Recent studies have indicated that enteral diets can play an important role in the treatment of persistent diarrhea. Khitchri, a local weaning food in Pakistan, is composed of rice and lentils, which have previously been shown to be well tolerated in many children with acute diarrhea. The effectiveness of a khitchri and yogurt (KY) diet, which is inexpensive and widely available in Pakistan, was studied. One hundred two weaned boys (6 to 36 months old) with persistent diarrhea were randomly assigned to receive either soy formula (group A) or the KY diet (group B) for 14 days. Group A also received the KY diet in addition to formula for days 8 through 14. Twenty-nine children did not complete the study because of severe infection (13) or their family's decision to leave the study early (9 in group A and 7 in group B). Sixty-six children successfully completed the study protocol; there were five clinical failures in group A and two in group B. On a comparable caloric intake, there was a significantly lower stool volume (group B: 38 ± 16 [mean ± SD] vs group A: 64 ± 75 g/kg per day, P < .05) and frequency (B: 4.4 ± 2.0 vs. A: 6.6 ± 4.2 stools per day, P < .005) in children fed KY during the first week of therapy. Group B children also had a significantly greater weight gain than children in group A during the first week (B: 468 ± 373 g/wk vs A: 68 ± 286 g/wk, P < .005). The addition of KY to the diet of the soy-fed group in the second week of therapy resulted in a significantly greater weight gain compared with the first week (575 ± 408 g/wk, P < .005). These data indicate that a traditional rice-lentil and yogurt diet can be successfully used for the dietary management of persistent diarrhea in children.
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