DIARRHEA

MODULE FOR TEACHERS

 OBJECTIVES
• Define diarrhea
• Present major causes and symptoms
associated with diarrhea
• Provide guidance as to when to seek
medical attention for diarrhea

Students should know:

• When diarrhea requires medical attention
• When to recognize and manage
dehydration
 DEFINITION

Diarrhea is “an abnormal increase

in the frequency and liquidity
of one’s stools”
SCOPE OF THE PROBLEM

• Incidence of diarrhea varies

significantly in different countries

• In the Philippines, as of January

2006 per FHSIS Annual Report -
diarrhea is the No. 1 cause of
morbidity (illness) in the Philippines
CAUSES OF DIARRHEA
• INFECTIOUS
– Viral
– Bacterial
– Parasitic

• NON-INFECTIOUS
– Certain medications
– Stress
– Changes in diet
– Other medical
conditions
 COMMON SIGNS &
SYMPTOMS OF DIARRHEA

• Nausea and vomiting

• Loss of appetite
• Bloating and gas
• Abdominal cramps and pain
• Fever
 COMMON SIGNS &
SYMPTOMS OF DIARRHEA

• General weakness or feeling faint

• Malaise and headache
• Blood in stool
• Mucus in stool
 When MUST a person with
diarrhea consult a doctor?

• If there is blood or mucus in the stool

• If the patient has fever
• If the patient has diarrhea lasting > 24
hours
• If the patient has persistent vomiting
• If the patient has signs of dehydration
(dehydration is the most common
complication of diarrhea)
What are the signs of dehydration?

• Dryness of the mouth

• Thirst
• Reduced amount of urine
• Weakness and lightheadedness
 TREATMENT

All diarrheas are “treatable”.

Dehydration can be avoided with
adequate fluid replacement.
 TREATMENT

Give Oral Rehydration Therapy (ORT).

It is important to start early
and continue giving
ORT throughout the
diarrheal illness
 How to prepare ORT
Ingredients:
1 liter of treated or clean water
2 tablespoons of sugar
½ teaspoon of salt

Dissolve sugar and salt in water.

Advise the patient to drink 1 cup after
each loose bowel movement
 TREATMENT

• Give small, frequent and soft

feedings as tolerated.
• Avoid milk, milk products, alcohol,
caffeine and oily foods.
• If diarrhea persists for more than
24 hours or is severe at the onset,
consult a physician.
PREVENTION OF FOOD AND
WATER-BORNE DISEASES
MODULE FOR TEACHERS
 BACKGROUND AND OBJECTIVES

• Primary strategy in preventing diarrhea is the

avoidance of food and water contaminated with
bacteria from stools.
• Students should understand the following:
– All untreated water and food that was not
properly prepared are probably contaminated
and could be dangerous to your health.
– Be aware of water and food-borne diseases
and how transmission occurs.
– Know the proper methods of food and water
preparation.
BASIC PREVENTIVE MEASURES

• Always wash your hands before handling

food (preparation or consumption).

• Keep your hands away from your mouth.

• Always wash your hands after using the

bathroom!

• Dispose of waste properly.

 WATER PREPARATION

• Tap water may be contaminated

unless it is known to be safe: i.e.,
potential bacteria are removed or
inactivated.

• Bottled water may be the best

advice.
 WATER PREPARATION
• Two preferred methods of water
disinfection – effective against all
pathogens
– Boil for at least 3 minutes.
– Filter using a 1-2 micron pore-size
filter FOLLOWED by treatment with
iodine or chlorine
• Chlorine bleach 2 drops/liter, let stand
for 15 minutes
• Iodine 2% 5 drops/liter, let stand for 15
minutes
• Iodine tablets ½ tablet/liter, let stand for
15 minutes
 FOOD PREPARATION
• Fresh fruits and vegetables
– All fruits and vegetables that can be peeled
are safe once washed and peeled.
– Any fruit or vegetable that is not or cannot be
peeled should be washed and soaked.
– Soak items in a solution of strictly one tbsp.
(15 ml) household bleach per gallon for 15
minutes and then rinse in treated water.
 FOOD PREPARATION

• Meat preparation

– All meats should be cooked thoroughly.

– Adequate cooking will prevent parasitic

and bacterial infections.
 FOOD PREPARATION
• Milk products
– Bring all fresh (unpasteurized) milk to boil
before consuming.
• Other tips:
– Canned foods are generally safe if consumed
before the expiration date.
– Freezing does not disinfect food.
– Food should be eaten immediately after
cooking and should be protected from flies
and other sources of recontamination.
 REFERENCES

• “Diarrhea” module, Pre-Service

Health Training for Volunteers
Binder, Peace Corps Office of
Medical Services
• “Food and Water Preparation”
module, Pre-Service Health Training
for Volunteers Binder, Peace Corps
Office of Medical Services
• Protocare Corporation 1997
 The Philippine College of Physicians wishes to
acknowledge the following for their invaluable
efforts in the preparation of this module

Philippine Society of Gastroenterology

Ma Lourdes O. Daez, MD