What are the main causes of Diarrhoea and Dysentery?

Diarrhea is the passing of loose, watery, unformed stools by the body and the number may vary from several per day to a few every hour. It may be due to some chemical or bacterial toxins, drugs or certain allergies.

When unformed stools are accompanied by the blood and mucous, the illness is called dysentery. The most common causes are an amoeba (Entamoeba histolytic) causing amoebic dysentery and bacteria (Shigella Bacillus) causing bacillary dysentery.

Factors Responsible for causing Diarrhea and Dysentery

(i) Malnourishment

When children are malnourished many deficiencies may develop-deficiency of calories, vitamins, proteins. The digestive system becomes weak and the body is susceptible to infections which can lead to the symptoms of diarrhea and dysen­tery,

(ii) Insanitary Conditions

They are the major causes of disease and infection. Flies carry disease gems from dirty places and settle on food contaminating it. Such food, when consumed, will cause not only diarrhea but many other diseases.

(iii) Unhealthy Feeding Habits

When children as bottle-fed, if the bottles and nipples are not properly sterilized and water is not fully boiled, children often get diarrhea. Also when children crawl, they tend to play with soil and pick up things from the ground which can again cause the entry of micro-organisms leading to diarrhea and other infections.

Types of Diarrhea

(a) Acute Diarrhea

It generally follows the ingestion of un­-hygienically handled irritating, decomposed or stale food. It is characterised by sudden onset of watery stools, abdominal pain, fever and vomiting. Its duration is about 1 to 3 days.

(b) Chronic Diarrhea

This type of diarrhea lasts for a much longer period and it is usually after an acute attack of dysentery that such a type diarrhea develops due to the intake of irritant or stale foods. In chronic diarrhea, nutritional deficiencies may develop because of the rapid passage of intestinal contents through the intestine. This does not allow sufficient time for absorption. The water-electrolyte balance is disrupted. There is depletion of the tissue proteins. Fat losses are considerable with consequent loss of calories and fat-soluble vitamins. There are increased losses of water-soluble vitamins due to the loss of water from the body by way of the loose watery stools. Vitamin B₁₂, folic acid, niacin and Vitamin C are also lost. Iron deficiency is also a common feature due to the loss of iron in the faeces following occasional blood loss.

Dietary Treatment

Calories

In acute and chronic diarrhea care should be taken so that the calorie needs of the patient are met with in accordance with his physiological condition.

Proteins

Easily assimilable protein-rich foods like curd, minced meat, egg, skimmed milk preparations may be given if tolerated.

Fats

Fats are restricted as they are not always absorbed due to intestinal burry and may aggravate diarrhea.

Carbohydrates

Easily assimilable carbohydrates such as vege­table puree, fruit juices, coujee or cereal water are given liberally.

Vitamins

Oral or parenteral vitamins, particularly water-soluble Vitamins B and C are necessary during the management of persistent diarrhea.

Minerals

Losses of sodium and potassium should be replaced by liberal intake of fluids such as fruit juices that are rich in potassium. Iron deficiency is also found due to iron losses in faeces. Blood loss and reduced iron intake also results in iron deficiency. Therefore, supplementary foods have to be given as tablets or in liquid form.

Fluids

Losses of fluids should be replaced by a liberal intake of water, juices, vegetable or meat soup and fresh lemon squash to prevent dehydration and to ensure an adequate intake of fluid and electrolytes especially in susceptible age groups, such as very young or old people.

The diet should be a low residue one and it should be non-irritant. Food should be given in small quantities at regular intervals of about two hours. A soft diet is prescribed for patients with chronic diarrhea. A soft diet is soft in consistency, easy to chew made up to simple easily digestible foods and contains no harsh fibre, no rich or highly flavored food.

Foods to be avoided

Spices, pulses, fried foods, fibrous foods and leafy vegetables, fatty foods, sugar and jiggery. Avoid pure milk and give it in the form of curds.

Foods to be taken

Soups, fruit juices, salt and glucose water, banana, biscuits, sago kheer, arrow-root, skimmed milk, potato, eggs, khichri, curds, soft custard, dal soups, boiled vegetables. Fruit juices such as of apples and pomegranate are helpful.