~Causes.~--Diarrhea may be acute or chronic in character. It may be
brought on by errors in diet, warm weather, certain drugs, ptomaines,
bad hygiene, polluted water or milk, and by overeating. Idiosyncrasies
against certain kinds of food have been found in both adults and
children; these idiosyncrasies are manifested by pain and diarrhea
whenever the offending foods have been eaten. Acute diarrhea has also
been brought on in children by the drinking of cold lemonade when
over-heated.
~Diarrhea in Children.~--All diarrheas in children, and especially
those developing during the hot months, must be looked on with
suspicion and given immediate attention before they have an
opportunity to develop serious features which may terminate in death
before the seriousness of the condition is realized.
As a rule, almost any diarrhea in children will raise the temperature.
This does not occur so often with adults unless the diarrhea results
from infectious fevers, ptomaines, etc., in which case it may rise
suddenly and to a considerable height.
ACUTE ENTERITIS (DIARRHEA)
~The Bowels.~--The symptoms of this condition are too liquid or too
frequent stools, the number varying from three to twelve or more a
day. They may be greenish yellow in color and contain particles of
undigested food and mucus. In prolonged diarrheal attacks the stools
sometimes contain blood.
The attack may be accompanied by more or less pain of a colicky
nature, due to the formation of gas in the intestinal tract. In
ptomaine poisoning this pain is sometimes very intense. As a rule the
intestinal tract is emptied by means of salt, oil, etc., but this is
generally directed by the physician. A soapsuds or salts and glycerin
enema to flush the colon will often give quick relief by dispelling
the gas.
~Starvation.~--The entire digestive tract requires absolute rest for a
certain period; no food and very little water, the latter in the form
of bits of ice only, are given for a period lasting from twelve to
thirty-six hours or more, depending upon the violence of the attack
and the condition of the patient. This is to allow the toxic
substances which are probably causing the disturbance to pass out of
the body, either in the feces or in the urine. When the acute symptoms
subside, that is, when the pain and distention of the intestines have
disappeared, and the bowel movements become more normal in number and
character, the dietetic treatment suitable to the condition is
instituted.
~Dietetic Treatment.~--The first day the patient is given a small cup
of weak tea, half a glass of buttermilk or peptonized milk, or a cup
of well-skimmed meat broth, every three or four hours. If the patient
is weak, the nourishment may be given oftener, and in those cases it
is often found advisable to give a small amount of alcohol in the
form of brandy in albumen water, or panopepton or liquid peptonoids.
These may be administered in tablespoonful doses every two hours.
Whole milk, unless it is peptonized, and at times even then, is not
advisable in diarrheal conditions on account of its liability to form
curds which decompose with the production of toxic substances, known
to be exceedingly irritating to the already inflamed mucous membranes
lining the intestinal walls.
~Increasing the Diet.~--As the diarrhea and inflammation subside, the
following foods are gradually introduced into the dietary, keeping in
mind always that a return of the acute symptoms is apt to occur. Hence
the patient must never be overfed. It is better to err on the side of
too little than too much food during the early convalescent period.
~Diet.~--Soft-cooked eggs, toast (slightly buttered), cocoa made with
water instead of milk, chicken, calf's-foot or wine jelly; later,
well-cooked rice, junket, and soft custard; still later, lightly
broiled beefsteak, lamb chops, chicken, squab or quail, sweetbreads or
brains. Not until the patient is entirely free from all symptoms of
diarrhea or intestinal disturbance may the following foods be given:
cream or cream dishes such as cream toast, cream chicken, or cream
soup, raw or stewed fruit, green vegetables, salt foods, spiced foods
of any description; pastries, confectionery and desserts in general,
unless they are simple in character and are sweetened with saccharin
instead of sugar, as the latter substance is particularly susceptible
to fermentation.
~Anemia as a Result.~--Anemia is one of the most common results of
prolonged diarrheal attacks, especially in those toxic diarrheas
resulting from infectious diseases, dysentery, etc. The blood-making
tissues suffer from a lack of nourishment and are in consequence
incapable of producing blood of the best quality. Hence the starvation
treatment cannot be carried on over a very extended period or the
resulting anemia may be more difficult to overcome than the original
trouble.
