Management of diarrhoea in children

Most children battle diarrhoea from time to time, It is often caused by infections that don't last long and usually are more disruptive than dangerous. It is important to know what to do to relieve and prevent diarrhoea. It is usually brought on by gastro-intestinal infections caused by bacteria, viruses, or parasites. Diarrhoea disease is a major cause of under-five mortality.

Diarrhoea is defined as frequent runny or watery bowel movements. Diarrhoea is usually defined as the passage of three or more loose stools in a 24-hour period. In diarrhoea, stools contain more water than normal. Dysentery is simply diarrhoea with visible blood in the stool.

In newborn and infants less than six months who are exclusively breastfed, they normally pass several soft or semi-solid stools each day. Therefore, in lay mans terms, diarrhoea is an increase in stool frequency or liquidity that is considered abnormal by the mums.

Causes

Rotavirus infection is a frequent cause of diarrhoea in children. Rotavirus usually causes explosive, watery diarrhoea. In general, infections that cause diarrhoea are highly contagious. Most cases can be spread to others for as long as someone has diarrhoea, and some infections can be contagious even longer. The specific germs that cause diarrhoea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene.

In villages and communities with poor sanitation or where human waste is used as fertilizer often have outbreaks of diarrhoea when intestinal bacteria or parasites contaminate crops or drinking water.

In the cities, diarrhoea outbreaks are more often linked to contaminated water supplies, person-to-person contact in places such as child-care centers, nannies, or "food poisoning".

Diarrhoea can be a symptom of a number of non-infectious diseases and conditions, especially when it lasts several weeks or longer. It can indicate food allergies, lactose intolerance, cow milk allergies or diseases of the gastrointestinal tract.

• Diarrhoeal infections can be spread through dirty hands, contaminated food or water, some pets, direct contact with fecal matter (i.e., from dirty diapers or the toilet). Anything that the infectious germs come in contact with can become contaminated. This includes toys, changing tables, surfaces in restrooms, even the hands of someone preparing food.

Signs and Symptoms: Symptoms typically start with crampy abdominal pain followed by diarrhoea that usually lasts no more than a few days. Infections with many of the viruses, bacteria, and parasites that cause diarrhoea also can bring on other symptoms, such as: fever, loss of appetite, nausea, vomiting, weight loss, dehydration In cases of viral gastroenteritis, kids often develop fever and vomiting first, followed by diarrhoea.

Prevention: Hand washing is the most effective way to prevent diarrhoeal infections that are passed from person to person. Make sure kids wash their hands well and often, especially after using the toilet and before eating. Keep bathroom surfaces clean to help prevent the spread of infectious germs. Wash fruits and vegetables thoroughly before eating. Refrigerate meats as soon as possible after bringing them home from the supermarket, and cook them until they are no longer pink.

Never drink from streams, springs, or lakes unless local health authorities have certified that the water is safe for drinking. In some developing countries, it may be safer to drink only bottled water or cool boiled water rather than water from a tap.

Treatments

Mild diarrhoea is usually no cause for concern as long as your child is acting normal, drinking and eating enough. Mild diarrhoea usually passes within a few days and kids recover completely with care at home, rest, and plenty of fluids including breast milk or formula for infants and milk for kids over one year old.

Antibiotics or antiviral medications are not prescribed for most cases of diarrhoea caused by bacteria and viruses because most kids recover on their own. But antibiotics are sometimes given to very young children or those with weak immune systems to prevent bacterial infection.

If the illness is caused by a parasite, it can be treated with anti-parasitic medicines to cure or shorten the course of the illness. The doctor may order a stool test, in which a stool sample will be examined in the laboratory to see which specific germ is causing the diarrhoea (bacteria, virus, or parasite).

The primary concern when treating diarrhoea is the replacement of fluids and electrolytes (salts and minerals) lost from vomiting and fever. Depending on the amount of fluid loss and the severity of vomiting and diarrhoea, your paediatricians will probably instruct you to: Continue your child's regular diet and give more liquids to replace those lost while the diarrhoea continues if there are no signs of dehydration.

Doctors often recommend that kids who show signs of mild dehydration be given oral rehydration solutions to replace body fluids quickly. In some cases, kids with severe diarrhoea may need to receive intravenous fluids at the hospital to help combat dehydration.

There are newer drug that helps to reduce the incidence of diarrhoea in children. This includes Zinc gluconate or sulphate, Probiotics (Flora norms).

In conclusions, children having diarrhoea should not be starved; they should be given fluids, small meals. The use of drugs like sulphuthiazole (Thalazole), mist kaolin, tetracycline and raw pap is harmful to children and should be discouraged.

Also, vaccinate your children against measles and rotavirus.