Mar 06, 2018
Diarrhea is a dilution( the stool can be watery or mushy) and more frequent( more than 3 times a day) stool, accompanied by the release of more than 200 g of feces of a changed consistency per day.
In its duration, diarrhea can be acute, lasting 7-10 days, prolonged - from 2 to 11 weeks, and chronic - 3 months or more.
Mechanisms for the development of diarrhea
1. Osmotic diarrhea develops as a result of a violation of absorption of nutrients in the intestine. Non-sucked components increase the oncotic pressure in the gut, which leads to increased intake of water in the lumen and an increase in the volume of fecal matter. The main causes leading to disruption in the digestion and absorption of nutrients in the intestine are a defect in the encephalic enzymes( peptidase), a violation of the exocrine function of the pancreas, intestinal dysbacteriosis, cholestasis and a violation of bile acid metabolism, the pathology of the intestinal mucosa( celiac disease, lactase or sugar insufficiency,exudative enteropathy, Crohn's disease, etc.).
2. Secretory diarrhea develops as a result of excessive excretion into the lumen of the intestine of Na +, K + ions, which pull along and water. The most common causes of secretory diarrhea are intestinal infections, such as viruses, for example, rotoviruses, and bacterial( staphylococcus, E. coli, cholera vibrio).To the development of diarrhea can lead and some drugs( theophylline, prostaglandins, diuretics), excessive production of gastrin( Zollinger-Ellison syndrome), malignant neoplasms that stimulate the synthesis of vasoactive intestinal peptides.
3. Exudative diarrhea occurs due to the inflammatory process of the intestinal wall, the result of which is necrosis and flaking of the mucous membrane of the colon. The work of the mucous membrane is disrupted, and an excessive amount of ions and water enters the lumen of the intestine. As a rule, the development of exudative diarrhea leads to bacterial intestinal infection - salmonellosis, shigellosis, iersiniosis, campylobacteriosis and some other, less frequent chronic bowel diseases - idiopathic colitis, Crohn's disease, ulcerative colitis and some others, bowel ischemia.
4. The pathology of the intestinal peristalsis leads to a disruption in the movement of the food mass through the intestines, resulting in the emergence of an unstable stool( episodes of diarrhea, followed by constipation).Such chronic diseases as diabetes mellitus, adrenal insufficiency, diffuse connective tissue diseases, thyrotoxicosis, parasitic infestation, neurological diseases, for example Parkinson's disease, toxic diarrhea( with uremia, mercury poisoning, arsenic) and even irritated syndrome can lead to the development of peristalsis disorders.guts.
5. Reduction of the suction surface leads to faster food movement through the intestines, and, consequently, to insufficient absorption of water and nutrients in the intestine. As a rule, the decrease in the suction surface arises as a result of surgical operations, viz., Extensive intestinal resection.
6. The cause of diarrhea can be severe nutritional disorders - "dietary overloads"( consumption of excessively fatty, spicy, fried foods, seasonings, spices, a large amount of coarse fiber), as well as nervous shocks, anxiety, fear.
7. Drug diarrhea may occur as a result of prolonged use of certain medications. Diarrhea can be caused by antibiotics, antitumor drugs, some antiarrhythmics( quinidine, procainamide), beta-blockers, ACE inhibitors, antidepressants( lithium preparations), tranquilizers, anticonvulsants, drugs that reduce blood cholesterol( lovastatin, clofibrate), antacids, H2-gistaminoblokatory and some others.
Acute diarrhea, frequent removal of watery stools, is not a disease, but rather a symptom of the underlying disease. When food passes through the digestive system, water is absorbed through the walls of the large intestine. Diarrhea and dehydration occur when the liquid is not absorbed, but remains in the intestines and is excreted with feces. Although diarrhea usually goes away without treatment within two or three days, any dehydration it causes is a serious problem( especially among infants and the elderly) and needs to be treated quickly.
• Food poisoning for various reasons, including viruses or bacteria.
• Viral infection of non-food origin.
The treatment of diarrhea consists of symptomatic remedies aimed at improving the general condition of the patient, and etiologic treatment aimed at eliminating the cause that led to diarrhea.
