Professional Documents
Culture Documents
K.G.M.U, Lucknow.
WHAT IS DIARRHOEA?
Diarrhoea is the passage of loose, liquid or watery
stool.
In many regions Diarrhoea is defined as passage of
three or more loose or watery stools in 24 hour
period.
However it is the recent change in consistency and
character of stool than the number of stools that is
more important.
In most cases the mother knows what is abnormal
stool for her child.
It is a killer disease in children.
One in four deaths in children under the age of
5yrs. is due to diarrhoea.
WHAT CAUSES DIARRHOEA?
Infectious Disease Agents Causing Diarrhoea.
BACTERIA
1. Escherichia coli
It produces heat labile (LT) and heat stable (ST) entertoxins.
E.COLI - COULD BE
Enteropathogenic- Causes infantile diarrhoea.
Entero toxigenic – Causes travellers diarrhoea.
Enteroinvasive- Dysentery type of diarrhoea.
Enteroadherent
Enterohaemorrhagic
VIBRIO CHOLERAE- produces enterotoxins
Vibrio para haemolyticus- Invasive.
Non-Cholerae vibrios
WHAT CAUSES DIARRHOEA?
Infectious Disease Agents
SHIGELLAE–Invasive, produce bloody diarrhoea or
Dysentery.
CAMPYLOBACTER JEJUNI – invasive.
SALMONELLAE OTHER THAN S.TYPHI- invasive.
PERSISTENT DIARRHOEA.
HOW SHOULD ACUTE WATERY
DIARRHOEA IN CHILDREN BE MANAGED?
ASSESSMENT OF DEHYDRATION
- ORS
Basis of ORS
HAF
- Hand washing
- Exclusive breast feeding
- Clean food
Environmental sanitation
Elimination of Reservoirs
Breaking the channel of transmissions
PREVENTION OF DIARRHOEA?
ELIMINATION OF RESERVOIRS
Prevention of dehydration
Correction of dehydration
Maintenance of hydration
Chemotherapy
-Pneumonia
-Measles
-Malaria
-Health promotion
-Immunization
-Breast feeding
-Vit. A & Iron Supplementation
WHAT ARE THE REVISED GUIDELINES FOR
MANAGEMENT OF DIARRHOEA?
GOI & IAP (Indian Academy of Pediatrics)
Low osmolarity ORS
Zinc (10mg Elemental Zinc for infants 2-6 month of
age 20mg Zinc for children > 6 months for 14 days)
Feeding of energy dense foods in addition to Breast
feeding
HAF
Hygiene
Antimicrobials for gross blood in stools or shigella +
culture.
MCQ’s in Diarrhoea
1. WHO ORS contains:
A) Sodium Chloride 2.5 gm
B) Potassium Chloride 1.5 gm
C) Glucose 20 gm
D) Sucrose 10 gm
E) Potassium Bicarbonate 2.5 gm
Ans- B,C,E
2. For controlling an outbreak of Cholera all of the following measures are recommended
except:
A) Mass chemoprophylaxis
B) Proper disposal of excreta
C) Chlorination of water
D) Early detection and management of cases
Ans- A
3. In ORS the concentration of sodium chloride is:
A) 3.5 gm
B) 2.5 gm
C) 2.9 gm
D) 1.5 gm
Ans- A