Q. What is Diarrhoea?       Top

A. Diarrhoea means frequent, watery bowel movements. Mild Diarrhoea is when the child passes a few loose stools. Severe Diarrhoea is the passage of many watery stools.

Q. Why does one get loose stools?        Top

A. Normally the food we eat is digested in stomach and the intestines. The food mixes with the digestive juices and is in liquid form. When the food reaches the colon, most of the fluid is absorbed, producing a semi-solid stool. Diarrhoea occurs when the food residue passes through the colon too quickly or the fluid is not absorbed because intestinal infection or any intestinal disease.

Q. Types of Diarrhoea?        Top

A. The different types of Diarrhoea are :

Gastroenteritis : This is a watery Diarrhoea. It is usually caused by an intestinal infection which can be due to viruses or bacteria. Other causes include anxiety, medications and allergies.

Q. Is Gastroenteritis such a serious illness?        Top

A. Diarrhoea and vomiting is a common complaint in children. It s therefore often taken lightly by parents. Fortunately most cases are mild self limiting. Sometimes gastroenteritis can be a serious illness. It remains the commonest cause of admission to hospital in children. Gastroenteritis is dangerous mainly because it can lead to dehydration. Children with gastroenteritis often get dehydrated quickly because of loss of water from the body due to the Diarrhoea and vomiting. In addition, children with gastroenteritis reduce their intake of food and water due to the accompanying nausea and abdominal pain. Infants in particular tend to get dehydrated  quickly. In case of severe dehydration it becomes necessary to maintain hydration by giving Intravenous fluids, which procedure is usually carried out in the hospitals.

Q. What are the signs of dehydration?       Top

A. There are signs of dehydration when :

Q. What is the treatment of Gastroenteritis?        Top

A. The treatment of gastroenteritis needs looking after:
* Dehydration
* Diet
* Drugs

Q. What are the signs of dehydration?        Top

A. Loss of fluid with loose stools and vomiting can result in dehydration. Dehydration can be recognized by the following signs:
* Dry tongue
* Less urine output
* Depression in the soft spot over the head (anterior fontanelle)
* Loss of elasticity of the skin
* Lethargy or excessive sleepiness
* Toxic look of the child

Q. What kind of diet can I give my child during Gastroenteritis?        Top

A. Diarrhoea results in loss of nutrients and children often lose weight during an episode. It is commonly believed that food should not be given during Diarrhoea because it worsens the Diarrhoea. This is not true. "Starving" the child or "giving rest to the intestine" are harmful practices.

Maintaining the nutrition in Diarrhoea is important. The following guidelines can be followed.

Breast Feeding: Must always continue.

Fresh Milk or Formula: Continue to offer milk. You need not dilute milk during a Diarrhoea episode. Milk may need to be diluted (e.g. 2 parts milk : 1 part water) only in cases where the Diarrhoea is prolonged and milk indigestion (lactose intolerance) is suspected.

Soya Milk: Is given when Diarrhoea is prolonged (e.g. more than 7 days) as the child may be having ‘Lactose Intolerance”. This is a condition where the child is not able to digest the sugar in the milk (i.e. lactose). Giving milk to these children worsens the loose stools. In such cases the child is put on a Soya Milk preparation.

Light Diet: Easily digested food should be offered to the baby; e.g. ripe banana, stewed apple/apple juice, arrowroot kanji, rice moong dal khichdi, curd rice.

Heavy Diet: Avoid: Fried, oily, spicy or heavy foods like eggs etc till the loose stools have settled.

Q. Are any drugs required to treat gastroenteritis?        Top

A. The main treatment of gastroenteritis is DIET and ORF. The following drugs are occasionally required:
* Antibiotics: Drugs to control the infection
* Antiemetics: Drugs to control vomiting
* Antispasmodics: Drugs to relieve abdominal pain
* Antipyretics: Drugs to control fever

Q. Are Antibiotics necessary in Gastroenteritis?        Top

A. The most important treatment in gastroenteritis is DIET and ORF. Antibiotics are usually not required. Most cases of gastroenteritis settle without them. Antibiotics are given under the following circumstances:

* When there is Blood and Mucus in stool
* Young infant 
* Severe Infection: i.e. high fever, toxic look, severe purging etc
* Stool Exam shows many pus cells

Q. Can I give any medicines to stop the loose stools?        Top

A. Drugs which stop loose stools without controlling the infection are not advisable in children for the following reasons:

1. They have side effects
2. They do not help the child. The loose stools do stop but the infection is not controlled. The infected liquid stools remain inside the body instead of coming out. This has potential problems. The infection can remain in the body and can spread to the blood causing more serious complications.

Q. How is vomiting controlled if accompanied by Diarrhoea?        Top

A. Vomiting often complicates Diarrhoea and this makes it even more difficult for the parent to prevent dehydration. The following strategies will help control the vomiting:

Drugs: Various medicines are given that control vomiting.

Small Feeds: This is crucial. When the stomach is irritated, it will not retain a large feed even if the child has taken it willingly. Small frequent feeds are more likely to be retained. One sometimes needs to give feeds as little as one teaspoon at a time.

Frequent Feeds: Offering liquids frequently every few minutes is useful. Offer liquids every minute or two initially in small quantities. Once these are retained, you can increase the amounts.

Liquid Feeds: Liquids are better tolerated than solids. Start with clear liquids. Try Electrolyte Solutions or ORF.

Soft Diet: Once liquids are tolerated start with soft foods.

Stop Antibiotics! Occasionally the vomiting may be caused by the antibiotic, which is prescribed for the Diarrhoea. The antibiotic might therefore create more problems than it might solve.

A. Diaper rash from Diarrhoea is common. The skin near your baby's anus can become irritated by the Diarrhoea. The following precautions will prevent nappy rash:

* Wash the area near the anus after each bowel movement and then protect it with a thick layer of nappy rash ointment.
* Changing the diaper quickly after bowel movements also helps.