1. To eliminate dehydration caused by the loss of fluid with caloric masses, saline solutions for oral administration are used: trisol, lactasol, regidron, oralite and others at a rate of 40-50 ml / kg of body weight for 4 hours or up to 150 ml / kgbody weight per day. The volume of fluid taken by adults should be at least 2-3 liters per day.
In case of severe dehydration, the fluid is administered intravenously, for this purpose, physiological saline, rehambyrine, haemodez, rheopolyglucin and other solutions are used. Rehydration therapy can prevent severe consequences caused by dehydration.
2. If you have acute diarrhea, you must follow an easy diet. The diet excludes fatty, fried and spicy food, as well as foods that enhance intestinal peristalsis. In the first 2-3 days of the disease, it is recommended to eat home-made breadcrumbs from white bread dried in the oven, with a gradual expansion of the diet: boiled porridge, mashed potatoes, vegetable soups, boiled beef.
3. In the treatment of acute non-infectious diarrhea, antidiarrhoeal drugs are used: Imodium is prescribed at a dose of 4 mg( 2 capsules) at one time, and then 2 mg after each act of defecation. The maximum dose for taking the drug inside an adult should not exceed 8-16 mg per day. Children older than 2 years, the drug is prescribed at the rate of 5 ml( 1 measuring cap) per 10 kg of body weight 2-3 times per day.
4. If the cause of diarrhea is an infection, antimicrobials are used to kill the harmful bacteria that caused it:
• nitrofuran drugs:
- furazoline - affects staphylococci, streptococci, pneumococci. Children under 1 year of the drug is prescribed 10-15 mg per reception, from 1 year to 2 years - 20 mg, 2 to 5 years - 30 and 40 mg, 5 to 15 years and adults - 50 mg of 3-4 times a day;
- furadonin - acts on staphylococci, streptococci, pneumococci, Escherichia coli, protea. The product is available in tablets of 50 and 100 mg. Children the drug is prescribed at the rate of 5-8 mg / kg per day, adults - 50-100 mg 3-4 times a day;
- furagin - acts on staphylococci, streptococci, pneumococci, shigella, klebsiely, enterobacteria, salmonella. The drug is available in tablets of 50 mg. Medication is taken orally 1 to 4 tablets 3 times daily after meals;
- enterofuril - is released in suspension and capsules of 100 mg. Children from 2 to 6 months are administered 2.5 ml 3 times a day, up to 2 years - 2.5 ml 4 times a day, over 2 years - 5 ml 2-3 times a day or 2 capsules, adults- 3-4 capsules 3-4 times a day;
- furazolidone - is available in tablets of 50 mg, single dose is calculated at 0.15 mg / kg per day, 4-6 times a day;
- intetriks - is released in capsules, the average single dose for children is 1/2 capsules, adults 1 capsule per reception, the drug is prescribed 3 times a day, inside;
- nifuroxazide - has the appearance of suspensions in vials and tablets. Children 2-6 months are prescribed 2.5 ml 2 times a day, from 6 months to 6 years - 5 ml
3 times a day every 8 hours, children over 6 years - 5 ml 4 times a day per day every6 hours or 2 tablets 4 times a day;
• Antimicrobials from the group of fluoroquinolones:
- norfloxacin - is used in children older than 15 years. It is appointed orally inside for 1 hour before meal on 200 400 mg 2-3 times a day. The drug is available in tablets of 200, 400 and 800 mg;
- ciprofloxacin - is available in the form of tablets of 250, 500 and 750 mg, as well as in solutions for intravenous administration of 50 and 100 ml( 100 and 200 mg respectively).The drug is prescribed for 125-500 mg 2 times a day;
- ofloxacin - is available in the form of tablets of 200 mg and solutions for intravenous administration of 100 ml( 200 mg);
- gentamicin - is administered intramuscularly or intravenously to newborn infants and children under 2 years of age at a rate of 2-5 mg / kg per day in two administrations, children over 2 years of age - 3-5 mg / kg per day. The drug is available in injection vials of 80 mg, in ampoules of 1 and 2 ml;
- tobramycin - intramuscularly or intravenously, the drug is prescribed at 4-7.5 mg / kg per day in 2-4 doses. The product is released in solutions for injection in ampoules of 1 and 2 ml, as well as in powder in ampoules of 40 and 80 mg;
- amikacin - the agent is administered intravenously or intramuscularly on the first day at a rate of 10 mg / kg, then at 7.5 mg / kg per day in 1-2 divided doses. The medicine is produced in vials with powder for injection at 100, 250, 500 mg and in ampoules with a solution of 2 and 4 ml;
