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Thursday, April 03, 2008

How to Manage the Trots (diarrhoea) at home

Diarrhoea is one of the most common childhood diseases all over the world. While infectious gastroenteritis (i.e. diarrhoea caused by germs) is the commonest condition leading to loose stools, or the "trots" as this is called in some parts of the world, non-infectious conditions such as the traveller's diarrhoea and diarrhoea due to food poisoning are also the causes in a small percentage of children.

When your small child gets loose motions, it is more often than not of the infectious variety, and in over 80% of such cases, the offending germ is a VIRUS, a type of microbe that is normally only visible when seen through the lens of an electronic microscope. Viruses, unlike bacteria, cannot be "killed" by using common antibiotics; rather, one has to bide one's time and wait till the body's own fighting power overwhelms them and leads to recovery of the individual.

Diarrhoea, by itself, is not necessarily a dangerous thing; the problems it causes are due to the loss of water and vital electrolytes from the body into the stools. This loss of vital fluid and electrolyes is called "dehydration".

Therefore, the most important thing that parents can do is to prevent the occurrence of dehydration by a two-pronged strategy:
a) Remove the cause of the diarrhoea by taking the child to a medical facility and check-up and treatment by a pediatrician or a trained pediatric assistant or nurse and
b) Give the child sufficient electrolyte enriched fluids (=containing salt and sugar) so that on-going losses are faithfully replaced and there is no net loss of fluid from the body.

To give the salt -sugar water, take a 2-finger pinch of salt and add it to a medium glass full of clean water (approximately 200 mL); next, add 1 teaspoon of sugar to the same and stir the mixture thoroughly with a clean spoon. Once the sugar has dissolved properly, the "Oral Rehydration Salts" (ORS) solution is ready. This solution can be given repeatedly, till the child is taken to a medical facility, or, in milder cases, till the diarrhoea gets resolved.

The ORS should be given with a spoon in infants and with a cup or glass in older children. For infants, each large stool is considered equivalent of 40-60 mL, and hence, the baby should be given at least a quarter cup of ORS between each pair of loose stools.For older children, the quantity needed should be half to three-quarters of a glass per stool. A similar allowance can be made for vomits passed in the interim.

All through the rehydration, the child must continue to be fed, whether breast milk or top milk or other foods. Feeding the child prevents the child from losing weight and becoming undernourished.

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Dr. Fuhrman

Dr. Fuhrman