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Diarrhea Blues

 Source : Health Today Magazine ( April 2008) – Brought to you by CCM Pharmaceuticals.

          Diarrhea is so common that an average adult has an episode about five times a year. But how severe is it? And when should we seek medical attention? Diarrhea is the purging of loose or watery stools more than three times in a day, for about a day or two. Most of the time, it will go away without any treatment as the body naturally clears the pathogen that causes it.

Causes of diarrhea

          Diarrhea is usually triggered by an infection – bacterial, viral or parasitic – resulting in a temporary stomach upset. When bacteria are the culprit, it is generally called ‘food poisoning’ as these bad bugs are easily taken into the body via contaminated food or water. Some of the more common bacteria are Salmonella, Escherichia coli, Campylobacter and Shigella. People who are traveling should be especially careful as they are at higher risk of contracting traveller’s diarrhea. Diarrhea can also occur if you have a sensitive stomach, either towards certain foods or drugs. Many Asians suffer from lactose intolerance. When food containing lactose- diary products- is consumed, a lactose-intolerant person lacks the lactase enzyme necessary to digest lactose. The body, in turn, reacts by purging this food, fast.

        Certain drugs may also upset a sensitive stomach and cause diarrhea. This includes antibiotics, hypertension medications and magnesium-containing antacids. If the purging is regular and does not go away after three days, it may be a sign of a chronic intestinal disease – inflammatory bowel disease (Crohn’s disease) or celiac disease – or a functional bowel disorder, like irritable bowel syndrome.

Signs and Symptoms

        Depending on the type of diarrhea –acute or chronic – the signs and symptoms can last for less than four weeks or longer. Besides the urgent and ‘explosive’ ordeal in the bathroom, diarrhea can also be accompanied by abdominal cramps, pain, bloating, nausea and fever. This is especially so with acute diarrhea. If you notice bloody stool or bloody watery diarrhea, you should immediately seek medical advice.

Red-alert

         Although diarrhea is common and not usually life-threatening, it can be dangerous if you lose too much fluid. Be extra careful when dealing with the elderly and children – especially newborns and infants- as they are more susceptible to dehydration. Know this: acute diarrhea is a serious killer of children under five.

 Watch out for these signs:

Ø      Thirsty

Ø      Little or less frequent urination

Ø      Dark colored urine

Ø      No wet diapers for three hours more (infants)

Ø      Dry skin

Ø      Dry mouth and tongue (children)

Ø      Lethargy

Ø      Light-headedness

Ø      High fever (common among children)

Ø      Sunken abdomen, eyes or cheeks (children)

It is very important to be well-hydrated when suffering from diarrhea, and to seek medical help immediately if a child or elderly person is dehydrated.

Treating diarrhea

         The immediate and most important step is to replenish lost fluids and electrolytes. Medicines are seldom prescribed unless necessary. These include antibiotics for bacterial infections and analgesics for stomach aches. Most of the time, your doctor will allow the diarrhea to run its own course as the problem will stop when the foreign body no longer exists in the gut. The only medication your doctor may give is oral dehydration salts (ORS) as recommended by the World Health Organization (WHO) in 1978. About 80% of acute diarrhea – Shigella dysentery and cholera – can be treated with ORS.

        A new ORS formula – sodium and glucose – has been recommended by the WHO since 2002 and has proven effective in fighting acute diarrhea. The treatment has succeeded in reducing the morality rate of children suffering from acute diarrhea from five million to 1.3 million annually. Dr. Tom Turmen, an executive director at WHO, recommends that every home have packets of ORS to be used at the first sign of diarrhea.

 PREVENTING DIARRHOEA

 To prevent diarrhea at home or when traveling abroad:

  Ø      Access only clean water; improve personal hygiene and sanitation practice.

Ø      Eat only well-cooked food and drink clean water. Avoid greasy foods or milk products and food from street vendors.

Ø      Improve health education by learning more about how infections spread.

           WHO and UNICEF recently recommended a new formulation which has proven to reduce stool by 20% and vomiting by 30% Dr. Tomrls Turman, Director of WHO recommends that every home has packets of ORS. This new formulation is now available in Malaysia. Please ask your nearby pharmacy or doctor for further information.

CONSULT A MEDICAL DOCTOR IMMEDIATELY IF YOU:

  Ø      Purge for more than three days.

Ø      Have severe pain in the abdomen or rectum

Ø      Have a fever (102^o F / 38^o C or more)

Ø      Have bloody or black, tarry stools.

Ø      Have signs of dehydration.

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