~Selecting and Regulating the Diet.~--The following points must be
kept in view when regulating the diets of individuals who are prone to
develop diarrhea:
~Preparing the Diet.~--Only such foods as are known to agree with the
individual, and these prepared in the simplest manner possible, must
have a place in the dietary.
~Fermentation.~--All foods that are subject to fermentation either in
the stomach or intestines must be withheld, at least until the attack
is well over. Sugar is an example of such foods; saccharin may be
substituted when necessary.
~Avoidable Foods.~--Pork, veal, and shellfish must be left out of the
dietary, possibly for months, since they have been found frequently
not only to bring about a return attack of diarrhea but also to have
been the cause of the original one.
Fatty foods of all sorts had best be avoided as long as there are
symptoms of diarrhea; these foods are handled with difficulty by the
digestive apparatus and impose extra work upon the intestine, which is
already taxed by the disease.
~Restricting Fluids.~--Fluid foods should be more or less limited in
the diet, since they require more effort on the part of the intestines
than the more concentrated foods.
~Proprietary Foods.~--Certain proprietary infant foods[94] are at
times found to be exceedingly valuable, since they furnish food in a
concentrated and digestible form. Among these Mellin's Food, Racahout,
and Imperial Granum may be mentioned.
CHRONIC ENTERITIS
~The Stools.~--When the diarrhea is chronic in character, the
character of the stools indicates the seat of the inflammation. When
there is a great deal of undigested food found in them the upper part
of the bowel is more affected; when the stools contain more mucus than
food the lower bowel is the chief seat of the trouble. The frequency
and fluidity of the stools impose a great strain upon the entire body,
causing a progressive emaciation and anemia.
The treatment is similar to that instituted in acute attacks. The
starvation regime cannot be carried out for a long period. Efforts
must be made to ascertain the cause of the trouble and to overcome it.
This is, as a rule, more easily accomplished with adults than with
infants and children.
~Dietetic Treatment.~--The diet is the chief point of observation and
attention. The same care must be observed as is found necessary in the
after-treatment of acute diarrhea. The patient must be cautioned not
to eat indigestible foods or those which are known to cause trouble in
this respect. She must be warned against eating when over-tired.
ENTEROCOLITIS
Enterocolitis is an inflammation of the lower intestines and colon.
The stools contain more mucus than those occurring when the
inflammation is higher up in the intestines and blood is also more
frequent in these stools. The prostration is more marked and the fever
apt to be higher than in ordinary diarrheal attacks. However, acute
attacks of enterocolitis do not produce the marked anemia or the
emaciation which are so common in the chronic cases of enteritis.
Dietetic treatment the same as that used in acute diarrhea.
ACUTE DYSENTERY
Dysentery is a disease in which the seat of inflammation is the colon.
The bowels are distended and tender, the pain at times is acute and
spasmodic, and the fever moderate. The constant desire to defecate and
the straining which accompanies each effort, as well as the small
stools, containing both blood and mucus, furnish the characteristic
symptoms of this disease. Rest in bed is absolutely necessary; the
patient must be induced to use a bedpan.
~Dietetic Treatment.~--The diet consists entirely of liquids as in
acute diarrhea, the same careful regime being observed as in those
conditions. The soreness in the abdomen is at times relieved by spice
poultices or a hot turpentine stupe.
CHRONIC DYSENTERY
When the above conditions become chronic, the patient loses weight and
strength rapidly, becomes anemic and emaciated. The treatment, like
that used in the acute disease, consists of rest and liquid diet. The
medicinal treatment is left entirely in the hands of the physician.
APPENDICITIS
Appendicitis is an inflammation of the vermiform appendix. It may be
acute or chronic in form.
~Symptoms.~--The disease is manifested by sudden pain in the right
side, tenderness over the seat of the inflammation, and a localized
rigidity of the right iliac fossa. The attack is as a rule accompanied
by fever which may run as high as 103 deg. or 104 deg. F. The patient may
suffer from nausea and vomiting. Constipation is generally an annoying
symptom of the disease.
~Rest in Bed.~--The treatment of the acute attack consists of total
abstinence from food for twelve or more hours until the most acute
stage has passed and the patient either passes into the hands of the
surgeon or the symptoms begin to subside in violence. It is necessary
that the patient be kept in bed, not being allowed to rise for
anything. The nurse must make him understand that his recovery,
possibly his very life, depends upon his absolute quiet during the
early stages of the disease.
