Acute diarrhoea or gastroenteritis is the
passage of loose stools more frequently than what is normal
for that individual. This increased frequency is often
associated with stools that are watery or semisolid,
abdominal cramps and bloating.
Acute
watery diarrhoea is an extremely common problem, and can be
fatal due to severe dehydration, in both adults and
children, especially in the very young and the old or in
those who have poor immunity such as individuals with HIV
infection or patients who are using certain medications that
suppress the immune system.
In healthy adults, however, it is often no
more than a nuisance. Because it may interfere with ones
ability to work, it can also adversely affect the
individual's income.
How does it occur?
Acute diarrhoea is most often due to an
infection. Bacteria such as E. coli and Vibrio cholerae,
certain viruses and parasites such as Giardia can cause
diarrhoea and vomiting. Certain medications and allergies to
certain food ingredients are some non-infectious causes of
acute gastroenteritis.
What are the symptoms?
Diarrhoea is the most troublesome symptom and
may be associated with nausea and vomiting. The frequency of
stools varies depending on the cause and the severity of the
illness. It is usually also associated with abdominal
cramps, and symptoms of gas. When the vomiting and diarrhoea
are severe it is not uncommon for the individual with the
illness to get dehydrated and this in turn may lead to
light-headedness, weakness, confusion, kidney failure and
even death.
How is it diagnosed?
When acute diarrhoea is due to
an infectious agent, it is usually not necessary to find out
the cause, because the diarrhoea is self-limiting and often
resolves in the majority of patients within a few days. If
the diarrhoea becomes chronic (more than two weeks) then
special tests may be necessary. For non-infectious causes of
acute diarrhoea it is important to find the underlying cause
so that the causative agent can be appropriately treated or
eliminated.
What is the treatment?
It is important to remember that
acute gastroenteritis is an illness that lasts only a few
days and does not, in general, require antibiotic or
anti-microbial treatment. Correcting water and electrolytes
deficits that occur, because they are lost in the stools and
vomitus, is best done with an oral rehydration solution.
This is a solution made up of glucose and electrolytes such
as sodium, potassium and bicarbonate. This solution should
be given to all patients who can take fluids by mouth
including those who are vomiting. Usually enough water and
electrolytes are absorbed to prevent the patient becoming
dehydrated despite the vomiting. One can buy packets of oral
rehydration salts, which are dissolved in safe drinking
water. A simple and effective solution can be made cheaply
and easily at home by adding one flat teaspoon of sugar,
one-eighth tip of a teaspoon of salt to eight ounces (240
ml/glass) of water. It is important that this solution be
drunk frequently to ensure that the patient does not get
dehydrated.
Medicines to decrease the diarrhoea and vomiting may be used
when symptoms are severe. Food can be given with no
restrictions as soon as the patient is able to eat without
discomfort. It is a common misconception that foods worsen
diarrhoea but this has not been shown to be the case in
carefully done studies.
Is hospitalisation necessary
for acute gastroenteritis?
Admission to a hospital for
intravenous fluids may be necessary if dehydration occurs
despite drinking the oral rehydration solution.
How can it be prevented?
Since most cases of acute watery
diarrhoea are infectious, especially in developing
countries, the majority of such illnesses can be prevented
by drinking water or eating foods that are not contaminated
with infectious agents. Washing hands frequently with
non-contaminated water, when caring for a patient with
diarrhoea as also always before eating is important. Proper
storage of food and water is also important to prevent
harmful bacteria from contaminating them.
Gastrointestinal Tract -
General
Global Health
Healthcare Provider
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