- netromycin - is administered intramuscularly or intravenously to premature and newborn infants younger than 7 days of 6 mg / kg per day in two administrations, newborns older than 7 days - 7.5-9 mg / kg per day in two administrations, children older than 2years - 6-7,5 mg / kg per day in two injections, however, a single administration of the drug is allowed;
• less commonly used drugs of the tetracycline group and levomycetin:
- terracycline - for children older than 8 years the drug is prescribed at a rate of 20-25 mg / kg per day in 2-4 admission. The drug is available in the form of tablets of 50, 100 and 250 mg, as well as in capsules of 250 mg;
- doxycycline - for children from 8 to 12 years, the drug is prescribed at a dose of 4 mg / kg per day, over 12 years - 200 mg per day in 1-2 divided doses. The drug is available in the form of capsules of 50, 100 and 200 mg, tablets of 100 and 200 mg, as well as in ampoules and vials for intramuscular injection;
- Levomycetin - for children under 3 years of age the drug is prescribed at the rate of 10-15 mg / kg, from 3 to 8 years - 150-200 mg, over 8 years - 200-300 mg 3-4 times a day. The product is available in the form of tablets of 250 and 500 mg, capsules of 100, 250 and 500 mg.
5. If the cause of diarrhea is dysbiosis, then bacteriophages are used to kill harmful bacteria. The bacteriophages include:
• intesti-bacteriophage liquid - available in 50 and 100 ml vials. The drug is used 3 times a day for 1 hour before meals in a single dose in children under 1 year of 5 ml, from 1 to 3 years - 10 ml, over 3 years - 15 ml. One intake of the drug inside can be replaced by rectal administration to children under 1 year - 10 ml, from 1 to 3 years - 20 ml, over 3 years - 30 ml. The duration of treatment is 7-10 days. Young children are recommended to dilute the bacteriophage with boiled water;
• bacteriophage staphylococcal - available in ampoules of 2 and 10 ml, in bottles of 20, 50 and 100 ml, as well as in the form of tablets, candles. The drug is administered orally, 3 times a day for 1 hour before meals for 7-10 days, children under 6 months of 10 ml or V2 suppositories, from 6 months to 1 year - 20 ml or U, suppositories, from 1up to 3 years - 30 ml or 1 candle, over 3 years of 40-60 ml or 1 candle. Evening reception of the drug can be done rectally;
• pyobacteriophage, streptococcal and proteus bacteriophage - available in ampoules of 10 ml and in bottles of 20, 50 and 100 ml. Children under the age of 6 months - 10 ml or 1/2 candles, 6 months to 1 year - 20 ml or 1/2 candles, 1 to 3 years - 30 ml or 1 candle, over 3 years - 40-60 ml or 1 candle 3 times a day. The third method can be performed rectally;
• coliprotein bacteriophage and bacteriophage pseudomonas aerogenosis - has the form of vials of 20 and 100 ml. It is prescribed in the same way as streptococcal bacteriophage.
After treatment with bacteriophage, probiotics are given a course of 1-2 months.
6. Sorbents are used to remove harmful substances that are produced by pathogenic bacteria, as well as to fasten the stool:
• Activated charcoal - available in tablets of 250 and 500 mg. Medium take 1-3 tablets 3-4 times a day;
• polysorbate - the drug is prescribed at the rate of 100-200 mg / kg per day in 3-4 divided doses. On average, for children with a body weight of 10 to 15 kg, the daily dose is 1-3 g, 20-25 kg - 2-5 g, 30-40 kg - 3-8 g, more than 50 kg - 5-12 g. Meansis released in powder for the preparation of suspensions for oral administration;
• Lactofiltrum - available in tablets of 500 mg. The drug is prescribed 1-3 tablets 1-3 times a day;
• smecta - children under 1 year of age are prescribed 1 packet per day, from 1 to 2 years - 1-2 packets per day, and over 2 years - 2-3 bags per day. The medicine is issued in the form of a powder for the preparation of a suspension for oral administration in bags containing 3 g of dry matter. Along with the sorption action, the smect binds viruses, bacteria and bacterial toxins;
• enterosorbent - is available in the form of granules for the preparation of a suspension for oral administration in bags of 3 and 10 g, in bottles of 100 and 200 g the drug is prescribed inside in the intervals between meals for children under 7 years - 5 grams, 7-14 years- 7.5 g 3 times a day. The average duration of treatment is 3-15 days;
• Enterosgel - for children under 1 year of age, the drug is prescribed for 1 tsp per day, from 1 to 2 years - 2 tsp per day, 2 to 7 years - 1 teaspoon per reception 3-4 timesper day, over 7 years - 1 tbsp.spoon at the reception 3-4 times a day.
