Diarrhoea by Kwadwo Nyanor Afriyie


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Diarrhoea by Kwadwo Nyanor Afriyie

  2. 2. Key facts  Diarrhoeal disease is the second leading cause of death in children under five (5yrs)years old.  Its kills around 1.8 million of which 90% are children under 5 yrs each year  Causes 1.7 billion cases each year  Leading cause of malnutrition in children under 5 years
  3. 3. What is diarrhoea?  Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual).  Frequent passing of formed stools is not diarrhoea, nor is the passing of loose, "pasty" stools by breastfed babies.
  4. 4. Clinical types of diarrhoea  acute watery diarrhoea – lasts several hours or days, and includes cholera;  acute bloody diarrhoea – also called dysentery; and  persistent diarrhoea – lasts 14 days or longer.
  5. 5. Why does it kill mostly children?  It’s a matter of water loss – dehydration.  Losing 2% of the body’s water will make you feel sick.  Losing 10% of the body’s water may kill you  Since babies and small children cannot tell us how they feel it’s important we go through the signs of dehydration.
  6. 6. Dehydration  The most severe threat posed by diarrhoea is dehydration.  During a diarrhoeal episode, water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost through liquid stools, vomit, sweat, urine and breathing.  Dehydration occurs when these losses are not replaced.  The degree of dehydration is rated on a scale of three.
  7. 7. Sign of Dehydration 1. Early dehydration – no signs or symptoms. 2. Moderate dehydration:  Thirst  restless or irritable behaviour  decreased skin elasticity  sunken eyes
  8. 8. 1. a 2. a 3. Severe dehydration:  shock, with diminished consciousness,  lack of urine output  cool, moist extremities  a rapid and feeble pulse  low or undetectable blood pressure  pale skin. Sign of Dehydration Cont.
  9. 9. What causes diarrhoea?  A virus, such as rotavirus, winter vomiting disease (Norwalk virus or norovirus), enterovirus, or a hepatitis virus.  A bacterium, such as E. coli, salmonella, shigella, C.diff (clostridium), or cholera (Vibrio cholerae).  A parasite, such as those that cause giardiasis and amoebiasis.
  10. 10. Other medical conditions  A number of non-infectious medical conditions may cause diarrhoea, too. These include:  Inability to digest certain foods  Surgery to remove part of your intestine.  After – effects of surgery to remove the gallbladder.  Certain diseases of the endocrine (hormonal) system, including thyroid disease, diabetes, adrenal disease, and Zollinger-Ellison syndrome.
  11. 11.  Inflammation in the intestinal tract, which can result in chronic diarrhoea. If you have inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), you will have bouts of diarrhoea during flare- ups of your disease.  Pouches of the intestinal wall in diverticular disease can lead to diarrhoea, especially if they become infected and inflamed (diverticulitis) Other medical conditions Cont.
  12. 12. Other causes  Malnutrition  Source: Water contaminated with human faeces, for example, from sewage, septic tanks and latrines, is of particular concern. Animal faeces also contain microorganisms that can cause diarrhoea.  Other causes:  Diarrhoeal disease can also spread from person-to-person, aggravated by poor personal hygiene.  Food is another major cause of diarrhoea when it is prepared or stored in unhygienic conditions.  Water can contaminate food during irrigation.  Fish and seafood from polluted water may also contribute to the disease.  Medications and other substances – antacids containing magnesium, laxatives, diuretics, radiotherapy for prostate cancer or cancers in the abdomen.
  13. 13. Symptoms of diarrhoea  Increased frequency of bowel movements  Loose, watery stools  Urgency (having to go right away)  Incontinence (leakage of stools)  Bloating, wind  Rectal pain
  14. 14.  Lower abdominal pain or cramping  Nausea, vomiting  Fever  Blood or flecks of mucus in the stool  Loss of appetite, weight loss Symptoms of diarrhoea Cont.
  15. 15. Seek medical advice if:  Seek medical advice if you have diarrhoea for more than three to four days  Blood in your stool  Dark-black stool that looks like tar (but tell your doctor if you have been taking over-the-counter medications, which also can make the stool look darker than usual)  Mucus passed with no stools  Abdominal pain
  16. 16.  Rectal pain  Fever  Dehydration  Recent travel abroad  Recent seafood consumption  Reason to believe that you have food poisoning  Family members who have similar illness Seek medical advice if: Cont.
  17. 17. Prevention and treatment  access to safe drinking-water  use of improved sanitation  hand washing with soap  exclusive breastfeeding for the first six months of life  good personal and food hygiene  health education about how infections spread  rotavirus vaccination.
  18. 18. Treatment of diarrhoea  Rehydration: with oral rehydration salts (ORS) solution. ORS is a mixture of clean water, salt and sugar.  Zinc supplements: zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.  Rehydration: with intravenous fluids in case of severe dehydration or shock.  Nutrient-rich foods  Consulting a health professional, in particular for management of persistent diarrhoea or when there is blood in stool or if there are signs of dehydration.