Figure 2. Diagnostic and therapeutic approach to prolonged diarrhea.

*Feeding pattern should be normalized according to the “4F” role: fat (increase dietary lipids to at least 35–40% of total daily energy intake), fiber (normalize fiber intake by introduction of fruits and wholegrain bread), fluid (restrict fluid intake if history is significant for high fluid consumption), and fruit juice (discourage overconsumption of fruit juices, especially those containing sorbitol or a high fructose/glucose ratio).

§ Empiric antibiotic treatment should cover most probable enteric infections ( Shigella and enteropathogenic Escherichia coli) and/or small intestine bacterial overgrowth.