7. Since often the cause of diarrhea is dysbiosis, a violation of the qualitative and quantitative composition of the microflora, and with the goal of restoring the normal microflora of the intestine, prebiotics and probiotics are used. Prebiotics refer to agents that are nutrients for bacteria, and probiotics are themselves useful bacteria.
Prebiotics include the following:
• hilak-forte - the drug is available as a solution for oral administration. Children are prescribed 20-40 drops 3 times a day, before or during meals, washed down with a small amount of water, after the condition is improved, the dose is reduced by half;
• Lactulose( Dufalac) - has the form of a powder for the preparation of solutions in bags of 5 and 10 mg and in bottles of 150, 200 and 350 and 700 g. The drug is prescribed for children from 6 weeks to 1 year of 5 ml, from 1 year to6 years - 5-10 ml, over 7 years - 15 ml each. The drug is used 1 time a day in the morning during a meal.
Probiotics include the following drugs:
• Bifidumbacterin - the drug is available in ampoules, vials, powder and capsules and can be used in children from birth, and in tablets - from 3 years. The contents of the vial or ampoule are dissolved with boiled water at the rate of 5 ml of water per 1 dose of the drug. Newborns and infants are prescribed 1-2 doses 3 times a day immediately before feeding, children older than 6 months - 3 doses 3 times a day, over 2 years - 5 doses 2-3 times a day;
• bifikol - has the form of vials and ampoules of 3 doses, as well as vials and tablets at 1 dose. It is prescribed for children from 6 months to 1 year for 3 doses, over 1 year - 5-10 doses per day for 20-40 minutes before meals;
• bifilysis, the form of release - bottles of 5 doses. Immediately before use, the drug is dissolved in boiled water at room temperature, taken orally, 20-30 minutes before meals. In young children, the medicine is given before meals, or it is mixed with the first portions of food. Children under the age of 1 year are prescribed 5-9 doses, from 1 to 3 years - 10-15 doses, over 3 years - 15 doses;
• Bifiform - comes in the form of capsules. It is prescribed for children under the age of 7 years for 1 capsule 2 times a day, from 7 to 14 years - 1 capsule 3 times a day;
• bifidumbacterin-forte - has the appearance of a powder for ingestion in a package containing 5 doses of the drug. Means taken inside, washed down with water or milk, 30-60 minutes before meals. Children under 6 months are given 5 doses, from 6 months to 1 year - 5-10 doses, from 1 to 3 years - 10-15 doses, from 3 to 7 years - 15-20 doses, over 7 years- 15-25 doses 2-3 times a day;
• lactobacterin - is available in the form of vials but 5 doses, ampoules of 3-5 doses, tablets at 1 dose and suppositories - 1 dose. Children under 6 months are prescribed 1-2 doses, from 6 months to 1 year - 2-3 doses, from 1 to 3 years - 3-5 doses, over 3 years - 5-10 doses. The contents of the ampoule or vial are diluted with boiled water, taken inside for 30-40 minutes before meals 2-3 times a day;
• acylactate - the drug is issued in vials of 5 doses, in tablets and candles for 1 dose. Children under 6 months are prescribed 5 doses, from 6 months to 1 year - 10 doses, from 1 to 3 years - 10-15 doses, over 3 years - 15 doses, from the same age, the drug can be used in the form of tablets;
• Linex - is available in capsules and is prescribed for children under 2 years, 1 capsule 3 times a day, up to 12 years - 1 -2 capsules 3 times a day. To infants before the drug is opened and mixed with a small amount of liquid( juice, tea, boiled water), older children take medicine, squeezed a small amount of liquid;
• Bifiform "Malysh" - is available in the form of powders and chewable tablets with orange-raspberry flavor, used for children under 1 year 1-2 powder 2-3 times a day, children over 2 years - 1-2 chewable tablets 2-3 times a day. The drug is taken regardless of food intake;
• Acipol - form of the preparation: vials and tablets of 5 doses, sachets - 20 doses each. Children under 3 years are prescribed 5 doses 3 times a day.
