Loose motions, Acute DIARRHEA... WATER LOSS.. DEHYDRATION... DYSENTERY,., QUERIES
Loose motions "acute gastroenteritis" dehydration dysentery For COUGH related queries, please read my article
for clinic address in Mumbai, India please visit www.doctorchild.com
For understanding risk of dehydration and treatment, a must visit website www.rehydrate.org
All diarrheas are not same…
They are caused by infections and many times without infections.
Causes of diarrhea are different at different ages too.
Apart from causes-- pattern of diarrhea is also important. Some are watery and some with less water. Some are sticky and some with blood. Some do have serious reason under it. Some do cause serious complications.
in summary a common medicine or formula can not be applied to a case of diarrhea without knowing above details.
Often there is a confusion that teething causes diarrhea, winter causes diarrhea.. monsoon causes diarrhea...etc there is scientific logic which needs to modify these beliefs.
Teething Diarrhea
Often parents come with various tonics for dentition available in market...practically teething per say does not cause diarrhea. during teething the important milestone of hand to mouth and biting starts developing. at this phase kids even start chewing clothes, fingers and toys. the germs that get carried along with this; often end up causing gut or throat infections. Both may cause diarrhea.. simple hygeinic measures and controlling cloth/toy chewing may settle this. If there is serious pica associated may need an attention.
Cold/ cough related diarrhea
in nose, throat, ear infections the mucus secretions or pus gets swallowed in small infants and passes through gut undigested and may look like mucus in stools.. but may smell same as nose secretions.
Monsoon Diarrhea.. India
Often this is due to water/ feed or hand contamination. Though usually rotavirus related in first year of life; there are many other viruses and bacteria that may cause such monsoon diarrheas. bacterial diarrheas and dysenteries predominate in summer and in areas and seasons of water scarcity too. Often such diarrheas are more watery compared to dysentery.
Watery diarrheas
diarrhea is often watery. how much water content per stool may decide the level of infection. Infections from small intestine often cause large watery diarrheas (enteritis). As the infection spreads from small to large intestine; the water content gets lesser and pain or cramps .. and mucus/blood may come in stools.(enterocolitis).when this happens.. the diarrhea is no longer just diarrhea, but is called dysentery. All diarrheas may not go through this phase. There are some viruses that causes redominant gastritis.. some do cause gastroenteritis; some cause only enteritis and some cause entrocolitis; while soem cause colitis.
Dysentery
whenever water content of stool is not enough to make the bed "wet", lets call these diarrheas as nonwatery or may be dysentry. dysentery is presence of mucus or blood in stool/poop. dysentery may be associated with spurts of water.. which is often due to inflammation of rectum ( proctocolitis).
Dysentery may be due to amebiasis, bacteria or antibiotic induced.
Viruses often do not cause dysentery.
Commonest cause of loose stools in developing countries like India are giardiasis (a form of protozoa); and in elderly kids may be amebiasis.
Commonest cause of watery diarrheas.. in infants in rotavirus related, in seasons. otherwise can be toxin producing e coli bacteria or salmonella bacteria.. Cholera is a serious cause of severe watery diarrhea... and needs specific therapy. In cholera 1 or 2 motions can make a child very sick. The stool has fishy smell and looks like rice water.
Common causes of diarrhea without too much of water loss, are non rotavirus viruses and bacteria..Most bacteria produce a toxin or they may also attack the intestinal skin (epithelium) and may cause infection, bleed or holes in mucosa that may take days to heal.
each bacterial diarrhea my not need antibiotic too, but most need it.
When to stop breast milk in diarrheas ?
Breast milk is best and should not be stopped in diarrheas. feeding is essential component in maintaining feeds and tackling dehydrations.In soem cases, when diarrhea lasts for longer than 4-5 days, the gut epithelium loses its factors required to digest lactose, a domonant sugar in milk. When lactose not digested, it carries water with it in stools and may harm and motions persist. In such cases breast milk or any milk that contains lactose should be promptly stopped for a week and the same phase should be replaced by lactose free formula or feeds for the same duration. Doctor diagnose this condition by looking at stool Ph and reducing substances in stools.
Danger signs in diarrhea: any of these signs if there may risk life by dehydration or sepsis..they are as below:
1.reducing urine frequency and quantity
2.sleepy child, lethargic
3.child refusing feeds, voomiting not getting controlled
4.cranky or irrtable child , very thirsty child.. but fails to drink or digest
5.perianal rash..nappy rash, diaper rash or skin sores ulcers or redness.. easy to secondarily infected to complicate matters
6.fever not settling despite 72 hours
If any of these danger signs.. prefer the doctor sees the child very often or the child remains under hospital supervision and therapy. Parents cannot feel or assess the severity of diarrhea related issues which child may be going through. A child of 10 kg often needs 1 litre liquid daily to maintain circulation.A motion of hundred ml will compromise it by 10 % aqnd a 5 motions can compromise it by 50%.
be liberal with fluids with children suffering from gastroenteritis.
