Skip to main content
SpringerLink
Log in

Management of diarrhoea in practice

  • Symposium on Common Pediatric Problems-II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Diarrhoea, a major cause of morbidity and mortality can be produced by a variety of etiological factors. Management protocol includes assessment of the child, physical examination, lab-evaluation, assessment of severity of dehydration and rehydration therapy using either of the following-WHO-ORS, Home available fluids (HAF), sugar salt solution (SSS), improve WHO-ORS, Amino acid fortified ORS, rice based ORS, low osmolarity ORS. Intravenous fluids are required if patients can’t accept orally. Commonly observed electrolyte disturbances are hypernatremia, hyponatremia and hypokalemia. Conculsion is a common problem and can result due to electrolyte imbalance, cavernous sinus thrombosis, associated meningitis, shigella eccephalopathy and hypoglycemia in undernourished children. Treatment includes I.V. diazepam and I.V. glucose and correction of electrolyte imbalance. Additional treatment interventions include antimicrobial drugs including antibiotics, antimotility drugs, absorbents, nutritional and micro and macro nutrient supplementation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Snyder JD, Merson MR The magnitude of the global problem of acute diarrhoeal disease: a review of active surveillance data.Bull WHO 1982; 60:605–613.

    PubMed  CAS  Google Scholar 

  2. Claeson M, Merson MH, Global progress in control of diarrhoeal diseases.Pediatr Infect Dis Journal 1990; 9:345–355.

    Article  CAS  Google Scholar 

  3. Victora CG, Bryce J, Fontaine O, Monarch R. Reducing deaths from diarrhoea through oral rehydration therapy.Bull WHO 2000; 78:1246–1255.

    PubMed  CAS  Google Scholar 

  4. Guidelines for management of Diarrhoea in children. Ministry of Health, Govt. of India, 2000.

  5. Water with sugar and salt.Lancet 1978; 2 :300-301.

  6. Santosham Met al. Oral rehydration for diarrhoea: an example of reverse transfer or technology.Pediatrics 1997; 100: E10.

    Article  PubMed  CAS  Google Scholar 

  7. Evaluation. Taining course for national CDD programme managers. Revision 1, Geneva, World Health Organization 1981 (Unpublished)

  8. Evaluation. CDD programme management. A training course, Geneva, World Health Organization, 1989 (Unpublished).

  9. Household survey manual. Diarrhoea case management, morbidity and mortality. Geneva, World Health Organization 1989 (WHO/CDD/SER/86.2 Revision 1).

  10. WHO/CDD Ninth programme report 1992-93. Geneva, World Health Organization 1994.

  11. Measuring progress towards child summit goals; a hand book for multiple indicator surveys. Newyork, United Nations Children’s Fund, 1994.

  12. Household survey manuahdiarrhoea and acute respiratory infection. Geneva, World Health Organization, 1994 (WHO/ CDRJ98.8)

  13. CDD strategies for the 1990s. Report of a WHOJUNICEF meeting. United Nations children’s fund, Newyork, 15th April 1991.

  14. Almroth S, Latham MC. Rational home management of diarrhoea.Lancet 1995; 345:709–711.

    Article  PubMed  CAS  Google Scholar 

  15. Benakappa DG, Benakappa A. Putting ORT and rehydration therapy in peoples hands.Indian J Pediatr 1990; 57:21–24.

    PubMed  CAS  Google Scholar 

  16. Touchette Pet al. An analysis of home based oral rehydration therapy in Kingdom of lesotho.Social Science and Medicine 1994; 39:425–432.

    Article  PubMed  CAS  Google Scholar 

  17. Molla AMet al. Rice powder electrolyte solution as oral therapy in diarrhoea due to V. Cholerae and EscherichiaColi. Lancet 1982; 1217–1319.

  18. Gore SM, Fontaine O, Pierce NF. Impact of rice based oral rehydration solution on stool output and duration of diarrhoea: Meta analysis of 13 clinical trials.B MJ 1992; 304:287

    Article  CAS  Google Scholar 

  19. As de Wit Maffy, Koopmans PGet al. Gastroenteritis in Sentinel general practices, the Netherlands.Emerg Infect Dis 2001; 7:82–92.

    Article  Google Scholar 

  20. Levine MM. Anti-Microbial therapy for infectious diarrhoea.Rev Infect Dis 1986; 8:207–216.

    Google Scholar 

  21. Van loon FPL, Bennish ML, Speelman P and Butlelr C. Double blind trial of loperamide for treating acute watery diarrhoea in expatriates in Bangladesh.Gut 1989; 30:492.

    Article  PubMed  Google Scholar 

  22. Gorbach SL, Bismuch therapy in gastrointestinal diseases.Gastroenterol 1989; 30:492–495.

    Google Scholar 

  23. Dupont HL, Sullivan P, Pickering LK. Symptomatic treatment of diarrhoea with bismuth sub-salicylate among students attending a Mexican University.Gastroenterol 1977; 75:715–717.

    Google Scholar 

  24. Arora NK, Bhan MK. Nutritional management of acute diarrhoea.Indian J Pediatr 1991; 58: 763–767.

    PubMed  CAS  Google Scholar 

  25. Brown KH, Gastanaduy AS, Saavedra JMet al. Effect of continued oral feeding on clinical and nutritional outcome of acute diarrhoea in children.J Pediatr 1988; 112:191–200.

    Article  PubMed  CAS  Google Scholar 

  26. Harrison M, Kilby A, Walker-smith JA, Francis NE, Wood CBS. Cow’s milk protein intolerance: a possible association of gastroenteritis, Lactose intolerance and IAg deficiency.BMJ 1976; 1501–1504.

  27. Dutta P, Mira U, Dutta A, Niyogi SK, Dutta S, Manna Bet al. Impact of Zinc supplementation in malnourished children with acute watery diarrhoea.J Trap Pediatr 2000; 46:259–263.

    Article  CAS  Google Scholar 

  28. Marson JR, Lewis JC. The effect of severe zinc deficiency on intestinal permeability: an Ultra-Structured study.Pediatr Res 1985; 19:968–973.

    Article  Google Scholar 

  29. Better WJ, O’Dell BL. A critical physiological role of zinc in the structure and function of biomembrane.Life Sci 1981; 28:1425–1438.

    Article  Google Scholar 

  30. Park JHY, Grandjean CJ, Antonson DL, Vanderhoof JA. Effects of short term zinc deficiency on intestinal growth and activities of brush border enzymes in weaning rats.Pediatr Res 1985; 12: 1333–1336.

    Article  Google Scholar 

  31. Trace elements and immune response. In Chandra PK, ed.Trace Elements in Nutriion in Children-11. Nestle Nutrition workshop series 1991; 23 :201–214.

Download references

Author information

Authors and Affiliations

  1. Dept of Pediatrics, NMCH, Patna

    Utpal Kant Singh & Bir Prakash Jaiswal

  2. Dept. of Pediatrics, B.P. Koirala Hospital, Dharan, Nepal

    Rajniti Prasad

  3. Sishu ArogyaKendra, Opposite Krishna Apartment, Boring Road, Patna, India

    Ranjeet Kumar

Authors
  1. Utpal Kant Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rajniti Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ranjeet Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bir Prakash Jaiswal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Utpal Kant Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, U.K., Prasad, R., Kumar, R. et al. Management of diarrhoea in practice. Indian J Pediatr 69, 687–695 (2002). https://doi.org/10.1007/BF02722706

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02722706

Key words

Search

Navigation