Diarrhoeal disease is very common in infants and young children. These are caused by more than 100 different bacteria, protozoa or viruses. The majority of diarrhoeas are viral in origin. Diarrhoeas of less than 14 days duration are called acute and are presumed to be infective in origin.
“Diarrhoea is usually watery and there is no blood or pus in the stool”
When it exceeds 14 days it is called chronic or persistent. Dysentery is a more serious form of diarrhea, where the stools are tinged with blood and mucus. The diarrhea can be quite severe, characterized by colicky pains and frequent purging in a child with dysentery.
Causes of acute diarrhoea
Infection of the gut is the common cause. Many bacteria, viruses and other ‘germs’ can lead to diarrhoea. Sometimes the germs come from infected food (food poisoning). Infected water is also a source of bacteria. Sometimes it can just be ‘one of those germs going about’. Viruses are easily spread from one person to another by close contact, or when an infected person prepares food for others.
Non-infectious causes of acute diarrhoea are uncommon in children. For example, colitis (inflammation of the gut), food intolerance and other various rare disorders of the gut.
There may be a prodrome of low-grade fever, body pain, headache and even upper respiratory tract symptoms. The diarrhoea is usually watery and there is no blood or pus in the stool. Vomiting often accompanies the diarrhoea and gastroenteritis can be manifested by vomiting alone. Abdominal cramps may occur. Usually the diarrhoea is self-limiting (2 – 7 days) and none of the true diarrhoea viruses cause chronic diarrhoea. However re-infections with the same virus like rotavirus can occur in childhood.
The most worrying aspect of diarrhoea is dehydration, which means that too much liquid has been drained out of the child’s body. So as soon as diarrhoea starts, it is essential to give the child extra drinks to replace the liquid lost. In spite of the frequent loose stools, the baby does not look very ill. A paediatrician must be consulted immediately if the baby, less than 6 months of age, has blood in the stool (dysentery), has frequent vomiting, 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. Apollo Cradle has a new born screening package called “In Safe Hands” conducts special screening on babies suffering from intense diarrhoea soon after their birth.
As long as the child looks 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. Oral Rehydration Therapy (ORT) is the cheap, simple and effective way to treat dehydration caused by diarrhoea. When diarrhoea occurs, essential fluids and salts are lost from the body and must be replaced. ORT is the giving of fluid by mouth to prevent dehydration that is a result of diarrhoea.
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