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AIMU > Diseases & Management > Diarrhoea : Diagnosis and Management
As per WHO, Diarrhoea is defined as the passage of three or more loose or liquid stools per
day (or more frequent passage than is normal for the individual). Frequent passing of formed
stools is not diarrhoea, nor is the passing of loose, “pasty” stools by breastfed babies.
Symptoms
Diarrhoea is associated with symptoms depending on the cause and who is affected.
Symptoms include:
• Watery stools
• Abdominal cramps
• Thin or loose stools
• Sense of urgency to have a bowel movement
• Nausea and vomiting
In addition to the symptoms described above, the symptoms of complicated diarrhoea include:
Causes
Diarrhoea usually occurs when fluid cannot be absorbed from the contents of bowel or when
extra fluid is secreted into bowel causing watery faeces.
• Antibiotics
• Antacid medicines that contain magnesium
• Some medicines that are used in chemotherapy
• Non-steroidal anti-inflammatory drugs(NSAIDs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Statins – cholesterol-lowering medicines
• Laxatives – medicine used to help empty bowels, if constipated
Long-term diarrhoea
Diarrhea can also sometimes be caused by bariatric surgery (weight loss surgery that is used
as a last resort to treat people who are dangerously obese).
Diagnosis
• In infants
• Moderate or severe diarrhoea in young children
• Associated with blood
• Associated non-cramping abdominal pain, fever, weight loss, etc.
• In travellers
• In food handlers, because of the potential to infect others;
• In institutions such as hospitals, child care centers, or geriatric and convalescent homes.
Blood test: Blood test is generally done to test the signs of inflammation which may suggest
disease like inflammatory bowel disease If the cause of diarrhoea is still not clear, then patient
may be advised for further investigations. Like:
Management
Drink fluids : It is important to drink plenty of fluids to avoid dehydration.
Oral Rehydration Solution (ORS) : ORS should be used to prevent dehydration. Standard
home solutions such as salted rice water, salted yoghurt drinks, vegetable and chicken soups
with salt can be given.
Medications: Antibiotics are beneficial in certain types of acute diarrhoea, they are usually
not used except in specific situations. Over the counter drug Pepto-Bismol ( Bismuth
subsalicylate ) , or anti-motility drug Imodium plus ( Loperamide hydrochloride with
simethicone ) are few of medicines for diarrhoea.
Eating : WHO recommends a child with diarrhoea should continue to be fed. Continued
feeding speeds the recovery of normal intestinal function. In contrast, children whose food is
restricted, have diarrhoea of longer duration and recovery of intestinal function is slow.
Prevention
To prevent the spread of infections that cause diarrhoea, always maintain high standards of
hygiene. For example:
• Wash hands thoroughly before eating or preparing food and after going to the toilet.
• To get toilet clean, including the handle and the seat, with disinfectant after each bout of
diarrhoea.
• Avoid sharing towels, cutlery or utensils with other household members.
• Avoid returning to work or school until at least 48 hours after the last episode of diarrhoea.