Diarrhea is defined as passing 3 or more loose stools per day and is the second leading cause of death in children under 5 globally. Every year around 1.5 to 2 billion cases of diarrhea occur resulting in death, with India seeing one in five child deaths due to contaminated food/water. Diarrhea is classified based on duration, clinical presentation, and physiology, and can be caused by infections, drugs, diet, surgery, or other miscellaneous factors. Management focuses on rehydration through fluid replacement, administering prescribed drugs, maintaining nutrition, and educating mothers on prevention.

1. DIARRHEA:
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’.

2. 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.

3. CLASSIFICATION:
1): ON THE BASIS
OF DURATION
ACUTE
DIARRHEA
CHRONIC
DIARRHEA

4. 2):
ON THE BASIS
OF CLINICAL
PRESENTATION
ACUTE WATERY
DIARRHEA
ACUTE BLOODY
DIARRHEA

5. 3):
On the
basis of
physiology
Secretory
Diarrhea
Osmotic
Diarrhea
Exudative
Diarrhea
Motility
Related
Inflamm
atory
Diarrhea

6. ETIOLOGY:
The causes of diarrhea are as follows:
1) Infection
2) Drugs
3) Dietary causes
4) Surgical conditions
5) Miscellaneous causes

7. PHYSIOLOGICAL DISTURBANCES IN DIARRHEA:
Diarrhea
Metabolic acidosis
Loss of normal
alkaline secretions &
fluids
Dehydration
Chronic diarrhea
Inflammation & edema of
mucosal membranes
Increased bacterial growth
Poor nutritional status
Released organic
acids
Fluid loss &
carbohydrate increases

8. 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)

9. SIGNS OF
DEHYDRATION
MILD DEHYDRATION MODERATE
DEHYDRATION
SEVERE DEHYDRATION
ASK
•Diarrhea
< 4 loose stool/ day 4-10 loose stool/ day >10 loose stool/day
•Vomiting None or small amount Same Very frequent
•Thrist More than normal More than normal Unable to drink
•Urine Normal Small amount dark No urine for 6 hours
LOOK
•Condition
Baby is well alert Unwell, sleepy or
irritable
Very sleepy,
unconscious
•Tears Present Absent Absent
•Eyes Normal Sunken Very sunken
•Mouth & tongue Wet Dry Very dry
•Breathing Normal Faster than normal Very fast & deep
FEEL
•Skin
Goes back quickly Goes back slowly Goes back very slowly
•Pulse Normal Faster than normal Very fast

10. DIAGNOSTIC EVALUATION:
1. History taking
2. Physical examination
3. Stool examination
4. Stool culture
5. Blood tests

11. MANAGEMENT:
Management of infants and young children with
diarrhea & dehydration focus on:
1) Replacement of the fluids
2) Administration of prescribed drugs
3) Maintenance of nutritional status
4) Educate the mother regarding prevention of
diarrhea