8. In order to normalize the functions of the pancreas, which affects intestinal infections, enzyme preparations are used: pancreatin, panzinorm-forte, festal, enzyme, mezim-forte, creon, etc.
9. Often a spasm of the intestine that occurs when a disease is accompanied by extremely intense pain, in which case antispasmodics are used.
10. If the cause of diarrhea is chronic autoimmune inflammation of the intestine( Crohn's disease, ulcerative colitis), then non-steroidal anti-inflammatory drugs, glucocorticosteroids, aminosalicylates, cytostatics are used in therapy.
In the light of new research, the treatment of diarrhea in children under the age of three has undergone three major changes.
Mandatory oral administration of electrolyte solutions. Forget about the previously recommended home-made drinks: jelly, cola, ginger beer, juice and water with sugar. Although it is possible to apply them, if solutions of electrolytes are not available( it is better to keep a bottle in the home medicine cabinet just in case), now they are no longer recommended because the salt content is too low and the sugar content is too high, which can aggravate diarrhea.
Earlier feeding. Attempts to starve diarrhea with hunger do not work. Early started feeding provides the body with the necessary nutrition and can accelerate recovery. The treatment described in point five is recommended by the American Pediatric Academy: after twenty-four hours from the start of treatment, you should return to the usual concentration of the mixture and switch to normal diet after forty-eight hours. Even a temporary diet consisting of time-tested bananas, rice porridge, apple juice and toast without oil, may be necessary only in severe cases.
Refusal of juice. Juice may not be the best friend of the intestine. Many juices contain sorbitol, sugar, which is not digested in the intestines and acts like a sponge, absorbing water from the intestinal mucosa and removing it along with the stool, thereby making the stool more watery and aggravating diarrhea. This is why plum juice is a laxative. Excessive consumption of juice( especially pear, cherry and apple) can cause diarrhea, and it also causes abdominal pain and swelling of the belly in two-year-old children who are too lean on it.(This is a general recommendation.) It is better to consult a doctor because your child's diet may need to be changed.)
What not to do with diarrhea
An inflamed bowel requires gentle care. Here's what can complicate the course of diarrhea:
• Do not stop breastfeeding. Breaking breastfeeding may be necessary only in very rare cases, since human milk is not an irritant and may even have a therapeutic effect;it can be the only food and fluid that a sick child will accept or be able to tolerate.
• Do not boil solutions, especially milk and sugar, as boiling causes evaporation of water, making the solution too concentrated, which aggravates dehydration.
• Do not hold the baby without food for longer than forty-eight hours. To recover, your child needs nutrients, and eating only water can in itself cause diarrhea, the so-called hungry stool.
Drugs for Diarrhea
Diarrhea is best treated by recovering fluids, by oral administration of solutions of electrolytes sold at a pharmacy, as described above. Drugs are rarely necessary to treat diarrhea in children under one year. In fact, narcotic drugs, often used to stop diarrhea in adults, are unsafe for children. Although these drugs stop diarrhea by slowing the bowels, in fact they can complicate the situation by allowing pathogens and contaminated fluid to stagnate in the intestines, which increases the risk of these microorganisms entering the bloodstream of the child where they can cause a serious illness. In addition, these medicines, although externally stop diarrhea, still do not affect the loss of fluid in the intestine( internal diarrhea), which leads to silent dehydration, which may be left unaddressed, as it seems that diarrhea is passing.
Diarrhea can occur in a child as a result of antibiotic treatment;parents report that if given daily during the course of treatment with antibiotics powder( which is stored chilled) Acidophilus( a kind of lactic acid bacteria), it reduces diarrhea. This remedy has the effect of restoring normal intestinal
When calling a doctor
Call a doctor if:
• dehydration is strengthened by
• the child has lost more than 5% of the body weight
• the child becomes more sluggish and lethargic
• high temperature
• vomit notdiscontinued
• the child has increased abdominal pain
flora( useful bacteria that live in the human intestine), which is destroyed by antibiotics. Acidophilus and Lactobacillus bifidus can be purchased at grocery stores.
