Passage of 3 or more, loose watery stools in the past 24 hours with or without vomiting is what is called as Acute Diarrheal Disease or ADD in short. Simple and common as it may seem ADD is a very dangerous condition. Globally, Acute Diarrheal Disease causes a huge burden, killing approximately 7 lakh children under the age of 5 constituting almost 16% of child deaths. In India, Acute Diarrheal Disease is the third most common cause of death in under-five children, responsible for 13% deaths in this age-group, killing an estimated 300,000 children each year. ADD causes dehydration. Dehydration is described as a harmful reduction in the amount of water in the body. As you know water is the single largest component of the human body, accounting for about 50 to 60% of total body mass…hence severe dehydration can possibly lead to multi-system failure and death.If a person has mild, moderate or severe dehydration, which is loss of water, you may notice some, or all of these symptoms- (ONE) the person may appear restless, irritable, or lethargic, floppy, (TWO) his or her eyes may appear sunken or deeply sunken, (THREE) there may be no tears if the person is crying, (FOUR) the mouth and tongue may be dry, (FIVE) the person may be thirsty and drinks eagerly or may not be able to drink due to lethargy, (SIX) if you pinch the skin gently- not hard pinching to induce pain and crying- but on gentle pinching…the skin may only go back slowly taking one, two or more seconds in the process, (SEVEN) breathing may be rapid ,(EIGHT) urine may be dark or may be scanty, (NINE) there could be loss of weight by less than 10% in case of mild or moderate dehydration or more than 10% in case of severe dehydration.
Acute Diarrheal Disease can be caused by bacteria, by virus, by parasites and sometimes by un common physiological conditions. Commonly though, ADD is caused by eating contaminated food or poorly cooked food or uncooked food or by drinking contaminated water in the last hour to last 12 days depending on the incubation period of the causal pathogen.
Whatever the status of dehydration, it is always necessary to consult qualified health care professional for management. Severe dehydration is a medical emergency and the person requires urgent hospital based treatment. Meanwhile some home based remedies can be started on like: (1) “oral rehydration solutions” or ORS ,Electral is a commonly available ORS in India.You can buy these products at most large grocery stores and pharmacy’s, Depending on age 100 ml to 250 ml of ORS need to be given after each watery stool, (2) Home-made sugar salt solution can be made with 6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 litre of clean water. Be very careful to mix the correct amounts. Too much sugar can make the diarrhoea worse. Too much salt can be extremely harmful to the person. Making the mixture a little too diluted (with more than 1 litre of clean water) is not harmful. Correct measurement techniques are essential for the preparation of home-made sugar salt solutions or you may end up preparing dangerous or ineffective solutions. (3) Some traditional remedies make highly effective oral rehydration solutions and are suitable drinks to prevent a child from losing too much liquid during diarrhoea: (a) Breastmilk (for the child who is feeding breast milk), (b) Gruels which are diluted mixtures of cooked cereals and water and (c) Rice water also called as Congee are known to be effective, (4) If none of these drinks are available, other alternatives are: (a) Fresh fruit juice, (b) Weak tea and (c) Green coconut water, (5) If nothing else is available, please give water from the cleanest possible source,if possible brought to the boil and then cooled.
Management of Acute Diarrhoeal Disease at the health care facility consists of any or all of the listed points (ONE) Rehydration to replace the loss of fluid and electrolytes, (TWO) A careful abdominal examination, to evaluate for tenderness and distention, (THREE) a stool examination under microscope or culture of stool, (FOUR) Medication according to the suspected type of pathogen. Most cases of ADD however, are self-limiting and hence may not require medication. It is also recommended to start regular food as soon as possible.
Acute Diarrheal Disease is preventable. ADD can be prevented by eating safely cooked and stored food and safe water. Hand washing with soap and proper sanitation is also essential to prevent Acute Diarrheal Disease.Elimination of pathogen reservoir where the bacteria, viruses and parasites breed and multiply, providing safe drinking water, educating people and health workers on early identification and faster management as we are trying through this video series will probably be helpful in the prevention of Acute Diarrheal Disease.
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