Consultant Paediatric Gastroenterologist, Medanta Institute of Liver Transplantation and Regenerative Medicine
What is diarrhoea?
Diarrhoea is the passage of watery stools without blood.
What are its causes in children?
Diarrhoea in children is most commonly caused by one of several diarrhoea-causing viruses. It usually gets better by itself within a week. In some children specific bacteria or parasites may cause diarrhoea. Amongst these are Shigella, Salmonella, Vibrio cholerae (cholera) and Clostridium.
What are the symptoms?
A child with viral diarrhoea has feverand usually diarrhoea is preceded by vomitings. In spite of the frequent loose stools, the baby does not look very ill. The paediatrician must be consulted immediately if the baby - is less than 6 months of age, has blood in the stool (dysentery), has frequent vomitings, 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.
What is the treatment?
As long as the child acts 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. Breastfeedingshould continue. If the babies abdomen appears bloated the doctor must be consulted to discuss a temporary change in diet.
Special fluids are recommended to replace water and salts lost from the body during diarrhoea. These fluid solutions called oral rehydration solutions or ORS are extremely helpful for the home management of mild to moderately severe diarrhoea. Although readymade solutions are available with the chemists, a cheaper option is to buy the powder and reconstitute the solution at home.
These powders are WHO recommended and a small sachet is prepared in 200 ml of water. They are given in small frequent amounts, after each stool with target of obtaining adequate urine and preventing dehydration. It is always preferred to give WHO recommended ORS solution rather than make home made solution of salt, sugar and water where chances of error are more frequent. In case of severe illness where there is evidence of moderate to severe dehydration, that is lack of water in the body & also when there is vomitings and oral acceptance is poor - fluids may be needed to be given as a drip into the vein. Once the child is rehydrated, he/she may be allowed to eat as much or as little of the usual diet as he wants. Liquids are to be replenished in the body. Anti-diarrhoea medicines like loperamide are not useful in most cases of diarrhoea and can sometimes be harmful and therefore are not recommended in children. Antibiotics may be prescribed by the doctor in cases of dysentery (blood in stool), infective diarrhoea, age <6 months, malnourished child, sick child or with evidence of sepsis/infection in the body like in urine, chest etc.