1. DIARRHOEA
What is diarrhoea?
It may be defined as a passage of three or more stool,
loose or watery in a period of 24 hours.
TYPES OF DIARRHOEA CLINICALLY:
1. Acute diarrhoea: sudden onset, duration less than 2
weeks.
2. Invasive diarrhoeaor dysentery: stools mixes with
blood.
3. Chronic diarrhoea: diarrhoea lasts more than 2
weeks.

2. CLASSIFICATION OF DIARRHOEA AETIOLOGICALLY
Aetiologically diarrhoea can be classified into 3types
1. Environmental
i. Moist and worm environment;
ii. Overcrowded living condition
iii. Lack of safe drinking water
iv. Lack of sanitary latrine
v. improper disposal of excreta
vi. Unhygienic home surrounding

3. CLASSIFICATION OF DIARRHOEA AETIOLOGICALLY contd.--
2. Pathogenic:
A. Bacteria: following bacteria are causing diarrhoea -
• Salmonella
• Shigella
• E. coli
• Clostridium perfringens
• Campylobactor jejuni
• Yersinia entero colitica
• Vibrio cholera and Vibrio parahaemolytica

4. CLASSIFICATION OF DIARRHOEA AETIOLOGICALLY contd.---
B. Virus: causing diarrhoea are as follows;
• Rota virus
• Norwalk virus
• Enteric Adenovirus
C. Protozoa: following protozoa causes diarrhoea:
• Cryptosporidium
• Entamoeba histolytica
• Giardia lamblia.

5. CLASSIFICATION OF DIARRHOEA AETIOLOGICALLY contd.---
3. Diarrhoea secondary to other diseases are :
1. Coeliac disease
2. Corhn’s disease
3. Tropical spru
4. Ulcerative colitis
5. Irritable bowl syndrome
6. Diverticulitis
7. Tuberculosis 8. Resection of gut
9. Parasitic infestation 10. Giardia
11. Drugs (laxative) 12. Pancreatic insufficiency

6. CLINICAL PRESENTATION OF DIARRHOEA
A. Specific symptoms:
1.Urgency and incontinence
1. Nausea 2. Vomiting 3. Thirst 4. Anorexia
5. Bleeding with stool 6. Lower abdominal pain
7. Lower abdominal discomfort 8. Stool with mucous.
B. Non specific symptoms are
1. Fatigue 2. Irritability 3. Drowsiness
4. Muscle cramp 5. Headache 6. Faintness
7. Decreased urine volume 8. Postural hypotension
9. Severe dehydration if remain untreated

7. TREATMENT OF DIARRHOEA
1. Bed rest
2. Hospitalization
3. Rehydration
Rehydration by oral Rehydration Salt (ORS),
composition of ORS are as follows
NaCl = 3.5 gm/L
Na2Co3 = 2.5 gm/L
KCl = 1.5 gm/L
Glucose = 20 gm/L

8. DOSES OF ORS ACCORDING TO AGE FOR TREATING DIARRHOEA
1. Children below 2 years of age: 50-100 ml after each
loose stool.
2. Between 2 to 9 years: 100-200 ml after loose stool
3. 10 years and above including adults: as much as
possible.
4. Breast fed baby: breast feed every 3 hours.
5. Non breast fed baby: Dilute milk with equal amount
of water and feed every 3 hours

9. PREVENTION OF DIARRHOEA
1. Encourage exclusive and extensive breast feeding.
2. Proper weaning practice
3. Provision of safe drinking water
4. Provision of safe latrine
5. Proper disposal of excreta
6. Hand wash:
i. After coming from toilet ii. Before preparing food
iii. Before eating iv. Before feeding a child.
7. Vaccination against diarrhoea (Rota virus)