Diarrhea: Causes, Treatment

Diarrhea

    • Diarrhea is defined by the World Health Organization as.

    • It having three or more loose or liquid stools per day, or as having more stools than is normal for that person.

    • In diarrhea increase in bowel Movement of patient.

PROBLEMS IN DIARRHEA

    • Abnormalities in the small intestine or the large intestine

    • Loose & watery diarrhea

    • More-frequent bowel movements

    • Mucus in stool

    • Watery stool

    • Stomach pain and Nausea

CAUSES OF DIARRHEA

    • Infections

    • Food poisoning

    • Travellers Diarrhea

    • Antibiotics

    • Anxiety, food allergy

    • Acute appendicitis

    • Acute radiation enteritis

    • Intestinal ischaemia

DIARRHEA CAUSATIVE AGENTS

   VIRAL AGENTS :

    • Rotavirus

    • Human caliciviruses

    • Adenovirus

   PARASITIC AGENTS :

    • Entamoeba histolytica

    • Giardia intestinalis

    • Cryptosporidium and Cyclospora

   BACTERIAL AGENTS :

    • Escherichia coli

    • Campylobacter

    • Clostridium specie

    • Shigella species

    • Vibrio cholerae

    • Salmonella

SYMPTOMS

    • Dehydration (thirst)

    • Dry mouth, lips and eyes

    • Rapid heartbeat

    • Headache

    • Dry skin

    • Low urination and Feeling thirsty, Dark yellow and strong smelling urine.

    • Decrease in urine less than 4 time in a day

    • Feeling dizzy or lightheaded

    • Feeling tired

PREVENTION

    • Drink more water

    • Limit outdoor time

    • Be hydrated using following fruit and drink

    • Take hygienic food like: Watermelon, Raw mango juice, Butter milk, Grapes, Lemon Juice, Coconut water, Kokum sharbat.

    • Avoid heavy exercise in outdoor conditions

TREATMENT

    1. Rehydration the patient by give fluid like water

    2. Need to stable patient so fluids given on primary basic to manage the water loss.

    3. ORS must be given to restore fluid and electrolyte balance.

    4. If ORS is not available, you should provide water or other fluid containing water.

    5. You should not provide drinks with a high sugar content, such as juice, soft drinks or sports drinks, because they could worsen Diarrhea.

   5 BEST MEDICINE DIARRHEA

    1. Loperamide

    2. Ofloxacin and Ornidazole

    3. Ciprofloxacin & Metronidazole

    4. Entero Quinol

    5. Sulfasalazine

     • ORS IS COMPULSORY WITH ANY COMBINATION

1. Loperamide (Imodium)

    • It is Antidiarrhoeal Drug

    • It is first choice during diarrhea

    • Antimotility drug So help to slow or stop loose, watery stools

    • 4 mg followed by 2 mg after each motion (max. 10 mg in a day)

    • 2 mg BD for chronic diarrhoea

Side effects

• Dizziness

• drowsiness

• tiredness

• constipation

2. Ofloxacin and Ornidazole

    • These Medicine is class of medication called antibiotics.

    • It is combination of two antibiotics

    1. Ofloxacin (200mg)

    2. Ornidazole (500mg) mg)

    • So, take 1 or 2 tablet per day

    • Take dose every 12 hour

Side effects

• Dizziness

• Headache

• Stomach upset

• Nausea & vomiting

• Loss of appetite

• Diarrhea OR constipation

• Metallic taste

3. Ciprofloxacin & Metronidazole

• Ciprofloxacin:

    • Ciprofloxacin (500 mg twice daily for one to three days), is usually safe and effective in adults with traveler's diarrhea.

    • If you are traveling to an area where TD is a possibility, you may prescribe cipro or a similar antibiotic for you on your trip.

• Metronidazole:

    • Metronidazole for diarrhoea Flagyl is used to treat parasitic infections including.

    • Amebic dysentery and diarrhea

    • Infection of the colon causing bloody diarrhoea.

    • Use orally as well as parenterally to treat diarrhea.

    1. Minimum dose: 200 mg TDS

    2. Maximum dose: 400 to 500 mg TDS

Side effects

• Dizziness

• Headache

• Stomach upset

• Nausea & vomiting

• Loss of appetite

• Diarrhea OR constipation

• Metallic taste

4. Entero Quinol

    • Entero Quinol is class of medicine called Antiamoebic Drugs use to treat various amebic infections.

    • Salt: Quiniodochlor (250mg)

    • Ideal dose: 250-500mg TDS

    • Maximum 1.5 g/day

    • Don't use in children

Side effects

• Abnormal liver function tests

• Headache & Abdominal pain

• Green color tools en

• Nausea

• Fever and chills

• Hair loss

• Vertigo

5. Sulfasalazine

    • Sulfasalazine is also used to treat bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain in Crohn's disease. Talk to your doctor about the possible risks of using this drug for your condition.

    • Dose 1.5-2 g/day in divided dose

Side effects

• Stomach upset

• Nausea, vomiting

• Loss of appetite

• Headache

• Dizziness

• Unusual tiredness

• Skin & urine to turn orange-yellow

HYDRATION FOR DIARRHEA (ORS)

    • Hydration is very important when you have diarrhea.

    • Dehydration from diarrhea can be fatal in young children and older adults.

    • Continue breastfeeding or formula feeding infants who are experiencing diarrhea.

    • Over-the-counter oral pediatric hydration solutions like ORS must be prefer for this.

FOODS TO EAT IN DIARRHEA

    • Prefer to low-fiber "BRAT" foods that will help firm up your stool.

These Include:

    • Bananas

    • Rice (white)

    • Applesauce

    • Toast

TREATMENT (acute diarrhea)

    In Orally

    • Normally :- loperamide hydrochloride (lopamide)[stat 2 tab] OR norfloxacin & tinidazole (norflox tz ) OR ofloxacin & ornidazole (zenflox oz )

    Abdominal Pain :

    • dicyclomine hydrochloride & paracetamol (cyclopam) OR dicyclomine hydrochloride & mefenamic acid (drotin m)

    Vomiting (bdac or tdsac) :

    • domperidone dispersible (dom-dt) OR ondansetron oral disintegrating (ondem md 4)

    Acid (odac) :

    • Pantoprazole (pan-40 or pan-D) OR Omerazole or Rabeprazole

    Acid+vomiting(odac) :

    • pantoprazole & domperidone (zolpan-D OR pantosec-D)

    Increase Intestine Absorption :

    • Racecadotril Capsule (zedott)

    • *ORS

Injectable Treatment

    Antibiotic (iv) :

    • gentamicin 80mg injection OR amikacin 500 mg injection  AND metronidazole iv infusion OR ceftriaxone iv infusion 

    Abdominal Pain :

    • dicyclomine injection OR diclofenac injection

    Vomiting :

    • ondansetron injection

    Low Blood Fluid :

    NS OR RL OR DNS

    **Monitor heart rate, blood pressure and mental status.

COMPLICATION

     • Deatstroke

     • Seizures due to eletrolyte loss

     • Organ failure

     • Effect of brain function

     • Even death