Abstract In Reply.—Dr Graham's interest in and comments on our work are appreciated. As our attention focuses increasingly on diet and other environmental factors that affect disease states, we agree that we must exert great care attributing these relationships to cause and effect. This is particularly important in an era when nutritional data evolve into national policy. Abnormal bowel movements have been characterized as disease states since the second century ad, when Arataeus described diarrhea as "the discharge of undigested food in a fluid state." Attempts to quantify diarrhea more precisely have met with little success, since "normal" bowel function differs for each person. Even the best index, stool weight, cannot suffice, particularly in cross-cultural comparisons.1 Thus, one cannot use these measures alone to standardize what is diarrhea and what is not. One must evaluate the change in stool pattern for the individual patient. The patients described in References 1. Phillips SF: Diarrhea: A broad perspective . Viewpoints Dig Dis , (November) , 1975. 2. Cohen SA, Hendricks KM, Eastham EJ, et al. Chronic nonspecific diarrhea: A complication of dietary fat restriction . Am J Dis Child 133:490-492, 1979.Crossref 3. MacLean WC, Klein GL, deRomana GL, et al: Transient steatorrhea following episode of mild diarrhea in early infancy . J Pediatr 92:562-565, 1978.Crossref 4. Lloyd-Still JD: Chronic diarrhea of childhood and the misuse of elimination diets . J Pediatr 95:10-13, 1979.Crossref 5. Cohen SA, Lake AM, Mathis RK, et al: Perspectives on chronic nonspecific diarrhea: Dietary management . Pediatrics 61:808-809, 1978.Crossref 6. Cohen SA, Hendricks KM, Laramee S, et al: Chronic nonspecific diarrhea: Dietary relationships . Pediatrics 64:402-407, 1979.
American Journal of Diseases of Children – American Medical Association
Published: May 1, 1980