Diarrheal diseases are very common in childhood days. Though it is very common, it causes huge anxiety in parents. In this talk I would like to brief you regarding this and preventions to be taken.
Causes of diarrhoea :
Diarrhoeal diseases can be due to infectious or non-infectious causes. In the infectious causes, it can be viral/bacterial or parasitic. Noninfectious causes are not very common and are mainly due to digestive issues. Viral diarrhea is less troublesome compared to bacterial ones.
Clinical symptoms:
Usually there will be loose stools, sometimes associated with vomiting or abdominal pain. Viral diarrhea will be more watery than bacterial ones but never bloody. Bacterial diarrhea may be associated with bloody and mucoid stools. It will be less in amount but more frequent. Fever is a common association. But bacterial diarrhea will be associated with high grade fever, severe abdominal pain and tenesmus. Child will become very toxic in bacterial diarrhoea like Shigella. It may go into complications like Encephalopathy and septicemia also very easily.
Danger signs:
Any kind of diarrhoea in children should be taken care properly as they may lead to dehydration and even death of the child if not properly managed. Children loose huge amount of water through loose stools and vomiting. So it needs to be replaced properly. We use some clinical clues to find out whether the hydration status is good or not. They are urine output, activity of the baby, condition of the oral mucosa, presence of tears, sunken eyes, depressed anterior fontanelle, eagerness to drink etc. Other than that, seizures , lethargy and poor responsiveness, inability to wake up, blood in stools, persistant vomiting, abdominal distension etc should also alarm us regarding the complications and need of immediate care. These should be explained to parents and advise them to come immediately if any danger signs are there.
Prevention:
The commonest route is feco-oral route. So personal hygiene is most important. Proper washing of hands before and after feeding, after using toilets, after playing outside etc is very important and should be taught to children. Proper disposal of wastes and excreta is also important. Never defecate in open space. Food items should be properly closed and kept neatly. Houseflies need to be controlled. Chlorinate your water source. It can also spread from person to person also. So whoever is taking care of the child with diarrhea also should maintain good hygiene. It is always better to avoid foods from outside which is unclean. Always drink boiled and cooled water. Better avoid old canned foods.
Treatment of diarrhoea :
- Correction of dehydration: If child is dehydrated, it needs to be corrected. It can be oral correction through home available fluids if only mild dehydration is there. If severe, child needs to get admitted and get intravenous fluids.
- Treatment of infection: It needs oral/IV antibiotics
- Pre/probiotics
- Zinc supplementation
- Proper nutrition- Never stop feeding. But don’t force feed also. Please maintain proper nutrition. Give small frequent feeds.
- Use of ORS fluid whenever needed