Diarrhoea Treatment in Indore

1. Understanding Diarrhoea

Diarrhoea can be defined as the passage of loose or watery stools, usually three or more times a day. Causes may range from infectious (bacterial, viral, parasitic), through non-infectious (medication-induced, food intolerance, inflammatory bowel disease), to systemic ones (endocrine disorders, malabsorption).

Key concerns in diarrhoea:

Dehydration: due to the loss of fluid and electrolytes

Electrolyte imbalance: mainly sodium, potassium, and chloride

Nutritional deficiencies, particularly if they are long-standing or begin early in childhood

2. General Principles of Treatment

Treatment involves symptomatic management, avoiding dehydration, and treatment of the cause.

a. Fluid and Electrolyte Replacement

Rehydration is the cornerstone of diarrhoea treatment:

Oral Rehydration Solution (ORS)

WHO-recommended formula:

Sodium: 75 mEq/L

Glucose: 75 mmol/L

Potassium: 20 mEq/L

Chloride: 65 mEq/L

Citrate: 10 mmol/L

Osmolarity: 245 mOsm/L

Small, frequent sips, especially in children

Goal: To prevent or correct dehydration

Intravenous Fluids

Indicated for severe dehydration or inability to take ORS orally

Common IV fluids: Ringer’s lactate, normal saline

Electrolyte replacement based on lab values

b. Nutrition

Continue feeding, particularly in children; do not fast

Easy-to-digest foods: rice, toast, bananas, yoghurt

Avoid very fatty, sugary or highly processed foods.

Probiotics may restore gut flora, for example, Lactobacillus.

c. Symptomatic Medication

Antidiarrheal drugs are used selectively:

Loperamide - slows intestinal motility; not for children < 2 years or in bloody diarrhoea

Bismuth subsalicylate -may reduce frequency and fluid loss

Antispasmodics (less commonly used) - to relieve abdominal cramping

Note: These are supportive, not curative; avoid in infectious diarrhoea with high fever or blood.

d. Specific Treatment (Aetiology-Based)

Bacterial diarrhoea:

Some pathogens will require antibiotics: for example, shigellosis, cholera, and serious Campylobacter.

Often, mild cases are self-limiting.

Viral diarrhoea:

Most self-limiting (rotavirus, norovirus)

Focus on rehydration and nutrition

Parasitic diarrhoea:

Giardiasis - metronidazole

Amebiasis - metronidazole followed by luminal agent

e. Preventive Measures

Safe drinking water

Proper hand hygiene

Food safety: cooked food, avoidance of raw contaminated foods

Vaccination, such as for rotavirus, among children

f. When to Seek Medical Attention

Signs of severe dehydration include sunken eyes, lethargy, and no urination.

Blood in stool

High fever, diarrhoea that continues for more than a few days or returns