Diarrhea is a symptom of some deeper disturbance/illness in alimentary system. It is a frequent phenomenon especially in summer, and is one of the main causes of illness in children, especially little ones.
When unformed stools are passed, diarrhea is said
to be present. It is a common and important system of intestinal disease varying in severity.
Signs & Symptoms
The life threatening aspect of diarrhea results from the loss of water/fluid from the body due to repeated and excessive expulsions of semi-liquid waste in the form of stools. This may lead to dehydration, and has to be guarded and monitored in the child rather carefully and closely.
In case of mild dehydration, the child may complain of thirst and may become irritable; the eyes may seem sunken. However, the child will still show normal skin resiliency i.e. of a fold of skin on the abdomen is tested by pinching; it will come back to its normal shape when left. Mouth and tongue will be moist; hands and feet will be warm; pulse rate would be normal i.e. 130-140 beats per minute.
(a) Acute Gastroenteritis.
1. Acute Gastroenteritis
(c) Food poisoning
(d) Chemical poisoning
(f) Enteric fevers.
2. Chronic Diarrhea
(a) Inflammatory diseases.
(i) Ulcerative colitis.
(ii) Regional ileitis,
(b) Carcinoma of the bowel.
(c) Coeliac disease and Sprue.
(d) Vitamin B deficiency.
(e) Prolorged dietary indiscretions, irregular meal-times, highly spiced food, indigestible food.
For the purpose of diagnosing the causes of diarrhea as well as to watch the effect of its treatment, the character of the stools is of great importance.
Gastroenteritis of Infants
Gastroenteritis presents a special problem when it arises in infants because it may have a serious effect on the baby and also in many cases is extremely infectious.
The digestive system of an infant is very easily disturbed, not only by diseases of gastro intestinal tract itself but also by disease of any other part of the body. Gastroenteritis of infants is therefore, divided in to two groups:
(a) Cases due to disease outside the gastro-intestinal tract. This is called parenteral gastroenteritis.
(b) Cases due to diseases of the gastroenteritis tract. It is called enteral gastroenteritis.
Any general infection of an infant may be accompanied by vomiting and diarrhea, such as, measles, whooping cough, bronchitis, pneumonia, etc.
It is caused by the disease in the gastro-intestinal tract and is often caused by improper feeding, over feeding, too strong milk mixtures or excessive use of sugar in. the feeds, are common causes of gastroenteritis.
These are also called dietetic forms of gastroenteritis, and usually rapidly respond to correct feeding.
Much more serious are the acute forms of gastroenteritis caused by intestinal infections, the commonest of which are acute bacillary dysentery, and acute infective gastroenteritis.
The most important aspect of the treatment is dehydration. It must begin immediately when the child shows diarrhea. Dehydrate the child orally with fluids available at home, such as, dal/rice water (water in which dal/rice had been cooked), coconut water, buttermilk, thin clear soups, and fruit juices. The loss of water must be compensated as early and as long as possible.
There are packets containing premixed combination of certain salts and sugar, and is to be mixed in a right quantity of purified water. This solution is called ORS i.e. oral dehydration solution. Different antibiotics like neomycin, streptomycin, tetracycline and chloramphenicol may be administered orally.
Precautions to be observed while managing Diarrhea
1. Do not give oral dehydration solution while the child is lying down, as he could easily choke and/or inhale the liquid down the lungs.
2. Keep the semi-conscious or comatose child warm when transferring her to hospital or a medical center.
3. If a child is vomiting, have the child sit up to prevent the vomitus from entering the wind pipe; if the child is vomiting while in coma, turn his face to one side.
Encourage breast-feeding of newborns. Besides being more hygienic (especially if the mother is reminded to wash herself before feeding), mother’s milk will pass on antibodies protecting the baby from gastroenteritis at least for the first few months. Tell the mother not to stop breast-feeding if the child develops diarrhea.
If nipple bottles are used for feeding infants, advise the mother to boil the bottle and the nipple in water for at least three minutes. Leave the nipples and bottle covered in boiling vessel until they are to be used again.
The bottle and nipple must be disinfected each time after use and should never be left in the open, where flies and other infect ants can contaminate them. However, bottle-feeding is not recommended. Mothers should use a cup and spoon for feeding the child.