Treatment of toddler’s diarrhea usually involves dietary modification and fluid restriction. Studies have shown that probiotics and proton-pump inhibitors (PPIs) or H2 blockers can control diarrhea tied to functional gastrointestinal disorders (FGIDs).

A study compared the efficacy of a short course of oral ranitidine and a probiotic in the treatment of toddler’s diarrhea.

The parallel-group randomized controlled trial (RCT) recruited 40 patients, of whom 20 were randomized to receive ranitidine treatment, ten to receive probiotic, and ten patients to receive placebo.

In the ranitidine group, patients were given oral ranitidine (3 mg/kg/day) once a day for 10 days. Patients in the probiotic and placebo groups received 5 to 10 billion colony-forming units (CFUs) per day of lyophilized Lactobacillus rhamnosus and 50 mg once a day oral vitamin C tablet, respectively, for 10 days. Primary outcomes included stool frequency and consistency on the 10th day. Student’s t-test was used to determine if there were significant differences in the mean daily stool frequencies in the three groups.

• In the ranitidine group, stool frequency declined significantly from an average of five per day on the first day to an average of about one per day on the 10th day of intervention. Stool consistency was normal on the 10th day.
• In the probiotic group, a significant reduction in stool frequency was noted, from an average of five per day on the first day to four per day on the 10th day. Stool consistency continued to be lose.
• Stool consistency and frequency were not significantly changed in the placebo group.

Oral ranitidine was more effective than probiotics for reduction of stool frequency and for normalizing stool consistency in toddler’s diarrhea.

Source: Uwaezuoke SN, Ndu IK, Eneh CI, et al. A short course of oral ranitidine as a novel treatment for toddler’s diarrhea: a parallel-group randomized controlled trial. BMC Pediatr. 2020;20:380.