Leave the judgement of medicines to doctors.. as all diarrheas are not same in presentation, severity and treatment response. Commonly a diarrhea starts responding to medicines in 72 hours.. but may last 7 to 10 days.
डॉ कोंडेकर संतोष ,एम .डी,.डी.एन .बी.,डी.सी.एच.,एफ.सी.पी.एस.
विशेष बाल रोग निदान व उपचार केंद्र, ओपिडी नं ११ सायं ७ ते ९, सोम ते शुक्र ; शुश्रुषा हॉस्पिटल appt: 9869405747 रानडे रोड दादर (प). मुंबई ४०००२८
Dr kondekar is available for private consultations at Shushrusha Hospital Dadar West Mumbai from Monday to Friday 7 to 9 pm. Please confirm appointment 91-9869405747 by call or sms. post your free queries at www.kondekar.com
Part II: managing diarrheas.. awaited..
डॉ कोंडेकर संतोष ,एम .डी,.डी.एन .बी.,डी.सी.एच.,एफ.सी.पी.एस.
सहप्राध्यापक बालरोग विभाग , बाल दमा विभाग टोपीवाला राष्ट्रीय वैद्यकीय महाविद्यालय बा.य ल नायर धर्मार्थ रुग्णालय मुंबई सेन्ट्रल
for clinic address in Mumbai, India please visit www.doctorchild.com
For understanding risk of dehydration and treatment, a must visit website www.rehydrate.org
All diarrheas are not same…
They are caused by infections and many times without infections.
Causes of diarrhea are different at different ages too.
Apart from causes-- pattern of diarrhea is also important. Some are watery and some with less water. Some are sticky and some with blood. Some do have serious reason under it. Some do cause serious complications.
in summary a common medicine or formula can not be applied to a case of diarrhea without knowing above details.
Often there is a confusion that teething causes diarrhea, winter causes diarrhea.. monsoon causes diarrhea...etc there is scientific logic which needs to modify these beliefs.
Teething Diarrhea
Often parents come with various tonics for dentition available in market...practically teething per say does not cause diarrhea. during teething the important milestone of hand to mouth and biting starts developing. at this phase kids even start chewing clothes, fingers and toys. the germs that get carried along with this; often end up causing gut or throat infections. Both may cause diarrhea.. simple hygeinic measures and controlling cloth/toy chewing may settle this. If there is serious pica associated may need an attention.
Cold/ cough related diarrhea
in nose, throat, ear infections the mucus secretions or pus gets swallowed in small infants and passes through gut undigested and may look like mucus in stools.. but may smell same as nose secretions.
Monsoon Diarrhea.. India
Often this is due to water/ feed or hand contamination. Though usually rotavirus related in first year of life; there are many other viruses and bacteria that may cause such monsoon diarrheas. bacterial diarrheas and dysenteries predominate in summer and in areas and seasons of water scarcity too. Often such diarrheas are more watery compared to dysentery.
Watery diarrheas
diarrhea is often watery. how much water content per stool may decide the level of infection. Infections from small intestine often cause large watery diarrheas (enteritis). As the infection spreads from small to large intestine; the water content gets lesser and pain or cramps .. and mucus/blood may come in stools.(enterocolitis).when this happens.. the diarrhea is no longer just diarrhea, but is called dysentery. All diarrheas may not go through this phase. There are some viruses that causes redominant gastritis.. some do cause gastroenteritis; some cause only enteritis and some cause entrocolitis; while soem cause colitis.
Dysentery
whenever water content of stool is not enough to make the bed "wet", lets call these diarrheas as nonwatery or may be dysentry. dysentery is presence of mucus or blood in stool/poop. dysentery may be associated with spurts of water.. which is often due to inflammation of rectum ( proctocolitis).
Dysentery may be due to amebiasis, bacteria or antibiotic induced.
Viruses often do not cause dysentery.
Commonest cause of loose stools in developing countries like India are giardiasis (a form of protozoa); and in elderly kids may be amebiasis.
Commonest cause of watery diarrheas.. in infants in rotavirus related, in seasons. otherwise can be toxin producing e coli bacteria or salmonella bacteria.. Cholera is a serious cause of severe watery diarrhea... and needs specific therapy. In cholera 1 or 2 motions can make a child very sick. The stool has fishy smell and looks like rice water.
