From the Guidelines
Zinc sulfate is a highly effective supplement for the treatment of diarrhea and gastroenteritis, particularly in children, as it reduces the duration and severity of diarrheal episodes. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, oral zinc supplementation is strongly recommended for children 6 months to 5 years of age who reside in countries with a high prevalence of zinc deficiency or who have signs of malnutrition. The recommended dose is 10-20 mg of zinc elemental daily for 10-14 days for children.
Key Points to Consider
- Zinc supplementation improves water and electrolyte absorption in the intestine, strengthens the intestinal barrier, and modulates the immune response.
- It is particularly important in developing countries where zinc deficiency is common.
- Zinc sulfate should be administered alongside oral rehydration therapy and continued for the entire recommended period, even after symptoms improve.
- Common side effects are generally mild and include nausea or a bad taste.
- Zinc sulfate does not replace rehydration, which remains the cornerstone of acute diarrhea treatment.
Clinical Application
In clinical practice, zinc sulfate can be used to treat diarrhea and gastroenteritis in children and adults, with a focus on those with zinc deficiency or malnutrition. The treatment should be tailored to the individual patient's needs, with close monitoring of symptoms and side effects. Overall, zinc sulfate is a valuable adjunct to oral rehydration therapy in the management of diarrhea and gastroenteritis, particularly in high-risk populations 1.
From the Research
Role of Zinc Sulfate in Diarrhea and Gastroenteritis Treatment
- Zinc sulfate has been shown to reduce the duration and severity of diarrhea in children 2, 3, 4
- Studies have demonstrated that zinc treatment, in conjunction with oral rehydration therapy, decreases stool output and shortens the duration of diarrhea 2, 4
- The use of zinc sulfate in the treatment of acute diarrhea has been recommended by the WHO/UNICEF, with a suggested dosage of 20 mg zinc/day for 10-14 days for children with acute diarrhea 5
- Zinc supplementation has also been found to reduce the risk of continued diarrhea and the proportion of diarrheal episodes lasting more than 5 or 7 days 2, 4
Efficacy and Safety of Zinc Sulfate
- A meta-analysis of randomized, controlled trials found that supplemental oral zinc therapy significantly reduced the duration and severity of acute and persistent diarrhea in children 4
- The study also found that zinc supplementation was associated with a higher incidence of vomiting, particularly when zinc gluconate was used instead of zinc sulfate/acetate 4
- Another study found that a zinc-containing hypotonic oral rehydration solution in a gel formulation was effective in reducing the severity and duration of diarrhea in children, with no adverse events reported 3
Benefits and Recommendations
- Zinc sulfate has been shown to be a low-cost and life-saving treatment for diarrhea and other infections, particularly in developing countries 6, 5
- The use of zinc sulfate in conjunction with oral rehydration therapy is recommended for the treatment of acute diarrhea in children 2, 5
- Further studies are needed to determine the efficacy of zinc supplementation in preventing and treating diarrhea in adults 5