Diarrhoea, a serious disease

Diarrhoea is a dangerous disease and must be treated as earliest as possible. Roughly one in every two hundred children who get diarrhoea dies from it. Diarrhoea causes dehydration and malnutrition and kills millions of children every year worldwide. Parents and the government can prevent almost all of these deaths and most of the malnutrition caused by diarrhoea by tackling the main causes of diarrhoea which are poor hygiene, lack of clean drinking water, overcrowding, and the trend towards bottle-feeding. It is the responsibility of the government to support the community in tackling these basic problems.
Diarrhoea can kill children by draining too much liquid from the body. So it is essential to give a child with diarrhoea plenty of liquids to drink. Most often diarrhoea kills by dehydration. This means that too much liquid has been drained out of the child's body. So as soon as diarrhoea starts, it is essential to give the child extra drinks to replace the liquid being lost.
Suitable drinks such as milk, gruel (mixture of cooked cereals in water i.e. thin porridge), soups, rice water, fresh fruit juices, green coconut water, water from cleanest possible source brought to boil and then cooled, oral rehydration salts solution must be given to the child to prevent the child from losing too much liquid during diarrhoea.
To replace the liquid being lost from the child's body one of these drinks (ORS) should be given to the child every time a watery stool is passed. Between a quarter and a half of a large cup for a child under the age of two and between a half and a whole large cup for older children.
If the child vomits, wait for ten minutes and then begin again, giving the drink (ORS) to the child slowly, small sips at a time. Extra liquids should be given until the diarrhoea has stopped. This will Usually take between three and five days.
A child with diarrhoea needs food
It is often said that a child with diarrhoea should not be given any food or drink while the diarrhoea lasts. This concept is wrong. Food can help to stop the diarrhoea. Diarrhoea can also lead to serious malnutrition unless parents make a special effort to keep feeding the child during and after the illness.
A Child with diarrhoea usually has less appetite, so feeding may be difficult at first. But the child should be tempted to eat as frequently as possible by offering small amounts of his or her favourite foods.
A child who is recovering from diarrhoea needs an extra meal every day for at least two weeks. Extra feeding after the diarrhoea is vital for a full recovery. At this time the child has more appetite and can eat an extra meal a day for at least a week. This will help the child to catch up on the food lost while the child was ill and the appetite was low. A child is not fully recovered from diarrhoea untill he or she is at least the same weight a when the illness began.
Serious condition
Trained help is needed if diarrhoea is more serious than usual, if it persists for more than two weeks or if the following conditions appear the parents should seek help from a health worker or a doctor without delay:
- has a fever
- is extremely thirsty
- will not eat or drink normally
- vomits frequently
- passes several watery stools in one or two hours
- passes blood in the stool (a sign of dysentery)
Medicines are harmful
Medicines other than ORS should not be used for diarrhoea except on medical advice. Most medicines for diarrhoea are either useless or harmful. The diarrhoea will usually cure itself in a few days. The real danger is usually not the diarrhoea but malnutrition and the loss of liquids from the child's body.
Do not give a child tablets or other medicines for diarrhoea unless these have been prescribed by a doctor. Antibiotics should be given after seeking medical advice. Other drugs should not be used.
Causes and prevention
Diarrhoea can be prevented by immunizing all children against measles, by keeping food and water clean and by washing hands before touching food.
Diarrhoea is caused by germs from faeces entering the mouth. These germs can be spread in water, in food, on hands, on eating and drinking utensils, by flies and by dirt under fingernails. To prevent diarrhoea the germs must be stopped from entering the child's mouth.
Poverty and lack of basic services such as clean drinking water mean that many families find it difficult to prevent diarrhoea. But the most effective ways are:
- Always use latrines to dispose off faeces.
- Wash hands with soap and water immediately after using latrine and before preparing or eating food.
- Cover food and drinking water to protect it from germs.
- If possible food should be thoroughly cooked and prepared just before eating. It should not be left standing, or it will collect germs.
- Bury or burn all refuse to stop flies spreading disease.
- Measles frequently results in serious diarrhoea. Immunization against measles therefore also protects a child against this cause of diarrhoea. There is no vaccine to prevent ordinary diarrhoea.