A Weekly column prepared by Dr. Balwant Singh’s Hospitap Inc.
What I need to know about diarrhoea (stomach flu)
By Dr Santosh Mhetre, MBBS,
MD (Paediatrics)
What is diarrhoea?
Diarrhoea is the sudden increase in the frequency of bowel movements
What are the causes?
Usually a viral infection of the stomach and intestines
It usually has to run its course; there is medical cure for this infection. The goal of treatment in this condition is to just treat the dehydration arising out of the diarrhoea.
In general, infections that cause diarrhoea are highly contagious. Most infections can be spread to healthy subjects for the duration the infected individual has diarrhoea, and some infections can be contagious even longer.
Diarrhoeal infections can be spread through:
dirty hands
contaminated food or water
handling pets
direct contact with faecal matter (ie, from dirty diapers or toilet seats)
Anything that the infectious germs come in contact with, can become contaminated. These include toys, surfaces in restrooms and the hands of people preparing food. Kids get infected by touching a contaminated surface, such as the toilet or a toy, and then putting the contaminated fingers in their mouths.
Danger signs: If your child is very weak, limp, unresponsive, or has loose skin, etc, then you need to see the paediatrician immediately.
Can vomiting and diarrhoea
be dangerous to children?
Yes, vomiting and diarrhoea can be harmful because they cause dehydration. Dehydration occurs when too much water is lost from the body as a result of the diarrhoea and vomiting.
Young babies can become dehydrated quickly, but dehydration can occur at any age.
Visit your paediatrician immediately if you see the following symptoms in your baby:
Signs of dehydration
Urine that is darker than usual
Not urinating as often as usual
Thirst (babies may show thirst by crying, being irritable and eager to drink when something is offered)
Irritability
Not eating as usual
Weight loss
Dry mouth
No tears when crying.
Sunken soft spot in babies younger than 18
months
Skin that isn’t as springy or elastic as usual
Blood in stool
Fever more than 102°F
Abdominal pain present for more than 2 hours
Excessive crying for 2 hours or more
Very watery diarrhoea combined with vomiting three or more times
home care advice for diarrhoea
Diarrhoea is the body’s response to getting rid of infection of the intestines. Here are a few tips to cope with rapid fluid loss in diarrhoea:
Mild diarrhoea:
Continue regular diet.
Eat starchy food like rice and ground provisions.
Drink a lot of water.
Avoid fruit juices because they make the diarrhoea worse. White grape juice is a juice that is safe in diarrhoea.
Formula-Fed Infants who are
less than a year old with
frequent, watery diarrhoea
Start oral rehydration solutions such as Pedialyte or ORS for frequent, watery diarrhoea. Formula is fine for average diarrhoea.
If parents can’t buy these products, consider making your own solution. Mix ½ cup of dry infant cereal with 2 cups (16 ounces) of water and ¼ level teaspoon of salt.
If neither is available, use formula (unlimited amounts) until the family can get some. Avoid Jell-O water and sports drinks
Diarrhoea when baby is on
formula feeds
Use full-strength formula. (Reason: it contains adequate water.)
Offer the formula more frequently than you would normally do. Lactose-free formulae are only needed for watery diarrhoea persisting for more than 3 days.
Extra Pedialyte can also give 2-4 ounces of these liquids for every large watery stool.
Solids: if older than 4 months, continue rice cereal, strained bananas, mashed potatoes, etc.
4. Breastfed infants with frequent, watery diarrhoea:
Continue breastfeeding at more frequent intervals. Add solids as above.
Offer 2-4 ounces of Pedialyte between feeds for each large stool especially if urine is dark.
5. Children older than a year with frequent, watery diarrhea:
If child eats enough solids, give water or ½ strength Gatorade. If your child refuses solids, give milk or formula.
Avoid all fruit juices and soft drinks. (Remember: white grape juice is fine for your child).
Pedialyte is rarely needed. For severe diarrhoea, give 4-8 ounces of Pedialyte for every large watery stool.
Starchy foods are absorbed best. Give dried cereals, oatmeal, bread, crackers, noodles, mashed potatoes, rice, carrots, apple sauce, strained bananas, etc.
Can diarrhoea be prevented?
Although it’s almost impossible to prevent kids from ever getting infections that cause diarrhoea, here are some things to prevent diarrhoea:
Make sure kids wash their hands well and often, especially after using the toilet and before eating. Hand washing is the most effective way to prevent diarrhoeal infections that are passed from person to person. Dirty hands carry infectious germs into the body when kids bite their nails, suck their thumb, eat with their fingers, or put any part of their hands into their mouths.
Keep bathroom surfaces clean to help prevent the spread of infectious germs.
Wash fruits and vegetables thoroughly before eating, since food and water also can carry infectious germs.
Wash kitchen counters and cooking utensils thoroughly after they’ve been in contact with raw meat, especially poultry.
Refrigerate meats as soon as possible after bringing them home from the supermarket, and cook until they no longer are pink. After meals, refrigerate or dispose of all leftovers as soon as possible.
Never drink from streams, springs, or lakes unless local health authorities have certified that the water is safe for drinking. Also, exercise caution when buying prepared food from street vendors, especially if no local health agency oversees their operations.
Don’t wash pet cages or bowls in the same sink that you use to prepare family meals.
People can reduce their chances of getting infected by frequent hand-washing, prompt disinfection of contaminated surfaces with household chlorine bleach-based cleaners. If food or water is thought to be contaminated, it is best avoided.
Is there a vaccine for viral
diarrhoea (gastroenteritis)?
Currently there is a licensed rotavirus vaccine available that protects against severe diarrhoea from rotavirus infection in infants and young children. Studies into a norovirus vaccine are underway.
