Gut microbiome dynamics in acute infectious diarrhea: A conceptual framework from acute dysbiosis toward precision restoration (Review).

Acute diarrhea affects >1 billion individuals annually, imposing a major health and economic burden worldwide. Although the involvement of the gut microbiota is increasingly acknowledged, the dynamics of microbiota disruption, recovery and related therapeutic opportunities remain poorly integrated. The present review proposed a conceptual framework that synthesizes current understanding of pathogen-driven structural and functional alterations of the microbiota, the staged ecological succession during convalescence (including risks of incomplete restitution) and emerging microbiota-based interventions, ranging from probiotics to phage therapy. The present review further highlighted the potential of artificial-intelligence-driven multi-omics integration, while mapping the distance between current evidence and future precision-medicine goals. Evidence-based interventions were explicitly distinguished from investigational strategies, and microbiota-derived diagnostic biomarkers were discussed as a promising research direction rather than ready-to-deploy clinical tools. Finally, the present review provided evidence-based recommendations to bridge ecological principles with bedside practice, framing acute infectious diarrhea as a severe but often reversible ecological perturbation (an acute dysbiosis) that reveals individual ecological vulnerability and offers a diagnostic window for risk stratification. The present review is intended as a conceptual and evidence-synthesis framework rather than a clinical practice guideline.