Abstract

Background: Acute infectious diarrhoea remains an important cause of illness and nutritional decline in children. Oral rehydration, continued feeding and appropriate zinc supplementation are the foundations of care. Kutaja (Holarrhena pubescens, commonly reported as H. antidysenterica) is widely used in Ayurveda for diarrhoeal and dysenteric disorders. Objective: To critically examine its Ayurvedic basis, phytochemistry, antimicrobial activity, possible antisecretory and antimotility effects, safety, and paediatric clinical evidence. Methods: A narrative review of classical sources, official standards, WHO guidance, phytochemical studies, experimental pharmacology and clinical reports was undertaken. Evidence was interpreted according to study design and paediatric relevance. Results: Steroidal alkaloids, especially conessine, are prominent constituents. Extracts and isolated alkaloids show activity against several bacteria, including enteropathogenic Escherichia coli. Animal models also suggest reduced stool output, intestinal fluid accumulation and excessive motility. However, extract composition varies, some mechanistic findings come from polyherbal products, and modern trials of standardised Kutaja monotherapy in children are lacking. Conclusion: Kutaja is a plausible adjunctive research candidate, but it should not replace oral rehydration, nutrition, zinc or indicated antimicrobial therapy. Child-specific dose, quality, pharmacokinetic and safety data are required before routine evidence-based use can be claimed.