Rotavirus infects and destroys the mature enterocytes of the intestinal villi, leading to villous atrophy and blunted villi. This damage impairs nutrient and fluid absorption, resulting in osmotic diarrhea. The destruction also disrupts the epithelial barrier, further exacerbating fluid loss. Unlike other mechanisms, rotavirus-induced diarrhea is primarily due to this mucosal injury rather than increased mucus secretion or motility changes. Understanding this pathophysiology is crucial for targeted management of rotavirus gastroenteritis.

Reference: Harrison’s Principles of Internal Medicine, Kasper et al., 20th Edition.