What is  Diarrhea?
Diarrhea is an intestinal disorder characterized by abnormal fluidity and frequency of fecal evacuations, generally the result of increased motility in the colon; may be an important symptom of such underlying disorders as dysenteric diseases, lactose intolerance, GI tumors, and inflammatory bowel disease.

 Diarrhea is the passage of watery stools, usually at least three times in a 24 hour period. However, it is the consistency of the stools rather than the number that is most important. Frequent passing of formed stools is not  Diarrhea. Babies fed only breastmilk often pass loose, "pasty" stools; this also is not  Diarrhea. Mothers usually know when their children have  Diarrhea and may provide useful working definitions in local situations.


Clinical types of  Diarrheal diseases
It is most practical to base treatment of  Diarrhea on the clinical type of the illness, which can easily be determined when a child is first examined. Laboratory studies are not needed. Four clinical types of  Diarrhea can be recognized, each reflecting the basic underlying pathology and altered physiology:

* acute watery  Diarrhea (including cholera) which lasts several hours or days:
the main danger is dehydration; weight loss also occurs if feeding is not continued;

* acute bloody  Diarrhea (also called dysentery):
the main dangers are intestinal damage, sepsis and malnutrition; other complications, including dehydration, may also occur;

* persistent  Diarrhea (which lasts 14 days or longer):
the main danger is malnutrition and serious non-intestinal infection; dehydration may also occur;

*  Diarrhea with severe malnutrition (marasmus or kwashiorkor);
the main dangers are: severe systemic infection, dehydration, heart failure and vitamin and mineral deficiency.

The management of each type of  Diarrhea should prevent or treat the main danger(s) that each presents.



Why is  Diarrhea dangerous?
Diarrhea causes rapid depletion of water and sodium - both of which are necessary for life. If the water and salts are not replaced fast, the body starts to "dry up" or get dehydrated. If more than 10% of the body's fluid is lost death occurs.

Severe dehydration can cause death.

Despite many advances,  Diarrheal diseases and the resulting dehydration are responsible for about 2.2 million child deaths every year. Of these, approximately

*

50% are due to watery  Diarrhea and occur
- either because of lack of access to ORS and/or health facilities,
- or because of incorrect case management (home or health facility).

*

The remainder are accounted for by persistent  Diarrhea (approximately 35%) and dysentery (approximately 15%).

 Diarrhea is caused by bacteria or viruses. Children who are malnourished suffer much more; in turn,  Diarrhea weakens children and makes them more malnourished.  Diarrhea is also a major cause of child malnutrition.


How can  Diarrhea be prevented?
Diarrhea can be prevented by pursuing multisectoral efforts by:

* improving access to clean water and safe sanitation
* promoting hygiene education
* exclusive breast-feeding
* improved weaning practices
* immunizing all children; especially against measles
* using latrines
* keeping food and water clean
* washing hands with soap (the baby's as well) before touching food
* and by sanitary disposal of stools.

The above is most important message that can help parents governments and communities to prevent almost all of these deaths and most of the malnutrition caused by  Diarrhea.




The key factors are unclean water, dirty hands at mealtime and spoilt food.

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