India is under the grip of scorching summer heat with temperature making a new record daily. In this season, people often suffer from dehydration and diarrhoea. Below five years old children get affected the most.
Here is a brief explainer on diarrhoea:
What is Diarrhoea?
Diarrhoea is when your stools become loose or watery. The definition of diarrhoea is passing loose or watery stools three or more times in a day.
What is dehydration?
Dehydration occurs when you lose more fluid/ water than you take in and your body doesnt have enough water to carry out its normal functions. If you dont replace fluids, you will get dehydrated.
Diarrhoea can cause dehydration, especially in young children and older people.
What are the Symptoms of dehydration in older children and adults?
- Thirst
- Lack of energy
- Passing less urine than normal
- Dizziness or light-headedness
What are the Symptoms of dehydration in children?
The symptoms of mild to moderate dehydration are
- Dry mouth
- Passing less urine than usual (often noticed as fewer wet nappies in babies and toddlers)
- Irritability
- Listlessness
- Less tears when crying
The signs of severe dehydration in children are?
- Sunken eyes, cheeks or belly, or a sunken fontanelle (the soft spot on the top of the head in babies and toddlers)
Who are at higher risk for dehydration?
Small children and old age people are at risk of becoming rapidly dehydrated. They require immediate medical attention
What are the other common symptoms which may co-exist in a child with diarrhoea?
- Painful abdominal cramps
- Blood or mucus in stools (Dysentery)
- Nausea
- Fever;
- Bloating
- Generalised weakness
What are the causes of Diarrhoea?
- Most common cause is infection (with a virus, bacteria or parasite);
- Indigestion
- Food intolerance (e.g. lactose)
- Inflammatory bowel disease (ulcerative colitis or Crohns disease)
- Irritable bowel disease;
- Medicines (e.g. a side effect of antibiotics or some diabetes medications)
What is the most common route of infection?
Infectious diarrhoea is most commonly spread by Faeco oral route. It gets spreaded by eating or drinking food or water contaminated with viruses or bacteria.
Is there any vaccination available to prevent diarrhoea?
Vaccination is available against rotavirus, which is the most common organism causing diarrhoea in young children below five years.
The vaccine is given as three doses as part of the routine childhood immunisation schedule at six weeks, 10 weeks and 14 weeks of life.
What is ORT (Oral Rehydrating Therapy)?
Hailed by WHO (World Health Organisation), ORS has saved lives of millions of children all over the world. It is proven fact that almost 90 per cent of childhood diarrhoea can be managed with ORS alone.
WHO-ORS :
Salt and sugar solution (2 pinch of salt and one teaspoon of sugar is added to 1 glass clean water)
Tender coconut water
Rice water or Butter milk with salt
What is not ORT?
Glucose water without salt
Fluids without starch or sugar and salt
Fluids consumed in small quantity like Tea, Coffee
What diet should be taken in Diarrhoea?
Food should be easily digestible and it should be taken in small quantities at shorter intervals.
Breastfeeding to be continued in young infants.
Cows milk/ regular formula milk is to be avoided if diarrhoea persists for more than one week.
Low lactose formula/ Soya milk can be given in such cases.
Easily available, culturally acceptable, palatable and energy dense foods can be offered. Example- Khichri with extra oil, mashed potatoes with oil, mashed banana, curd rice, bread and other cereals can be taken.
Food with high fibre content like fruits and vegetables are avoided.
When do we seek medical help in diarrhoea for children?
- Diarrhoea lasting for more than 48 hours
- Vomiting that is stopping them from keeping down fluids
- Blood or pus in their stool
- An associated rash
- Severe pain in their abdomen
- They are lethargic, cool, floppy, pale or looking unwell
(Disclaimer: The writer is Dr Mohammed Yunus Kafil, Director Embrace, Consultant Paediatrician, Primecare Hospital, MBBS, DNB Paediatrics, PGPN. The views are personal opinion.)
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