Common causes of diarrhea without too much of water loss, are non rotavirus viruses and bacteria..Most bacteria produce a toxin or they may also attack the intestinal skin (epithelium) and may cause infection, bleed or holes in mucosa that may take days to heal.
each bacterial diarrhea my not need antibiotic too, but most need it.
When to stop breast milk in diarrheas ?
Breast milk is best and should not be stopped in diarrheas. feeding is essential component in maintaining feeds and tackling dehydrations.In soem cases, when diarrhea lasts for longer than 4-5 days, the gut epithelium loses its factors required to digest lactose, a domonant sugar in milk. When lactose not digested, it carries water with it in stools and may harm and motions persist. In such cases breast milk or any milk that contains lactose should be promptly stopped for a week and the same phase should be replaced by lactose free formula or feeds for the same duration. Doctor diagnose this condition by looking at stool Ph and reducing substances in stools.
Danger signs in diarrhea: any of these signs if there may risk life by dehydration or sepsis..they are as below:
1.reducing urine frequency and quantity
2.sleepy child, lethargic
3.child refusing feeds, voomiting not getting controlled
4.cranky or irrtable child , very thirsty child.. but fails to drink or digest
5.perianal rash..nappy rash, diaper rash or skin sores ulcers or redness.. easy to secondarily infected to complicate matters
6.fever not settling despite 72 hours
If any of these danger signs.. prefer the doctor sees the child very often or the child remains under hospital supervision and therapy. Parents cannot feel or assess the severity of diarrhea related issues which child may be going through. A child of 10 kg often needs 1 litre liquid daily to maintain circulation.A motion of hundred ml will compromise it by 10 % aqnd a 5 motions can compromise it by 50%.
be liberal with fluids with children suffering from gastroenteritis.
Leave the judgement of medicines to doctors.. as all diarrheas are not same in presentation, severity and treatment response. Commonly a diarrhea starts responding to medicines in 72 hours.. but may last 7 to 10 days.
डॉ कोंडेकर संतोष ,एम .डी,.डी.एन .बी.,डी.सी.एच.,एफ.सी.पी.एस.
विशेष बाल रोग निदान व उपचार केंद्र, ओपिडी नं ११ सायं ७ ते ९, सोम ते शुक्र ; शुश्रुषा हॉस्पिटल appt: 9869405747 रानडे रोड दादर (प). मुंबई ४०००२८
Dr kondekar is available for private consultations at Shushrusha Hospital Dadar West Mumbai from Monday to Friday 7 to 9 pm. Please confirm appointment 91-9869405747 by call or sms. post your free queries at www.kondekar.com
Part II: managing diarrheas.. awaited..
डॉ कोंडेकर संतोष ,एम .डी,.डी.एन .बी.,डी.सी.एच.,एफ.सी.पी.एस.
सहप्राध्यापक बालरोग विभाग , बाल दमा विभाग टोपीवाला राष्ट्रीय वैद्यकीय महाविद्यालय बा.य ल नायर धर्मार्थ रुग्णालय मुंबई सेन्ट्रल
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This page will help you understand type and patterns of diarrheas in children and how a dysentery can be specific. Each type may have specific presentation and specific therapy. Not understanding same may result in unsatisfactory cure.. There are rare causes too that will be discussed at a later date.
Dr Kondekar is also available for private consultation in Mumbai, send a sms with child age reason for visit and selected date and time of consultation, Visit www.doctorchild.com for clinic address. Often confused and so mismanaged. Dysentery does not cause heavy water losses..ORS is important in water loss diarrheas so are some newer magic medicines like probiotics / racecadotril. Do discuss with doctor when the doctor will prefer ORS, when he may modify diet, and how zinc may help. Clear the concepts at this site. Ask. The current diarrhea season in Mumbai is unlikely to be rotaviral as immunised kids and adults equally affected. The diarrhea of this season is greenish sticky mucoid with cramps and at times fever. So its more like enterocolitis than frank dysentry .... and likely that it will need antibiotics.please discuss with your doctor. Probiotics are seen this season to effect better and faster. June 2013 |
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Updated Today: child with loose motions.. what is the danger? - Mumbai India Diarrhea or Dysentry?
With rains water pollution, pipeline diarrheas and water born diseases like diarrheas, typhoid and hepatitis,lepto can spoil the gut and liver.. also the mosquitoes in stagnat water can cause malaria/dengue. Flu may spread fast too. Whatever it is .. common issue is loose stools .. and if not tackled on time, one may get dehydration,spread of infection with life threatening issues. If there is vomiting, lethargy,reduced intake or reduced urine or increased thirst... that may be beginning of danger if not tackled in time. Read here . Diarrhea updates: must visit |
