A


Tuesday, April 23, 2013

An Article published in Healthy Life Magazine in Issue April 2013



A word so simple, but yet diseased with morbidity but may turn into the word of mortality if not taken care in time. It is common but potentially serious illness in early childhood. A child suffer on an average 10-20 episodes of diarrhea in the first five year of life and it accounts for 20% of all pediatric admission in hospital.

Since this is one of the most common cause of morbidity and mortality in developing countries like ours, especially in children below 5yrs of age, it is very important to know the basic facts about this illness and recognize its severity in time and get the timely medical management to prevent its further complication and death. So here are some of the most frequently asked questions by the parents/Patients.

Q1. What is diarrhea?

Answer:
It’s merely an infection of the Gastrointestinal tract with change in consistency of the stool.
It is defined as a passage of liquid or watery stool more than three times a day


Q2. What are the causes of diarrhea?

Answer:
Diarrhea can be caused by various organisms like: bacteria, viruses, parasites and  protozoans e.g: rotavirus, cholera, E.coli, salmonella, shigella, campylobacter, giardia, amoeba, cryptosporidium, ascariasis. It can also be a symptom of some underlying systemic, metabolic  or chronic diseases like: chronic malnutrition, lactose intolerance, measles, pneumonia, typhoid, urinary tract infection, ear infection, hyperthyroidism, heavy metal poisoning, cancers etc.

Q3. What are the risk factors which may precipitate diarrheal diseases?

Answer:
The most common being poor eating habits like eating and drinking of unhygienic food and water, poor sanitation, lack of proper hygiene while cooking or preparing food , immunodeficiency state, chronic systemic illness, vitamin deficiency, prolong antibiotic uses etc

Q4. What other symptoms can my child face during this diarrheal disease?

Answer:
Child will develop frequent loose stools with or without blood and mucus with some commonly seen symptoms like: crampy abdominal pain, vomiting, fever, weakness, lethargy, and rashes in the perianal area. While some will  present with symptoms of underlying diseases.

Q5.What is the difference between Diarrhoea  and Dysentery ?

Answer:
Diarrhoea with visible blood in the stool is called dysentery. It is more severe form and presents with fever, crampy abdominal pain, tenesmus and is responsible for 15% of death in diarrhoeal  diseases.

Q6. When should I see my doctor for this illness?

Answer:
You can see the doctor any time for this illness but better if you visit your doctor before your child develops complication of this disease like dehydration, dyselectrolytemia, seizures which increases the risk of mortality. But visit your doctor or seek nearby health facility if your child have frequent loose watery stool, blood in the stool, fever, repeated vomiting and  if child is unable to drink or eat.

Q7. What are the danger signs in diarrhea illness?

Answer:
The most important danger signs in diarrhoeal disease is:
Inability to drink/feed/suck
Decrease in urine output
Increase irritability, lethargy
Sunken eyes
Depressed anterior fontanelle
Weight loss of more then 10% of body weight
Absent tears, dry tongue and mouth.

The above  mainly indicates the signs of severe dehydration hence in these case  parents should immediately consult their doctor or a nearby health facility.

Q8. What is the basic home management that one should take before visiting the doctor?

Answer:
First and foremost is ORS, or home made salt sugar water solution each time the baby pass stool. The other food that can be given is clear fluids, rice kanji, salted lassi, coconut water, soup, yoghurt drink, dal pani and if the baby is on mother’s milk continue breast feeding. But there is a miss concept that water should not be given to the child with diarrhea disease in village, so it’s very important to educate such people the importance of early feeding and ORS in diarrhea.

Q9. How can I prepare ORS at home?

Answer:
It’s a mixture of water sugar and salt. Take 1 litre of water, mix 4 tea-spoon full of sugar, and half spoon of salt. Give it to a child every time a child passes loose stool or after vomiting.

Use the solution within 24 hours of preparation.


Q10.Which type of food should I feed my child  during diarrhea illness?

Answer:
ORS and soft diet basically rice based diet, banana, curd, khichari (jaulo) and liquids as mentioned before.

11. What type of food should we avoid during diarrhea?

Answer:
Hot spicy oily food, junk foods, Plain sugar or Glucose water, soft drinks, canned juices, citrus fruits, meat, fish etc

12. What if my baby develops nappy rashes?

Answer:
In case the baby develops nappy rashes then avoid putting nappy’s to the baby, keep the area clean open and dry, wipe the area softly after the baby passes stool, avoid harsh rubbing and one can apply diaper rash free cream or coconut oil that is easily available and meet your doctor to prevent its further worsening.
                                                                                                                        
 13. What is the treatment for diarrhea?

Answer:
It includes: giving adequate fluids, feeding properly, rational use of drugs, and applying of preventive measures in day to day life.

The most important is ORS, homemade fluids, IV fluids, soft diet, dietary supplement, extra calorie diet, breast feeding, vitamin and mineral supplements mainly zinc, vitamin A, vit B-complex, appropiate antibiotics and vaccination as per the doctor advice.


Q14. What are the complications of dairrhoea?

Answer:
It mainly causes dehydration leading to shock, dyselectrolytemia, renal failure, acid base imbalance, malnutrition and complication related to underlying systemic diseases causing diarrhea.
  
Q15. How can I prevent diarrhea?

Answer:
It’s the illness of low socio-economic  people because of the poor eating and drinking habits with unhygienic living condition and poor sanitation.  So the most important step to prevent diarrhea is to maintain proper hygiene and good sanitation.

Wash hands before feeding infants, cooking meals and after going to toilets. Exclusive breast feeding, avoid bottle feeding or the feeding bottles should be sterilized every day.
The cooking utensils should be washed properly before cooking. The vegetables, fruits and salads should be washed properly before cooking and eating. Use of clean drinking water. Eat freshly prepared and well cooked food

One should avoid eating outside on the road side because the food is uncovered and there is increased chance of infection through flies, dust and mosquitoes.
Vitamin supplements is necessary in case of chronic illness, avoid inappropriate and random use of antibiotics, treatment of systemic illness on time.

The most important is by vaccination like we have vaccine against diarrhea e.g. rotavirus vaccine, cholera vaccine, typhoid vaccine, measles vaccine and consult your pediatrician for these vaccination.

 Hence disease so simple but yet fighting with increased mortality number in developing countries like our’s. It demands early recognition and treatment, with increase necessity to educate people and increase awareness especially among rural and village peoples.



Total Pageviews

Followers