~Dietetic Treatment.~--When the first acute symptoms have passed, the
diet must consist of fluids, well-skimmed meat broths, buttermilk,
peptonized milk, albumen water or albumenized orange juice. No solid
food must be given until the acute symptoms have disappeared. When the
tenderness in the right side has entirely left him and he no longer
suffers the pain or nausea, a gradual return to a normal diet may be
made. The patient must be cautioned against eating indigestible foods,
as an attack of intestinal indigestion may readily start up an
irritation in the susceptible appendix and cause a second attack of
appendicitis which is often of a more serious nature than the first.
~Convalescent Diet.~--The return to solid food is made gradually as in
other intestinal disorders, by giving the most digestible foods first.
Soft toast, soft eggs, fine cereal gruels, well-cooked rice,
well-baked white potatoes, meat, wine or fruit jellies; then lightly
broiled beefsteak, lamb chop, chicken, sweetbreads, or brains given in
small quantities until the intestinal tract has regained its vigor.
~Foods to Be Avoided.~--Highly seasoned foods must be avoided on
account of their astringent qualities, which may cause constipation.
Long, tough-fibered meats, coarse vegetables, rich foods, in fact
anything which may cause intestinal indigestion, must be eliminated
from the dietary. A decomposition of the foods lying in the lower part
of the small intestine is dangerous to such individuals, since such
products are highly toxic in character and exceedingly irritating to
the already tender appendix.
CHRONIC CONSTIPATION
Chronic constipation is so universal a condition that it must be
treated and overcome whenever it is possible. This condition is not
only the cause but the result of disease. It may be induced by
improper food, poor hygiene, sedentary habits, lack of exercise, the
taking of drug preparations such as cough sirups which contain opium
in some form, the constant taking of cathartics and enemas, or it may
be an hereditary condition.
~Diet, Exercise, and Fresh Air.~--The chief means of overcoming this
deplorable chronic condition is by regulating the diet and increasing
the amount of exercise in the fresh air.
At times it is necessary to resort to artificial stimulation of the
intestinal movements; at others, on account of the disease of which it
is only one of the symptoms, it is dangerous to irritate the already
inflamed mucous membranes lining the intestinal wall. In these cases
the physician prescribes the method of procedure. In ordinary cases,
however, the following suggestions may be used as a guide in
overcoming the condition.
~Available Foods.~--It must be borne in mind that the food must not be
too concentrated in character or it will be so completely absorbed as
to leave little or no residue for the feces, and since the waste
products of metabolism, both of food and body materials, must be
eliminated, a certain amount of fecal matter is necessary to assist in
this work. Vegetables, such as celery, turnips, lettuce, asparagus,
string beans, spinach, and beans, lentils, lima beans, and onions;
fruits, such as raisins, figs, and prunes; and cereals which have not
had all the bran removed, such as cut oats, cracked wheat, etc., on
account of the cellulose they contain, act admirably in overcoming
chronic constipation. It is found, however, that when even these are
not sufficient in certain cases, bran added to the food, either
alone, with the breakfast cereal, or in the form of biscuits, muffins,
or cookies, will give just the necessary amount of ballast to the food
mass to make it stimulate the peristaltic movements by its pressure
upon the intestinal walls.
~Stimuli to Peristalsis.~--Foods yielding certain acids exert a
stimulating action upon intestinal peristalsis.
~Available Foods.~--Those particularly valuable for this purpose are
limes, oranges, apples, prunes, figs, raisins, and most fruit juices
(with the exception of blackberries, which are constipating),
tomatoes, and rhubarb. The fruit juices may be diluted with water or
carbonated water (in the latter case the action is increased because
of the gas contained in the water), and taken the first thing in the
morning, or the fruit may be eaten at night before retiring, and in
the morning on an empty stomach. Prune pulp or prune jelly may be
given to children as well as to adults. The action of this fruit is
augmented by the addition of senna leaves. A conserve made of prunes,
figs, and raisins given in teaspoonful doses at night and before
breakfast often gives splendid results in curing chronic constipation.
