In this post I would like to share some of my medical experience in dealing with child diarrhea. Some of you might think this is a simple matter. How ever if it is left untreated, it’ll bring harm to the patients.
What is Diarrhea ?
Diarrhea is a medical condition characterize with loose, watery stool more than three times in 24 hours. Not only there is excess loss of water, but also loss of electrolyte (Sodium, Potassium and Chloride) and zinc in diarrhea cases. Consistency of the stools rather than frequency is the mot important in considering diarrhea diagnosis. A frequent passing of formed stools is a not considered to be diarrhea (WHO, 2007)
There are several things that we have to understand before going further
- Stool of breastfeeding and artificially feeding infant usually is watery. But this is not a diarrhea. Note on the regularity of your infant defecation. If it exceed the regular frequency, i strongly suggest to see your physician.
- Irritable Bowel Syndrome (IBS) may also cause watery stool. However, this is not diarrhea. I will discuss about IBS on another post in this website.
- Factitious diarrhea, this is a condition where a person deliberately produce diarrhea by using (usually) laxative.
There are various causative agent of diarrhea. It can be virus (such as Rotavirus which is the most common cause), bacterial (such as E. Coli) and parasite (Amoeba). For parasite infection, we may see blood stained stool. On the other hand, we need a fecal examination to rule out bacterial and virus.
Type of Diarrhea
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Based on duration:
- Acute Diarrhea : 3 – 7 days
- Indeterminate Diarrhea : 8 – 14 days
- Persistent Diarrhea : > 14 days
Based on characteristic of the stool:
- Watery Diarrhea
- Bloody Diarrhea
There are several mechanism of the diarrhea:
- Osmotic Diarrhea: this type usually caused by the presence of non-absorbable substance in the intestine, such as lactose intolerance. We just have to avoid the substance causing diarrhea.
- Secretory Diarrhea: the cause of this is a presence of endogenous substance that induce fluid secretion. The common example is toxin produced by E. Coli. This bacteria actually a normal flora in the intestine. However due to certain change in the intestine’s environment, this bacterial can turn into pathogenic.
- Congenital Defect Induced Diarrhea
- Reduction of Anatomic Surface : typical example is the short bowel syndrome.
- Alteration of colon motility : typically found in children with malnutrition, person with Diabetes and in the case of intestinal obstruction.
Why it can be dangerous?
Diarrhea, if left untreated, may cause death due to lost/lack of fluid and electrolyte. As we all know that human body consist of 80% of water. A reduce of great amount of bodily fluid (dehydration) can cause a disturbance in our homeostasis.
Based on the severity, dehydration can be classified into 2 types:
- Mild to moderate dehydration: children usually don’t show any dangerous sign. They usually get thirsty easier. However can still do daily activity well. Sometimes they also become restless.
- Severe dehydration (this is dangerous!): children will show a symptom of weakness, lethargy and unwillingness to do anything. If your children fall into this dehydration, please rush to the ER to seek a professional medical treatment.
Same goes with electrolyte. Several electrolyte plays an important role in cell metabolism, which is the very basic of human’s body. In diarrhea case, as a person let out a watery stool, certain amount of electrolyte also loss with the watery stool.
For example: Potassium Ion. This ion regulate the heart pumping mechanism. Loss of this ion in a large amount will disturb it and suddenly lead to cardiac arrest.
Now we get to the main part of this article, how to make a home treatment for diarrhea. However there are several things that you need to know:
- Firstly, only non bloody diarrhea can be treated with home remedies.
- Second, if dehydration follow, only diarrhea with mild-to-moderate dehydration is allowed to be treated home.
- Last but not least, i strongly suggest to bring your children to doctor if the diarrhea persist longer than 5 days.
FIRST STEP: Identify Your Children
First thing first, you have to clearly understand your children problems. You have to identify the type of diarrhea that get your children. If dehydration follows, then identify the severity of it. You must rule out three things that I’ve mentioned above.
In case of dehydration, you really need to determine whether it is mild to moderate or severe dehydration. Beside paying a close attention to any sign of lethargy or weaknesses, there is also another simple examination to rule out severe dehydration. Try to palpate an upper area of frontal bone like shown below, especially on anterior frontella. In severe dehydration, you will feel the frontella a bit sunken compare to other area of the skull. If this happen, you have to immediately go to the hospital to seek medical professional.
SECOND: Treat the Dehydration!
As I mentioned above, dehydration caused by diarrhea may lead to a fatal outcome. So always make sure that your children free of dehydration. If your children don’t have any sign of dehydration, it doesn’t mean they are yet free from it. You can say it is on its way.
Make sure they take enough fluid to replace the loss one. Also make sure their electrolyte supply is enough. If you happen to have ORT (Oral Rehydration Therapy) at home, you can use it. But if you don’t, try to make some home-made soup that have salt and sugar in it. Not only it use for fluid therapy but it also help to replace electrolyte since it has salt and sugar in it. And hey! It’s a soup, everybody love it!
THIRD: Give Medication
The only medication that can be given at home is Zinc. Several medical research found that giving zinc as an adjunct to ORT in children with diarrhea can improve their healing rate. For child under 6 months old, give 10 mg of Zinc once daily for 10 days. For child older than 6 months, give 20 mg of zinc once daily for 10 days. You can use both tablet and syrup, choose one.
I don’t recommend early antibiotic or anti-parasite use, cause most child bacterial is cause by a viral infection (a self limiting disease). For parasitic and bacterial infection, usually need a hospitalization. Give your children not more than 5 days with supportive treatment. If the diarrhea persist, immediately seek medical help.
And try to reduce fiber consumption during diarrhea period. Fiber can induce secretory fluid loss in the colon. It will worsen the condition.
KEEP IT CLEAN: Before entering kid’s mouth
Last but not least, keep the hygiene of everything before putting it into your children mouth. Tell your children to always wash their hand.
That’s all about it, I hope this can be useful. Thank you.
Stay healthy and eat your soup!