At the time of this book, Imodium is the only safe and effective remedy for diarrhea that is over the counter and is recommended for children under one year of age. The appropriate dose you will find on the package. Be sure to check with your doctor before using a cure for diarrhea.
To prevent rash, apply a barrier cream every time you change a diaper.
"If not from one end, so from the other," complained one mother to the sensitivity of her child's digestive tract. This is a fact of infantile life: what gets inside the child, partially comes back. Here are the most common causes of vomiting in children and what to do.
Dehydration: when diarrhea should cause anxiety
In most cases, diarrhea is only a nuisance, not a disease or problem and quickly passes, it is only necessary to provide a plentiful drink and make small changes in the diet. The main threat that diarrhea carries is dehydration, or dehydration. In your child's body, salts( otherwise called electrolytes) and water are in a well-balanced balance. A healthy intestine and kidneys regulate this balance. Equilibrium is necessary for the normal functioning of organs. Diarrhea breaks this balance, causing the body to lose water and electrolytes, that is, dehydrate. Add vomiting here, and the risk of dehydration increases even more.
How to deal with diarrhea in your child
First point: find out the reason.
Have you changed the baby's diet recently, for example, transferred from artificial infant formula to cow's milk, weaned and transferred to an artificial mixture, introduced new products;or does the child over-feed on a single product, such as juice? A liquid, watery stool( usually without mucus or blood) in a child who is otherwise healthy, and a red ring around the anus( allergic ring) are signs of intolerance to the newly introduced product. Return to the previous diet of the child and reduce the consumption of the product, which is suspected, or completely abandon it( see about food allergies).To the chair should return the previous characteristics in a week. Or, perhaps, your child has a cold and a fever, and he has a poor overall health in addition to a liquid, slimy chair? If so, proceed to the next step.
Point two: determine the severity of diarrhea and dehydration.
Does the child continue to play and do not have dryness( wet eyes, mouth, wet diapers)?Perhaps, if there were no more dirty diapers, you would not have noticed that something is wrong. In this case, you do not need to change anything( except for diapers), and you only need to observe in which direction the chair will change.
To ensure that diarrhea does not cause dehydration, weigh the baby daily, preferably without clothing, in the morning before feeding, on the finest scales you can get. The main rule: there is no weight loss - there is no reason to worry, and there is no need to call a doctor. The degree of severity of dehydration is determined by the amount of lost grams and the rate of weight loss. If your child does not have significant weight loss, he does not dehydrate. However, if your child lost 5% of his average body weight, for example, lost 500 g( with weight to diarrhea 10 kg), he has dehydration with a degree of severity from mild to moderate, which deserves a phone call to the doctor. Sharp weight loss causes more concern than gradual weight loss. If a child with a body weight of 10 kg has lost 500 grams per day, his condition is more troubling than if a child with the same weight lost 500 grams per week. But children under one year usually look very unhealthy if they lose weight quickly;they do not seem so sick if they lose weight gradually. Weight loss of 10%, especially if it occurred within three to four days, indicates severe dehydration, and you should immediately call a doctor, it is better even before such a weight loss occurs.
If you notice that the stool has become more frequent, even greener and even more watery, gushing and your child has symptoms of malaise, although he does not have dehydration and plays cheerfully, go on to the next point.
Third item: eliminate irritant products. If the child also has vomiting, stop giving him any solid food, milk( excluding breastfeeding) and artificial infant formula. If the child does not have vomiting and diarrhea only mild, give up all dairy products, juices and fatty foods. If diarrhea is severe( watery, flowing stools every two hours), do not give the child any food, milk, artificial mixtures and juices. Only in very rare cases is it necessary to interrupt breastfeeding. Abstain from these foods and liquids for 12-24 hours, depending on the severity of diarrhea, starting at the same time oral rehydration( point four).
Fourth point : do not allow dehydration. If the child is not breastfeeding, replace the baby's usual diet with electrolyte solutions in the mouth( such as "Naturalyte" or "Pedialyte", which you can buy without a prescription at a nearby pharmacy or supermarket).