~Gas-forming Foods.~--The eating of foods which give rise to a slight
formation of gas owing to their tendency to ferment likewise acts as a
stimulus to intestinal movements. Among these may be mentioned honey,
molasses, cauliflower, cabbage, spinach, and onions. If the honey and
molasses are poured on bran muffins or biscuits, on breakfast food, or
added as sweetening agents to cookies, they will be found particularly
valuable. Care must be taken, however, not to give too much of either
of these foods or they will disturb the digestion and do more harm
than good.
~Use of Salt Foods.~--Foods such as herring, caviar, anchovies, ham,
etc., on account of the salt they contain, exert a stimulating effect
upon the movements in the small and large intestines. Graham bread,
spread with brown sugar, molasses, or honey, makes an acceptable
addition to the meal of the majority of children and to that of many
adults.
~Fats and Mineral Oils.~--The use of fats is often recommended; olive
oil may be given in tablespoonful doses before breakfast and at night
or it may be served on vegetables and salads. If one or two
tablespoonfuls are taken at night and before breakfast, it may act as
a laxative. In many cases, however, this oil is completely absorbed in
the small intestine and hence there is none left to lubricate the
passage for the food mass. When vegetable oils do not prove
satisfactory, mineral oils may be substituted. These oils have
absolutely no fuel value and are not digested in the intestinal canal
but mix with the fecal mass, softening it and stimulating its passage
through the large intestine. There are certain individuals with whom
the mineral oils do not act as lubricants and instead of softening the
feces and lubricating the passage will slip through the intestinal
canal without carrying the feces along.
~Sample Diet Sheets.~--The following menus are suggested for the use
of individuals suffering with chronic constipation:
BREAKFAST
7 A.M. Orange juice and water.
8 A.M. 1 bran muffin with honey and cream.
1 or 2 slices of bacon.
Whole wheat biscuits.
A cup of coffee, cereal coffee, or hot milk (not boiled).
LUNCHEON
1 P.M. Casserole of beef made with lean beef.
Turnips and potatoes.
Graham bread or muffins and honey or preserves.
Milk or "hot water" tea.
DINNER
Tomato bouillon.
Roast lamb.
String beans.
Potatoes baked with jackets on.
Celery salad, dressed with plenty of oil and lemon juice.
Prune jelly with whipped cream.
BREAKFAST
Prunes and figs cooked together.
Slice of ham with 1 soft-cooked, poached, or scrambled egg.
Whole wheat or bran biscuits.
Coffee with cream and sugar.
LUNCHEON
Vegetable soup.
Pork and beans.
Boston brown bread.
Baked apple (skin eaten).
Oatmeal wafers.
DINNER
Roast beef.
Spinach or cauliflower served with butter sauce.
Cold slaw.
Pineapple jelly (pineapple left in), whipped cream,
or
Date and fig pudding.
AUTO-INTOXICATION
Auto-intoxication is a condition produced by the absorption of the
decomposition products of food in the intestinal canal.
~Absorption of Toxins.~--As a rule the condition occurs in
individuals suffering more or less from constipation which may be due
to errors in diet or a lack of tone in the intestines, giving rise to
a sluggishness in the peristaltic movements in this region of the
alimentary canal. In certain individuals the liver is more or less
sluggish, or in some way fails to do its regular work of detoxifying
the products of metabolism brought in by the blood stream, in which
case these toxins are reabsorbed into the system and induce a
condition known as auto-intoxication.
~Care of Bowels.~--As a rule the patient has more or less fever,
nausea and at times vomiting. The head aches and the abdomen may be
distended by the formation of gas in the intestines. The treatment is
like that used in the majority of intestinal disorders. The bowels are
emptied by means of soapsuds or salts and glycerin enemas. Certain
physicians recommend an enema made with equal quantities of milk and
molasses, with enough hot water added to make a thin, warm solution.
Care must be used in preparing this flatus enema on account of the
danger of curdling the milk with the acid in the molasses and the hot
water. If the solution should curdle it must be discarded and a fresh
solution prepared. A flatus enema containing salts, glycerin, and a
few drops of turpentine is also valuable in removing the gas formed by
the action of the putrefactive bacteria upon the unabsorbed food mass.
This enema must be given "high" so as to reach the spot in the colon
where it may efficiently do its work.
