Diarrhoea Diseases– All you need to know
What is diarrhoea?
Diarrhea or Diarrhoea is an abnormally frequent passage of loose or watery stools. According to the World health organization, the frequency has to be more than 3 bowel movements within 24 hours. But indeed it depends on the person’s normal number of bowel movements per day.
It is the 2nd leading cause of death in children less than the age of 5 years (525 000 deaths each year). The morbidity rate is even higher. Even though it has a significant morbidity and mortality, it’s easily preventable and treatable.
Causes of diarrhoea
Its causes can be broadly classified into infective and non-infective causes. Out of the infective causes, viruses are the commonest. Viral types usually settles within a few days without much of a problem. On the other hand, bacterial diarrhoea, also known as bacterial gastroenteritis, typically produces disturbing symptoms. Transmission of the pathogens is mainly by food or water.
Commonly known viruses causing this disease
- Rotavirus is the commonest cause this disease in children
- Adenovirus
- Norvo virus
Bacteria that cause it include
- Campylobacter jejuni
- Escherichia coli
- shigella dysenteriae
- Vibrio cholerae – causes cholera
- Salmonella species
Non-infective diarrhoea has a wide range of causes. It can be simply due to lactose intolerance or gluten allergy (coeliac disease) or even due to colonic cancer. The commonest cause of non-infective type is irritable bowel syndrome. Here the person may develop loose motion or constipation intermittently without having any problem in the gastrointestinal tract. This is thought to be due to stress or lifestyle changes. Inflammatory bowel diseases; Chron’s disease, ulcerative colitis, is another entity that causes non-infective diarrhoea.
Types of diarrhoea
It is primarily classified as acute and chronic. Acute diarrhoea; an episode that lasts less than 2 weeks, is frequently caused by infective organisms. Meanwhile, chronic diarrhoea; an episode that lasts more than 4 weeks, is typically caused by non-infective agents.
It can be further classified according to the type and the consistency of the stools.
- Watery motion – commonly caused by viral infections and sometimes by bacteria like Vibrio cholerae
- Dysentery; blood and mucus diarrhoea – Frequently due to bacterial infections like Campylobacter or Shigella or due to inflammatory bowel disease.
- Bloody diarrhoea without mucus – A characteristic of colonic cancer
Symptoms of diarrhoea
Its symptoms vary depending on the causative factor. Viral causes rarely have any other symptoms than marked watery motion and features of dehydration.
But in contrast, bacterial diarrhoea is often associated with
- Fever,
- Severe abdominal pain
- Abdominal cramping,
- Abdominal bloating,
- Mucoid stools
- Blood in stools
- Vomiting
- Diarrhoea is typically not marked except in cases of Cholera.
Excessive water loss may produce features of dehydration in addition to the other symptoms. These include,
- Sunken eyes
- Irritability and restlessness
- Increased skin turgor
- Thrust (but if the patient has severe dehydration, he may be unable to drink)
- Very low or no urine output
- Absent or weak pulse
Complications
The most severe complication of this disease is dehydration. Unfortunately, it’s the commonest as well. Deaths due to acute diarrhoea are invariably related to dehydration. Children and elderly people are particularly vulnerable to dehydration.
Electrolyte imbalance and acidosis are common among such patients having severe symptoms. Their sodium level and potassium level in the blood tend to go down as a result of excessive loss through the stools.
Campylobacter jejuni is notorious to cause Guillen barre syndrome, is an autoimmune disease involving the nervous system.
Long-standing diarrhoea may lead to malnutrition of the person.
Treatment
The primary treatment of viral diarrhoea is supportive therapy. Bacterial diarrhoea is treated with antibiotics. Non-infective diarrheal diseases have specific methods of management.
Irrespective of the cause of the management of dehydration has to be done. This is achieved by fluid supplementation. In a case of a severe dehydration, oral fluids are contraindicated and the patient is given intravenous saline. If the dehydration is mild or moderate, oral fluids can be given.
Anti-diarrheal drugs are given in some instances for the symptomatic relief of the disease. However, it shouldn’t be given in bacterial or childhood diarrhoea as it can worsen the infection.
Management at home/ home remedies
One of the most effective home remedies considered as the best treatment option of diarrhoea at home is the oral rehydration solution (ORS). It’s proven to be effective in reducing the duration and improving dehydration as well. ORS is prepared by mixing the powder in an ORS packet with exact volume of water mentioned on the packet. About 100-200 ml of oral rehydration fluid is indicated to be given after each episode of diarrhoea.
Prevention
- Proper food hygiene is a key factor in preventing infective types
- Meat should be consumed only after cooking well.
- Drink only boiled water
- Avoid eating from the food outlets that you don’t trust
- Use proper sanitation
- Vaccinations are available for traveler’s diarrhoea