To fix the course of a child's illness, fill out the table. These records will help your doctor give you the right advice as to how soon you can return to normal diet and whether the child has dehydration. Maintaining the table will allow you to contribute to the treatment of your child.
Keep a diary record diary of
Day Weight Number of bowel movements Treatment Treatment of illness
Consult a doctor regarding the minimum and maximum amount of solution that should be given to the baby. These solutions have an ideal balance of water and electrolytes and replace what the child loses with diarrhea. They also contain an amount of sugar that does not exacerbate diarrhea, especially solutions with
Let's, often, sips or slices: sips of a solution and pieces of ice or candies made from a solution of electrolytes. If you are feeding your child from a bottle, give half the amount of electrolyte solution instead of the usual artificial mixture, twice as often. The minimum amount of solution to be given to a child is 130 ml per 1 kg for 24 hours. For example, if your child weighs ten kilograms, give him 1200 ml per day.
If the baby is breastfeeding, give him breastfeed as long as he likes. He will receive all the necessary liquid and will calm down by sucking. If he temporarily gives up his breast, give him a solution of electrolytes in return. Even if he vomits, let him take his breast - maybe it's a little slower to feed, do not give a full chest. If even milk remains in the stomach for only ten to twenty minutes, most of it will be absorbed, and the child will not be harmed if it is vomited by breast milk. In fact, if there is why to empty the stomach, this is perhaps less uncomfortable than the urge to vomit dry.
Point five: go to regular feedings. Depending on the course of the diarrhea and how bad your child feels and also your doctor's recommendations, go back to artificial mixtures( half diluting them with electrolyte solutions) about eight hours after you started treatment.(During these eight hours the child received electrolyte solutions without interruption.) After twenty-four hours, go to the mixture in the usual concentration. Before the end of forty-eight hours, give your child the usual diet, but for several more days, in frequent, small portions. While the diarrhea does not pass, avoid cow's milk, but yogurt or kefir will not cause harm. For a period of recovery from an intestinal inflammation lasting from one week to six, your doctor may advise you to use a lactose-free soy mixture, because the healing bowel may not tolerate lactose. If the baby's diarrhea becomes worse, when you return to solid food, take a step back and start giving more fresh food such as rice, rice porridge and bananas. The main rule: when your child's stool becomes harder, then food can become more solid.
The intestine recovers slowly. It's a common thing when "annoying diarrhea" lasts several weeks during the recovery period after a viral intestinal infection."The chair stays liquid, but the baby stays healthy" - these are the main events of the month. If diarrhea does not go away, especially if it is accompanied by abdominal pain and a bad weight gain, your doctor may send a stool to several crops, in order to identify a parasite such as Giardia( a genus of flagellar parasites in the small intestine of mammals).
Congenital chloride diarrhea
Until now, the only defect of intestinal transport of electrolytes has been clearly described - congenital chloride diarrhea. This disease is characterized by severe watery diarrhea, a decrease in the content of potassium in the blood, chlorides and a violation of the acid-base equilibrium in the body. Distinctive and the most striking feature of the disease is a high concentration of chlorine in the feces.
Congenital chloride diarrhea is a rare disease transmitted by the autosomal recessive type. Evidence of this type of inheritance is more than enough: the cases of the birth of sick children in consanguineous marriages, the horizontal transmission of the disease in the pedigrees and the equal distribution of patients by sex. In carriers of mutant gene, the content of chlorides and potassium in the plasma, as well as the pH of the blood, are normal.
