Diarrhoea is passing of loose watery stools more than three in number in a day. Diarrhoea is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths/year in children under 5 years of age. Diarrhoea is also a leading cause of malnutrition in children under five years old. Most common cause of diarrhoea is viral infections. Other causes include bacterial infections, food allergy, diseases of intestine interfering with the absorption of food.
Tips for Prevention of Diarrhoea:
Safe disposal of excreta
Childhood Immunization e.g rotavirus
Vitamin A supplementation in children aged 6-59 months.
Antibiotics in cases of invasive bacterial diarrhoea
The role of oral rehydration in Diarrhoea Management:
A major concern in diarrhoea is not the infection per se, but it is the deficit of water and salts that result from frequent passage of stools. Dehydration or water deficit may be severe enough to cause death.
Fluid losses if severe enough can impair blood supply to the kidney, resulting in even renal failure. Diarrhea also results in salt losses along with water which is important for normal functioning of a vital organ like heart and brain.
Salt imbalance can cause unconsciousness and seizures. So the main treatment of diarrhoea and dehydration is rehydration or replacement of lost fluids and salts. Oral rehydration is the best method to replace losses as long as patiently is able to accept orally and tolerate.
Oral rehydration therapy (ORT) with ORS remains the cornerstone of appropriate case management of diarrheal dehydration and is considered the single most effective strategy to prevent diarrheal deaths in children.
ORS replaces the lost fluids and essential salts thus correcting dehydration resulting from fluid losses in diarrhoea, and replenishes salt stores and thus reducing complications and death. The glucose contained in ORS solution enables the intestine to absorb the fluid and the salts more efficiently. If glucose is added to a saline solution, the glucose molecules are absorbed through the intestinal wall – unaffected by the diarrhoeal disease state – and in conjunction, sodium is carried through by a cotransport coupling mechanism. This increased relative concentration of Na+ across the intestinal wall pulls water along. This way ORS containing the specific concentration of glucose and salt helps to correct dehydration without worsening of diarrhoea.