1. Diarrhoea
Introduction
Diarrhea is derived from Greek word, meaning ‘flowing through’. It is the second leading cause of death in children
under 5 years of age.
Definition
According to WHO, Diarrhea is defined as ‘passage of 3 or more loose stools per day or passing more stools than
normal for the age’.
Incidence
• Every year there are about 1.5 to 2 billion death of diarrheal diseases occurs. Diarrhea is the second leading cause
of child mortality and morbidity in the world.
• One in 5 children die of diarrhea every year in India. It mostly due to contaminated food and water sources.
Classification
On the basis of duration
• Acute diarrhea
• Chronic diarrhea
On the basis of clinical presentation
• Acute watery diarrhea
• Acute bloody diarrhea
On the basis of physiology
• Secretory Diarrhea
• Osmotic Diarrhea
• Exudative Diarrhea
• Motility Related
• Inflammatory Diarrhea
Etiology
The causes of diarrhea are as follows:
• Infection
• Drugs
• Dietary causes
• Surgical conditions
• Miscellaneous causes
2. CLINICAL FEATURE & ASSESSMENT
Clinical feature of diarrhea depends on its severity:
1) Mild diarrhea (2-5 loose stool)
2) Moderate diarrhea (10 or more loose stool)
3) Severe diarrhea (100 loose stool within 24 hours)
Diagnostic evaluation
• History taking
• Physical examination
• Stool examination
• Stool culture
• Blood tests
Management
Management of infants and young children with diarrhea & dehydration focus on:
• Replacement of the fluids
• Administration of prescribed drugs
• Maintenance of nutritional status
• Educate the mother regarding prevention of diarrhea
Diarrhoea
Loss of normal
alkaline secretions
& fluids
Inflammation & edema of
mucosal membranes
Chronic diarrhea
Metabolic
acidosis
Dehydration
Released organic
acids
Fluid loss &
carbohydrate
increases
Increased bacterial growth
Poor nutritional status