Disease first appears during pregnancy with water, which indicates the onset of diarrhea before birth. Neonates do not have meconium. Concentration of electrolytes in the amniotic fluid is normal. Consequently, congenital chloride diarrhea is a disease in which the phenotype of the fetus affects the course of pregnancy. There are no reports of a successful attempt at diagnosis during pregnancy, although with the presence of a sick person with the same pathology among relatives( especially a brother or sister), the development of polyhydramnios with high probability indicates congenital chloride diarrhea in the fetus. Children are always born prematurely with physical parameters corresponding to the term of pregnancy, with increased at the time of birth, with intestinal obstruction, which lasts for several weeks and does not depend on loss of potassium. Defect in this disease is caused by a violation of transport of chlorides in the ileum and colon. The secretion of chlorine in the stomach and its release through the kidneys are normal. In this disease, sodium and chlorine are secreted into the intestinal lumen, the latter entering more rapidly than sodium, which leads to a decrease in pH in the lumen of the intestine. In the first month of the child's life, jaundice is usually observed, an increased loss of fluid. In the absence of adequate substitution of electrolytes, a severe disturbance of the acid-base state in the body, alkalosis, a decrease in the amount of chlorine, potassium and sodium in the blood develop. Later, the level of sodium in the blood serum is normalized by the addition of hormonal disorders. After the first few months of life, the excretion of electrolytes with feces takes on such a character, when the concentration of chlorine is so high that the diagnosis no longer causes any doubt.
Treatment of congenital chloride diarrhea consists of lifelong replacement therapy with electrolytes and liquid.
• Reactions to certain foods( eg, citrus fruits or beans).
• A large number of artificial sweeteners, such as sorbitol, xylitol and mannitol, found in foods, chewing gum and other products.
• Alcoholic beverages.
• Some medicines, including anti-hypertension medications, for the treatment of heart disease, some antibiotics.
• Infectious diseases such as diarrhea occurring in travelers, typhoid fever, amoebiasis and bacillary dysentery( shigellosis).
• Emotional stress and anxiety.
• Watery stool.
• Increased frequency of bowel movement.
• Spasms and abdominal pain.
• Signs of dehydration in young children: drowsiness;indifference;stretched skin;glazed eyes;dry, sticky mouth and tongue;constant crying.
Clinical manifestations of diseases that caused diarrhea are diverse, but there are fundamental differences in infectious diarrhea from non-infectious diarrhea. If the cause of diarrhea is an intestinal infection, frequent defecation will be accompanied by an increase in body temperature, intoxication, pronounced dehydration, nausea, vomiting, and often the appearance of mucus and blood in the stool.
Loss of fluid and electrolytes( sodium chloride and potassium chloride) is accompanied by the appearance of dizziness, pronounced dryness of all mucous membranes, strong thirst. Pronounced dehydration can lead to disruption of orientation in time and space, coma and even death.
Noninfectious diarrhea is accompanied by the patient's normal condition and state of health, and only with prolonged flow can lead to weakness, weight loss and dehydration as a result of loss of excess unsweetened water and nutrients.
However, almost always diarrhea is accompanied by discomfort or cramping pain in the abdomen, a sense of rumbling, flatulence, painful palpation of the abdomen.
• Diarrhea is easy to identify by characteristic features.
• Laboratory stool analysis can be performed with constant diarrhea.
• Colonoscopy with rectal biopsy can help diagnose diarrhea caused by viruses, bacteria or inflammation.
• Prevent dehydration( which is especially important for the elderly and young children), for which you should drink a solution of one teaspoon of salt and four teaspoons of sugar in one liter of water. Measure accurately, since too much salt can enhance dehydration. Drink 0.5 liters of solution while diarrhea continues.
• Do not take medication for diarrhea within the first few hours( diarrhea can rid your body of carriers of infection or irritants).If work or other obligations require the use of anti-diarrhea drugs, use one that contains loperamide( eg, imodium) or bismuth subaliphaticate( Pepto-Bismol).
• Reduce consumption( or avoid) of dairy products, alcohol and foods rich in dietary fiber, during recovery. What folk remedies can be used with this disease look here.
• For young children: while diarrhea persists, do not feed them with milk. Instead, give them an electrolyte solution, which you can buy at the pharmacy. If diarrhea lasts for two days, start giving milk gradually within 24 hours.
• Do not eat if you think it has deteriorated.
• Avoid foods that you are sensitive to.
• When traveling abroad, drink only bottled or boiled water or other bottled beverages. Eat cooked foods and fruits that you can clean yourself. Local water or raw foods may contain bacteria that cause diarrhea.
• Find ways to relieve emotional stress and try to avoid stress.
• Consult a doctor if diarrhea persists for more than 48 hours or is accompanied by dizziness, severe spasms, fever above 38.3 ° C, or blood in the stool.
• Consult a doctor if diarrhea frequently recurs.
• Attention! Call a doctor immediately if a young child or an elderly person shows signs of dehydration.