Diarrhea is defined as having three or more loose or liquid stools
per day, or as having more stools than is normal for that person.
Classification
(a) Based on onset of symptoms
• Acute
• Chronic
(b) Based on absence or presence of blood/mucous
• Secretary Diarrhea
• Inflammatory Diarrhea
Causes of Diarrhea
• Viruses
• Bacteria (common in food poisoning)
• Laxative abuse
• Diseases of Intestine
• Malabsorbtion syndrome
• Colon cancer
Complications of Diarrhea
• Dehydration
• Electrolyte disturbances
• Dehydration occurs
when there is excessive loss of fluids and minerals (electrolytes) from
the body due to
Diarrhea, with or without vomiting i.e. Electrolyte
disturbances. Dehydration is common among adult patients with acute
Diarrhea who have large amounts of stool, particularly when the intake
of fluids is limited by lethargy or is associated with nausea and
vomiting. It also is common in infants and young children who develop
viral gastroenteritis or bacterial infection. Patients with mild
dehydration may experience only thirst and dry mouth. A prolonged bout
of Diarrhea or vomiting can cause the body to lose more fluid than it
can take in. The result is dehydration, which occurs when your body
doesn’t have the fluid it needs to function properly. Severe dehydration
can cause Renal Failure or kidneys to shut down. Dehydration can be
particularly dangerous in children and the elderly.
Know the Signs of Dehydration
If one is sick with Diarrhea or vomiting, watch carefully for these signs of dehydration:
• Thirst
• Less frequent urination than normal
• Dark-colored urine
• Dry skin
• Fatigue
• Light-headedness
• Inability to sweat
By the time these symptoms show up, however, dehydration may be well
advanced. At the first sign of Diarrhea or vomiting, begin replacing
lost water and the essential salts called electrolytes.
Classifications of dehydration in a child with Diarrhea:
• Severe dehydration
• Some dehydration
• No dehydration
How to Prevent Dehydration
When one is sick with Diarrhea or vomiting, one tends to lose fluid
rapidly. So it’s important to take in as much fluid as possible.
Drinking plenty of water is the top priority. The amount of water
required is to replenish depends on how much is being lost.
Water rehydrates the body. But water alone doesn’t replace the
essential salts required by the body for fluid balance and other
functions. Most experts recommend drinking oral rehydration solutions.
Moderate to severe dehydration may cause orthostatic hypotension with
syncope (fainting upon standing due to a reduced volume of blood, which
causes a drop in blood pressure upon standing), a diminished urine
output, severe weakness, shock, kidney failure, confusion, acidosis (too
much acid in the blood), and coma.
Electrolytes (minerals) also are lost with water when Diarrhea is
prolonged or severe, and mineral or electrolyte deficiencies may occur.
The most common deficiencies occur with sodium and potassium.
Abnormalities of chloride and bicarbonate also may develop.
Preventing Dehydration in Children
Children can lose a tremendous amount of fluid in a short time from
Diarrhea or vomiting. In addition to routine signs of dehydration,
parents of sick infants and children should also watch for dry mouth and
tongue, no tears when crying, listlessness or crankiness, sunken cheeks
or eyes, sunken fontanel (the soft spot on the top of a baby's head),
fever, and skin that does not return to normal when pinched and released
also known as Skin pinch test.
If your sick child shows signs of dehydration, give fluids called
oral rehydration solutions. Sport drinks and fruit juices are helpful
too, but they don’t provide the ideal balance of water, sugar, and salt.
Treatment
The goal of treatment is to ease the symptoms and get the bowel movements back to normal. People don't always need to take medication for Diarrhea.
Drugs like Antibiotics and antimotility agents should be used only after consultation with doctor.
Oral Rehydration Solutions:
Made at Home the most effective, least expensive way to manage Diarrheal dehydration.
The Simple Solution “Do-It-Yourself...” Encouraging self-reliance made at home: ORS Solution a special drink for Diarrhea.
Give the child a drink made with 6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 litre of clean water.
Be very careful to mix the correct amounts. Too much sugar can make
the Diarrhea worse. Too much salt can be extremely harmful to the child.
ORS packets are available from health centers, Chemist shops.
Following traditional remedies make highly effective oral rehydration
solutions and are suitable drinks to prevent a child from losing too
much liquid during Diarrhea:
• Khichdi or Gruels (diluted mixtures of cooked cereals and water)
• Carrot Soup
• Rice water
• If none of these drinks is available, other alternatives are:
• Fresh fruit juice
• Weak tea
• Green coconut water
• If nothing else is available, give Water from the cleanest possible source (If possible brought to the boil and then cooled).
It is advised mothers must continue breast feeding their infants.
How is the ORS drink prepared?
Put the contents of the ORS packet in a clean container. Check the
packet for directions and add the correct amount of clean water. Too
little water could make the Diarrhea worse.
Add water only. Do not add ORS to milk, soup, fruit juice or soft drinks. Do not add sugar.
Stir well, and feed it to the child from a clean cup and clean spoon. Do not use a bottle.
How much ORS drink to give?
Encourage the child to drink as much as possible.
A child under the age of 2 years needs at least 1/4 to 1/2 of a (250-ML) cup of the ORS drink after each watery stool.
A child aged 2 years or older needs at least 1/2 to 1 whole large (250-ML) cup of the ORS drink after each watery stool.
Preventing Dehydration in the Elderly People
Seniors are at increased risk of becoming dehydrated because they may
not be as sensitive as younger adults to the sensation of thirst. In
addition, age-related changes in the body’s ability to balance water and
sodium increase the danger.
To decrease the incidence and prevalence of Diarrheal disease in India through safe drinking water
While continuous efforts have been made to provide drinking water in
India over the past decade, the tremendous adverse impact of unsafe
water on health continues. The highest mortality from Diarrhea is in
children under the age of five, which calls for urgent focused
interventions to prevent Diarrheal disease in this age group.
Despite investments in water and sanitation infrastructure, many
low-income communities in India continue to lack access to safe drinking
water. Regardless of the initial water quality, widespread unhygienic
practices during water collection and storage, poor hand washing and
limited access to sanitation facilities facilitate the transmission of
Diarrhea-causing germs through the faecal-oral route.
Improved hygiene and sanitation also play an important role in
reducing Diarrheal and other water-borne diseases. Motivation is
required to bring about behavioral changes necessary for improved
hygiene and sanitation Main emphasis is to raise...
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