What is diarrhea?

Passage of 3 or more abnormally loose or liquid motions regardless of cause, color or illness associated with it.

What is dysentery?

Presence of blood and pus in the stools along with abdominal cramps and fever.

Age group

Over 80% of acute diarrhea (diarrhea lasting less than 7 days) occurs in the age group of 6 months to 3 years.

Season

Hot humid climate and monsoon

How dangerous is diarrhea?

Two major danger of diarrhea are 'dehydration' and 'under nutrition' both of which may kill the child.

What is dehydration?

Most people know that diarrhea can make the body very weak. This weakness is the most important sign of what doctors call "dehydration". Dehydration is loss of water and salts from the body. When a child has diarrhea, she loses a lot of salts and water with every loose motion. If the salts and water are not replaced fast  enough, child will become weaker and weaker. Most children who has diarrhea dies because they do not have enough water left in their bodies.

RECOGNISING SUNKEN EYES video 


What causes diarrhea?

Diarrhea can occur because of Gastro intestinal infection due to a variety of infecting organisms. Large majority are due to viral (Rotavirus) and bacterial (cholera, shigella, E.coli) infections. In smaller percentage of cases, food intolerance to various foods/ food components like lactose, cow's milk protein, gluten (protein in wheat) can also cause diarrhea.

TREAT DIARRHEA AT ONCE

Begin treatment at home.

3 rules for management of diarrhea at home are
•Increase fluids – home based and breast feeding
•Continue feeding.
•Recognize danger signs.


Most children will recover from diarrhea just by drinking lots of whatever fluid is available at home. The treatment is so simple! All you have to do is to replace the water your child loses each time she/he passes a loose motion.
Home available feeds (HAF) — which could include —
• lime juice,
• salted butter milk,
• tender coconut water,
• rice kanji,
• weak tea with sugar and
• barley water.

If no fluids are available at home you can make a Sharbath drink, (salt sugar solution) with salt, sugar and water, which are usually found in every home. Sharbath drink can be made by taking 200ml of clean water (large cup of glass) and adding 1 two finger pinch of salt (0.8gm) and 1 heaped Tea spoon of sugar (8gm). Give your child any fluid available at home as soon as she has a loose motion. Early treatment not only restores strength to your child, it could even save her life! If diarrhea continues, child should receive special mixture of a life-saving drink in a packet. This is known as an Oral Rehydration Salt (ORS). 

For over 25 years, WHO and UNICEF have recommended ORS to prevent / treat dehydration  from diarrhea irrespective of the cause or age group suffered. WHO considers ORS as a drug. ORS has saved more lives than
all drugs put together.

How to make the special drink from the ORS packet?

ORS packets are available at health center or commercially as Electral, Electrobion, Walyte, Relyte, Punarjal etc.
• Wash your hands with soap and water.
• Take 1 liter of water (5 glasses) in a clean container.
• Empty ORS packet into the container and stir till it dissolves.
• Prepare fresh solution everyday (should be consumed within 24 hrs).

How to give ORS

•Give frequent sips from a cup
• If child vomits, wait for 5-10minutes, then give the solution more slowly (2 to 4 tea spoon fulls) every 5-10minutes.


When to see doctor? 

• Loose motion large in number and quantity
• Presence of blood and mucus
•Vomiting and pain in lower abdomen
•Thirsty, tired and weak
•Dryness of mouth
•Soft spot on the baby's head gets sunken
•Skin — looses its firmness and looks wrinkled
•If skin is pinched, it stays folded for a few seconds
•Sunken eyes, cold, clammy skin
• Passes little or no urine
• Faints or gets convulsion
•Weak pulse
•Stomach gets distended

Practical tips for management of acute diarrhea:

•Treatment is not meant to stop diarrhea but to prevent and correct dehydration
•Acute diarrhea is a self limiting disease in most cases
•Very small percentages of cases require drugs. (Cholera, Dysentery, Amebiasis etc.)

Following is a small video, regarding Loose motions myths and management


STOP DEHYDRATION, NOT DIARRHEA

Not with drugs but with ORS.  Important rules for feeding during and after diarrhea are as follows: 
• Continue Breast feeding - It will prevent dehydration
• Give - Home available fluids. Special drink (salt sugar solution)
• Continue feeding during diarrhea As patient cannot digest food, give small, frequent feeds. Give soft foods like Khichri, Mashed bananas
• Give extra food after diarrhea stops.Feed extra meal a day for at least one week

What causes Diarrhea?

• Feeding bottles — Never use them as they carry germs
• Dirty water — from rivers and lakes
• Spoilt or dirty food — unwashed vegetables and fruits Left over food can get bad and give you diarrhea
• Flies — sit on stools, then sit on food and make it dirty
• Dirty hands and nails — dirt can get on to the food and cause diarrhea 
• No proper toilet— stools passed near houses are dangerous
 

How to Prevent Diarrhea?

• Mother's milk is cleanest and safest food. Give other fluids with cup and  spoon
• Clean drinking water from a hand pump, tube well or other clean sources
•Wash all vegetables and fruits. Try to eat freshly cooked food as far as possible. Do not eat any food that smells bad or tastes bad
•Cover the food and drinking water, so that flies cannot sit on it
•Wash your hands with soap and water after going to toilet and before meal
•Use toilet, If there is no toilet, pass stool far away from home and drinking water supply in the fields. Cover the stool with earth.