DIARRHEA

Diarrhea is the passage of watery stools, usually at least three times in a 24 hour period. It is still one of the most prevalent and important public health problems in the developing nations of the world. The incidence of diarrhea is common among infants and young children in these countries remaining the 2^nd largest killer disease in under-five children after neonatal causes. 

watery stool

When the diarrhea episode (the duration/period of passage of the watery stool) is < 14days it is called Acute diarrhea and when > 14 days it is Chronic diarrhea.

                Acute diarrhea means the symptoms associated with the diarrhea appear suddenly , worsen rapidly and disappear.
                Chronic diarrhea means the symptoms develop gradually, and worsens over an extended period of time.

Generally, diarrhea can be caused by different microorganisms. These organisms thrive in a poorly sanitize and unhygienic environment typical of developing countries. When these pathogenic organisms or their toxins are found in food, food borne diarrhea disease may occur.

In infant, one of the following among others may cause diarrhea. Detail explanation would be shared later.

·         Cow’s milk and Soy-protein

·         Inherited transport defect

·         Immune deficiency status

·         Mid-gut malrotation

·         Glucose-galactose malabsorption

Consequences of Diarrhea.

These include;

·         Loss of fluids

·         Loss of nutrients

·         Dehydration

·         Malabsorption

·         Malnutrition.

Basic Management of Diarrhea (extensive discussion subsequently)

Rehydration: Because water and electrolytes are lost in all types of diarrhea, replacement of these by rehydration is always the first priority treatment. This is possible using suitable available fluids (or ORS+Zinc) at home immediately once diarrhea starts

Refeeding: Starts an age –appropriate unrestricted diet as soon as dehydration is corrected. For some individuals (infants), a lactose free solution can be given for quick recovery from malnutrition and severe dehydration.

Note: anti diarrhea agents in children should not be encouraged.

Tips for home management

1.       Give extra fluid

2.       Continue feeding

3.       Give Zinc supplement for 10-14 days.

4.       Recognize the signs that suggest the child need medical help.

Reference

World Health Organization

Nestle Nutrition Institute Africa.