Fecal pH as a marker of stunting among children hospitalized for diarrhea and other non-diarrheal pathologies

Background: Fecal pH is a simple, non-invasive diagnostic tool used for initial screening of certain gastrointestinal (GI) diseases. Increased fecal pH indicates reduction of beneficial microbiota in the gut, which has emerged as a key factor contributing to stunting. The purpose of this study was to investigate the association of fecal pH with stunting in hospitalized children. Methods: This cross-sectional study was conducted on 200 children aged 06-24 months getting admitted in icddr,b Dhaka Hospital with diarrhea and Dhaka Shishu Hospital for other non-diarrheal pathologies. Length-for-age Z scores (LAZ) was measured and data on factors affecting linear growth was recorded. Fecal pH was measured on freshly collected stool samples following standard procedure. Multivariate linear regression was performed to explore relationship between fecal pH and LAZ scores. Results: The mean fecal pH of diarrheal and non-diarrheal children was 5.54±0.98 and 5.95±0.76, respectively. After inclusion of factors affecting linear growth into the regression model, a statistically significant inverse association between fecal pH and LAZ scores was observed in non-diarrheal children (p<0.01). However, such association did not apply for diarrheal children. Conclusion: Increased fecal pH in non-diarrheal children was found to have significant association with stunted growth, making fecal pH a possible indirect determinant of childhood stunting. However, no such associations were observed in case of diarrheal children.