Diarrhoea refers to the frequent passage of loose or watery, unformed stools. It is one of nature’s eliminative actions, whereby the intestines throw off the unwanted matter. As a rough guide, passing three or four loose stools a day can be considered as diarrhoea.

Diarrhoea is one of the most common diseases that afflict infants and young children. It is one of the major contributors to malnutrition, poor health and inadequate performance in children. In many countries, it is the main cause of death among children in this age group. In the case of acute diarrhoea, they die as their bodies do not quickly replace enough water and electrolytes (sodium, potassium etc.) lost in the stools and vomit. The peak age of incidence, in general, is between six months and two years. However, where babies under six months are bottle-fed, can also be affected by this disease.

Symptoms

Diarrhoea in children is of two types, simple and infective. Simple diarrhoea may be accompanied by vomiting or griping pain in the stomach. The child refuses milk, keeps on crying and cannot sleep.

Infective diarrhoea is, however, a serious disease. It is the most commonly seen form of diarrhoea in children. It presents itself in two forms. IN the first form, the onset is gradual and looseness of the bowels is the first symptom. There may be five to ten motions a day. Thin and frequently green they soon show traces of mucus. Usually fever is also present. It may run into a mild course, or become progressively worse and turn into inflammatory diarrhoea.

In the second form, the onset is sudden and marked by vomiting, fever and numerous loose green motions. In the beginning, the motions may be large and watery and contain blood, but later they become green or brown and contain mucus.

Causes

There are many and varied causes of diarrhoea in children. Contaminated milk or infection in the ailmentary canal may cause this disease in infants. If an infant is breast-fed, the digestive disorders of the mother can be transmitted to the child. Diarrhoea is often associated with poor hygiene and careless preparation of feeds, crowing in homes and hospitals. Other causes include nervous irritability, excessive intake of laxatives, parasites, virus, bacteria. In grown-up children, the cause in all cases is wrong feeding, especially the intake of large quantities of protein foods such as meat and fish in hot weather.

The disease sometimes occurs as a complication of measles, malaria and other infections outside the gut such as tonsillitis, and pneumonia. Chronic diarrhoea is sometimes due to chronic infection of the gut, but is more often due to damage to the intestines from a previous acute infection.

Complications

Diarrhoea for prolonged periods can lead to certain definite complications. Among these, dehydration poses a serious problem, especially when disease is accompanied by vomiting. It can even be fatal if not treated early. Dehydration is characterised by hot, dry skin over the abdomen, sunken eyes, dry mouth, intense thirst and reduced flow of urine. This can usually be prevented if the child-patient is given plenty of liquids with electrolytes.

Treatment

A simple diarrhoea, resulting from digestive disturbances, is severe. It can pass off with the removal of the cause. The child should be given the juice of an orange diluted with water on 50:50 basis for a day. This will help in improving the condition. Correct dietary method will prevent further occurrences of the trouble.

In case of infective diarrhoea, the child should rest in bed. He should be given warm-water enema daily, for the first two or three days of the treatment to cleanse the toxins in his bowels. It will expel gas and check diarrhoea by decreasing rectal tenesmus. He should be given orange juice and water for a few days. Milk and solid foods should be avoided at all costs. As soon as the condition improves, the child may be put on an exclusive diet of fresh fruits for two or three days. Thereafter, he may be allowed to gradually embark upon a regular, well-balanced natural diet, according to his age, with emphasis on milk, fruit juices, fresh fruits and steamed vegetables.

Certain home remedies have been found effective in curing diarrhoea. These include carrot soup, pomegranate and the butter milk. Carrot soup supplies water to combat dehydration, replenishes sodium, potassium, phosphorus, calcium sulphur and magnesium. It also supplies pectin and coats the intestine to allay inflammation. It also checks the growth of harmful intestinal bacteria and prevents vomiting. Half a kg. of carrots may be cooked in 250 ml. of water until it is soft. The pulp should be strained and boiled water added to make a litre. Three-quarter tablespoon of salt may be mixed. This soup should be given in small amounts to the patient every half an hour.

Pomegranate (anar) has proved useful in controlling diarrhoea, on account of its astringent properties. It is especially beneficial in case of weakness due to profuse and continues purging. The patient should be given about 50 ml. of pomegranate juice to drink at frequent intervals.

The use of buttermilk is also found beneficial in the treatment of diarrhoea. It helps overcome intestinal flora and reestablish the bening or friendly flora. The acid in the butter milk also fights germs and bacteria. A cup of buttermilk mixed with a pinch of salt may be taken three or four times a day for controlling this disease.

The best water treatment for diarrhoea is the application of abdominal compress at 60 o F. It should be renewed every 15 to 20 minutes. A cold hip bath for 10 minutes will be beneficial for older children suffering from diarrhoea. For this bath, ordinary bath tub can be used. It should be filled with cold water ( 50 o to 65 o F), so as to cover the hips when the patient sits in it. In case of abdominal pain, hot fomentation for 15 minutes should be administered every two hours.