What is diarrhoea?
Diarrhoea is the passage of watery stools without blood.
What are its causes in children?
Diarrhoea in children is most commonly caused by one of several
diarrhoea-causing viruses. It usually gets better by itself within
a week. In some children specific bacteria or parasites may cause
diarrhoea. Amongst these are Shigella, Salmonella, Vibrio cholerae
(cholera) and Clostridium.
What are the symptoms?
A child with viral diarrhoea has fever and usually diarrhoea is
preceded by vomitings. In spite of the frequent loose stools, the
baby does not look very ill. The paediatrician must be consulted
immediately if the baby - is less than 6 months of age, has blood
in the stool (dysentery), has frequent vomitings, significant
abdominal pain or fullness of abdomen or urinates less frequently
and is extremely thirsty and has dry lips and mouth with poor
intake of liquids, has high fever, weight loss or is malnourished.
What is the treatment?
As long as the child acts well and is taking adequate fluids and
food, loose stools are not a great concern. Children should
continue to eat a normal diet including formula or milk while they
have mild diarrhoea. Breastfeeding should continue. If the babies
abdomen appears bloated the doctor must be consulted to discuss a
temporary change in diet.
Special fluids are recommended to replace water and salts lost
from the body during diarrhoea. These fluid solutions called oral
rehydration solutions or ORS are extremely helpful for the home
management of mild to moderately severe diarrhoea. Although
readymade solutions are available with the chemists, a cheaper
option is to buy the powder and reconstitute the solution at home.
These powders are WHO recommended and a small sachet is prepared
in 200 ml of water. They are given in small frequent amounts,
after each stool with target of obtaining adequate urine and
preventing dehydration. It is always preferred to give WHO
recommended ORS solution rather than make home made solution of
salt, sugar and water where chances of error are more frequent. In
case of severe illness where there is evidence of moderate to
severe dehydration, that is lack of water in the body & also when
there is vomitings and oral acceptance is poor - fluids may be
needed to be given as a drip into the vein. Once the child is
rehydrated, he/she may be allowed to eat as much or as little of
the usual diet as he wants. Liquids are to be replenished in the
body. Anti-diarrhoea medicines like loperamide are not useful in
most cases of diarrhoea and can sometimes be harmful and therefore
are not recommended in children. Antibiotics may be prescribed by
the doctor in cases of dysentery (blood in stool), infective
diarrhoea, age <6 months, malnourished child, sick child or with
evidence of sepsis/infection in the body like in urine, chest etc.
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