~Dietetic Treatment.~--The diet may consist of fluids for the first
few days, or as long as the fever continues. ~Buttermilk~ is probably
the best fluid food to use under such conditions, since it not only
nourishes, but likewise furnishes lactic acid bacteria which aid in
the destruction of the more harmful bacteria, especially numerous
under the conditions just mentioned. When whole milk is given it is
best to peptonize it. Well-strained meat broths may be given
occasionally to vary the diet and albumenized orange juice or orange
juice in carbonated water may also be given once or twice daily during
the febrile period. After this, the patient may have well-cooked
cereal gruels. These may be dextrinized with vegetable diastase (Taka
diastase) if necessary. A return to normal diet is made gradually to
prevent a return of the trouble. The patient should be advised against
overeating, and eating highly seasoned or indigestible foods.
~Convalescent Diet.~--The diets recommended for use during
convalescence from other intestinal disorders may serve here,
reducing, however, the allowance of meat, since meat proteins are
particularly susceptible to attacks of putrefactive bacteria.
~Dietary Precautions.~--After the body has returned to its normal
state, the patient must keep in mind the danger arising from
constipation and intestinal putrefaction. The following menu is given
as a guide to aid the individual in selecting a diet which will in a
measure assist in preventing future attacks of intestinal putrefaction
and auto-intoxication:
7 A.M. 1 glass of water with orange or lime juice.
BREAKFAST
8 A.M. Stewed prunes or figs.
Cereal and cream.
Buttered toast.
Crisp bacon.
Coffee.
LUNCHEON
Vegetable or tomato soup.
Green vegetables such as cauliflower, greens, or tomatoes; or
Baked dishes such as macaroni and cheese, scalloped macaroni and
tomatoes; or
Baked potatoes, or potatoes _au gratin_, or stuffed tomatoes with rice.
Stewed fruit or fruit jelly.
Sponge cake with simple sauce.
Junket.
Toasted crackers or bread.
DINNER
Milk soup.
Cream of spinach, celery, peas, or tomatoes.
Baked eggs, cheese souffle or nut loaf.
Tender green peas, cauliflower, spinach, boiled or creamed potatoes,
well-boiled rice.
Fruit, vegetable, tomato, or cheese salad.
Simple dessert, such as cottage pudding with simple sauce, fruit
pudding, prune whip, or frozen desserts; ice cream or water ices;
or
Cheese and crackers.
Coffee.
SUMMARY
DIARRHEA
~Character.~--Acute or chronic, accompanying many pathological
conditions, especially in children in whom diarrhea in any form must
be given immediate attention.
~Causes.~--Errors in diet, polluted water or milk, ptomaines, bad
hygiene, and certain drugs.
~Bowels.~--The stools vary in number from three to twelve a day. They
may be greenish yellow in color, containing mucus and particles of
undigested food and, in prolonged cases, blood.
~Treatment.~--Rest in bed and total abstinence from food for from
twenty-four to forty-eight hours. Salines are usually given by mouth
or by rectum, but this is left to the discretion of the physician.
Very little water is given by mouth during the period of total
abstinence. Thirst is relieved by bits of ice, and enemas are given if
necessary.
~Administration of Diet.~--When acute symptoms have disappeared and
the stools are becoming more normal in character and number, a fluid
diet of from four to six ounces is administered every three or four
hours or oftener if patient is very weak. Brandy may likewise be given
in cases in which exhaustion is marked.
~Dietetic Treatment.~--Concentrated foods of the simplest character
and only those known to agree. Proprietary infant or invalid foods,
except malted foods, which exert a laxative effect; among those found
to be good may be mentioned Mellin's Food, Imperial Granum, and
Racahout.
~Foods to Be Avoided.~--Fatty foods; pork, veal, and shellfish; all
foods that are subject to fermentation in the stomach or intestinal
tract (sugar).
~Foods to Be Limited.~--Fluids, soup, beverages, etc., because they
impose more work on the intestines.
ENTEROCOLITIS
~Seat of Inflammation.~--Lower intestine and colon.
~Differentiating Characteristics.~--More mucus and blood in stools;
greater prostration; greater rise of temperature; and less anemia than
in chronic enteritis.
~Dietetic Treatment.~--Practically the same as in other diarrheas.
