Rehydration

In those with excessive fluid losses and dehydration, more aggresive measure like intravenous fluids or oral rehydration therapy with isotonic, electrolyte solutions containing glucose or starch should be given. Oral rehydration therapy is less expensive, often just as effective, and more practical than intravenous luids. A number of oral rehydration solutions are available, including pedialyte, rehaldehyte, ricelyte, resol. The world health organization (WHO) formula and home made Oral Rehydration Solution (ORS) are equally effective. Fluids should be givenat rates of 50 to 200 ml/kg/24 hour, depending on the hydration status. Intravenous fluid (RL solution) are prefferd acutely for patient with severe dehydration and in those who cannottolerate oral fluids.
Rice water
Rice-flour based ORS was found to be an inexpensive, palatable, easily available, and an effective alternative to glucose-based formula. Results of the study showed that rice-ORS treated episodes of watery diarrhea ended with shorten duration (median duration 2 days vs 4 days) and fever hospitalization (0,1 % vs 0,5%) compared to those treated with glucose-ORS. These differences were statically significant.

Dietary modification using kaind of healthy food
Total stopping of food is unnecessary and not recommended.

Patient should be encouraged to take frequent feedings, soft, easily digested foods such as bananas, rice, crackers, and soups are generally well tolerated and provided needed nutrients for the repair of the intestinal tract. Diary products should be avoided because transient lactase deficiency can be caused by enteric viral and bacterial infections. Caffeinated beverages and alcohol, which can enhance intestinal motility and secretions, should be avoided. It is best to avoid sugary fluids such as soft drinks. High sugar beverages tend to draw fluid into the intestinal tract rather than increase the absorption of fluid.

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Diarrhea

Diarrhea is one of the leading public health problem in developing countries. Diarrhea is characterized by the frequent evacuation of liquid stool usually exceeding 300 milliliters per day, accompanied by an excess loss of fluid and electrolytes, especially sodium and potassium. Diarrhea is not disease, but a symptom of many medical conditions and complication of some medical treatment, including many medications.
Most cases of diarrhea are due to bacterial or viral contaminated food or water, or lack of immunization against infection diseases. Diarrhea can deplete the body of fluid and nutrients and produce malnutrrition as well. Mild diarrhea that remits in 24 to 48 hours is seldom a cause for concern unless the person is already dehydrated.
Symptom of diarrhea
Patient with acute infection diarrhea typically present with nausea, vomiting, abdominal pain, fever, and frequent stools, which may be watery, mal-absorptive, or bloody depending on the specific pathogen. The principle components of the treatment of acute diarrhea are fluid and electrolyte replacement, dietary modifications, and drug therapy.

Dietary modification using for healthy food
Total stopping of food is unnecessary and not recommended. Patient should be encouraged to take frequent feedings, soft, easily digested foods such as bananas, rice, crackers, and soups are generally well tolerated and provide needed nutrients for the repair of the intestinal tract. Dairy products should be avoided because transient lactase deficiency can be caused by enteric viral and bacterial infections. Caffeinated beverages and alcohol, which can enhace intestinal motility and secretions, should be avoided. It is best to avoid sugary fluids such as soft drinks. High sugar beverages tend to draw fluids into the intestinal tract rather than increase the absorption fluid.
Dietary modifications and treatment
Treatment includes replacement of lost fluids and electrolyites to prevent dehidration untill the diarrhea resolves. Fluids that provide both glucose and sodium help maximize the body's absorption of fluids and electrolytes.
- For mild to moderate cases of diarrhea, oral rehydration formulas / simple solution of water, salts, and sugar provide needed fluids and electrolytes.
- For severe cases, especially if dehydrated or experiencing persistent vomiting, intravenous fluids and electrolyte replace losses.
- If eating aggravates diarrhea only clear liquids (including oral rehydration formulas) are advised and in severe cases all foods and beverages should be stopped untill the diarrhea remits, usually a day or two.
- For people who can tolerate solid foods the liberal use of foods with soluble fibers (apples, citrus fruits, oats, barley) can often help control diarrhea. Yogurt which contains helpful bacteria can help to control diarrhea in some cases.
- Foods with insoluble fiber (wheat bran, corn bran, whole grain breads and cereals, vegetables) should be avoided temporarily. The diet also temporarily excludes lactose, caffeine, highly seasoned foods, foods high in fat, foods that cause gas and any food that aggravates the diarrhea.
- Frequent small meals are easier to tolerate at first. permanent dietary changes may be necessary fo diarrhea caused by food sensitivity or allergies.
Preventing diarrhea
In the vast majority of cases the diarrhea can be prevented through healthy food and water sanitation programs, immunizations and adequate diets. The early use of oral rehydration fluids shorten the duration of diarrhea. Rehydration generally takes 4 to 6 hours after the fluids are introduced and say bye bye to diarrhea. (by Prasanna prakash)

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