DIARRHOEA

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Diarrhoea is not a disease but a symptom of an underlying condition.  The patient experiences frequency of bowel movement and there is the frequent passage of watery stools.  Diarrhoea usually clears up in a few days if symptomatic treatment is started promptly.  In adults the condition is usually not serious.  However in children and elderly, if the accompanying dehydration is not treated, the condition could be fatal.

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Symptoms

v Increased frequency of passing stools.
v Loose watery stools, sometimes accompanied or preceded by abdominal cramps.
v Flatulence or excessive passing of wind.
v Loss of appetite.
v Sometimes fever.
v Sometimes nausea, vomiting.
v Muscle pain.

Complications

The most common complication is dehydration.  Dehydration could be slight or severe.
Slight dehydration is when the patient has the following symptoms/signs: -
v Loses 5-10% of body weight.
v Restless and irritable.
v Has sunken eyes.
v Tears are absent.
v Mouth and tongue are dry.
v Thirsty and drinks eagerly.
v Slight loss of elasticity of the skin.

In severe dehydration the patient has the following signs/symptoms: -
v Loss of more than 10% body weight
v Lethargic and may even become unconscious.
v The eyes are very sunken.
v Tears are absent.
v Mouth and tongue are very dry.
v Drinks little or unable to drink.
v Skin elasticity is reduced markedly, so that when the skin is pinched upwards, it takes a
    few seconds for the skin to go flat again.
v Decreased amount of urine.

Causes of Diarrhoea

v Drinking contaminated water.
v Eating contaminated food.
v Food intolerance e.g. lactose intolerance.
v Viral, bacterial or parasitic infection of the intestines e.g. Rotavirus, Shigella and amoeba.

Chronic causes

When diarrhoea lasts for more than 3-5 days, it might be due to one of many chronic causes such as,
v Gastrogenous or stomach disorders – e.g. anemia, cancer.
v Following surgery –e.g. gastrectomy.
v Diseases of the intestine.
v Chronic enteric infection - Bacterial infections like Salmonella and Shigella, viral infections     and protozoal infections
v Infestations of the intestines e.g. roundworm
v Absorption defects
v Post-operative problems
v Internal fistula
v Deficiency conditions e.g. pellagra
v Common ulcerative diseases e.g. ulcerative colitis.
v Functional colonopathy e.g. excessive or prolonged use of laxatives.
v Cancer
v Toxic drugs containing mercury or arsenic.
v Pancreatic diseases- e.g. tumors, chronic pancreatitis.
v Gall bladder and biliary tract disease –e.g. fistula between biliary tract and intestinal tract.
v Reflex diarrhoea due to extracolonic disease e.g. pelvic inflammation, urinary tract
    condition, appendicitis etc.
v Constitutional diseases- e.g. hyperthyroidism, uraemia, collagen diseases.
v Organic neurological diseases –e.g. intracranial disease.

What You Can Do

Simple diarrhoea is usually of a short duration of 3 days and is self-limiting, provided the accompanying dehydration is attended to quickly.

v Take lots of fluids.
v Avoid alcohol, caffeinated drinks and milk.
v Take oral rehydration fluids (consult your pharmacist)
v Take soft, bland diet such as porridge, crackers or toast, cooked apple or bananas.
v Avoid fatty food and meats and raw vegetables, which are more difficult to digest.
v If the diarrhoea does not stop in 2-3 days or the condition becomes worse, consult your
    doctor.
v Take antidiarrhoeal medicine after consultation with your pharmacist or doctor.

Babies

v Continue breast-feeding.
v If formula fed, dilute the formula and give oral rehydration fluids after consultation with your
    pharmacist or family doctor.
v Avoid giving an antidiarrhoeal medicine for babies and children.
v Monitor the condition of the baby or young child very closely.
v Consult your doctor if the diarrhoea does not stop or the child starts vomiting or there are
    any signs of dehydration or if there is blood or mucus in the stools.

What Will The Doctor Do and Recommend