DYSENTERY
~Characteristic Symptoms.~--Acute and spasmodic pain, tenderness and
distention in the bowels, moderate fever, straining and a constant
desire to defecate, small stools containing blood and mucus, loss of
weight and marked anemia when condition becomes chronic.
~Treatment.~--Rest in bed absolutely necessary; the use of the bedpan
made obligatory; soreness relieved by hot turpentine stupes or spice
poultices.
~Dietetic Treatment.~--No food for a period of from thirty-six to
forty-eight hours, after which fluids and the regime recommended in
acute diarrhea are advisable. In chronic dysentery the diet is
practically the same. The extreme exhaustion and anemia accompanying
these conditions make it necessary to increase the diet carefully but
soon to offset as far as possible the devastating effects of the
disease.
APPENDICITIS
~Treatment.~--Confinement to bed is absolutely necessary while acute
symptoms prevail. The life of the patient may depend upon the care
with which this "quiet" period is carried out. No food should be given
for twelve or more hours to enable the physician to make a proper
diagnosis and to allow the intestinal tract and appendix complete rest
from the irritating effects of food passing down the canal.
~Dietetic Treatment.~--~Acute Stage:~ Total abstinence for a period,
after which fluids as given in other acute intestinal disorders. No
solid food until acute symptoms have subsided; then a gradual return
to normal.
~Convalescence.~--When tenderness in right side has disappeared, the
return to a normal diet is made gradually. Gelatin, soft eggs, soft
toast, fine cereal gruels, well-cooked rice, well-baked white
potatoes, tender rare beefsteak or lamb chops, the breast of chicken,
sweetbreads, and brains are recommended.
~Relapse or Recurring Appendicitis.~--The patient must be warned
against eating indigestible foods or any kind of foods liable to cause
constipation; also against overeating or eating when over-heated or
over-tired. One attack predisposes to another, hence the above
precautions are necessary to prevent the condition from becoming
chronic.
CHRONIC CONSTIPATION
~Causes.~--Improper foods, indoor occupations leading to a lack of
fresh air and exercise, bad hygiene, certain drugs, such as cough
sirups, etc., containing opium in some form, constant use of
cathartics and enemas to move the bowels, heredity.
~Dietetic Treatment: Foods to Be Avoided.~--Highly spiced foods must
be avoided on account of their astringent qualities, too concentrated
foods because they fail to furnish the necessary bulk without which
the waste matter cannot pass out of the body at a sufficient rate of
speed to prevent putrefaction taking place in the intestinal tract.
~Foods Stimulating Peristalsis~ on account of their bulk: Bulky foods,
such as vegetables, cabbage, turnips, cucumbers, spinach, beans,
celery, lettuce, etc.; cereal foods containing a high percentage of
bran, bran bread and cookies, fruits such as raisins, prunes, figs.
~Foods Acting as Stimuli to Intestinal Movements~ on account of their
acid content: Limes, oranges, apples, prunes, figs, raisins, most
fruit juices (blackberries excepted), rhubarb, tomatoes, cauliflower,
spinach, onions, honey, and molasses; senna leaves likewise have a
distinct action upon the peristaltic movement of the intestines, hence
are included here.
~Precautions.~--Emphasis should be placed upon the dangers of (1)
overeating any of the foods indicated in the above list and thus
bringing about conditions more dangerous in result than the original
disturbance; (2) the taking of drugs to move bowels on account of the
ease with which the habit is acquired and the consequent inability of
the bowels to move without such whips; (3) the taking of too little
water, thereby allowing a too concentrated condition of the food mass
and a consequent accumulation of substances which inhibit peristaltic
action.
~Use of Fats and Mineral Oils.~--Olive and other vegetable oils, if
not completely absorbed, are advised on account of their lubricating
effects. The same can be said of the mineral oils which have no food
value but in many cases furnish the lubricant necessary in certain
individuals suffering from sluggish intestinal peristalsis.
PROBLEMS
(a) List the food used in the treatment of enterocolitis; outline the
method of administering the diet.
(b) Formulate a convalescent diet for diarrheal cases.
(c) List the foods used in chronic constipation; list the avoidable
ones.
FOOTNOTE:
[94] Malted foods are contraindicated, as malt exerts a very laxative
effect.