Selasa, 25 November 2008

Diarrhea : between myths and facts

You and me will agree if there is a wrong view or wrong opinion about a problem, it will cause wrong action to solve the problem as well. And so do the things with diarrhea problem. In reality,especially in my country (Indonesia) still many moms believe in myths, as the consequence, they give wrong handling when the child experiences diarrhea. While, Otherwise get handling quickly and correct action, diarrhea can cause child (especially infant) experience dehydration or Liquid deficit that have further consequence as death.


Between myth and Fact
Here are some myths that still many moms in my country (especially those who live in rural area) believe:
1. Breast-feed Mom who eat hot (chili) food or contain many cooking spices will causes the baby be attacked by diarrhea.
2. Diarrhea is such kind of sign that their child is going to be smarter.
3. Child who suffered diarrhea is preferable not being given food or Drink so the diarrhea will quickly stop.


While the true facts seems to be different :
1. A New kind of Formula Milk or Solid food that given to a child can causes diarrhea.
2. Baby and child under five has habit to put his finger into mouth that cause the germ easily enter the body and causing many diseases including diarrhea.
3. Consumption of snack that not well guaranteed it’s cleanliness causes diarrhea.
4. Milk bottle using or Spoon or Plate that not well washed can causes diarrhea in child.
5. Child has lower level of body stamina compared with adult. So, they easier to be infected by diarrhea caused germ.
6. Late to be fed is another factor causing a child easier experience diarrhea.
7. Diarrhea that caused by germ sometimes as consequence from environment and Not always come from food, if child suffered diarrhea doesn't eat or drink will make him weaker and tend to experience liquid deficit (dehydration) that can be fatal.


Diarrhea causes
There are some factors that cause diarrhea:
1. Bacteria, virus and or parasite (e.g., worm) infection in digestive track.
2. Bacteria, virus and or parasite that causing infection outside the digestive track, for example the infection in ear channel, throat infection, and measles.
3. Allergy towards certain medicine or food.
4. Psychiatric disorders like fear, stress or worried .
Diarrhea general symptoms
Diarrhea evokes physical and mental symptoms.

Physical symptoms :
• Frequency of defecates more than four times (in infants) and more than thrice in one month or elder babies
• Liquid feces and Can be espoused with mucus or blood
• Diminish of appetite or absolutely gone
• The child looks weak and pale
• Feel pain in stomach
• Vomit
• Fever

Mental symptoms :
• The child is restless and whine
• More spoiled from usually, inclined to be hugged or carried.


How to overcome it?

Basic diarrhea therapy :
1. Liquid therapy
- Oral rehydration liquid, Like:
  • Oralit
  • Household liquid, For example: Salt sugar solution (is made from two teaspoon of refined sugar mixed with one teaspoon of salt and mixed with 200 cc warm water, starch water, Vegetable sauce (gravy).
- Parenteral liquid (given through intravenous drips)

2. Diet (Feeding)
E.g : Breast feeding, low lactose formula milk, milk porridge and Rice porridge.

3. Diarrhea medicines
These days widely available diarrhea medicines that contain Kaolin and Pectin that can neutralize poison or bacteria that caused Diarrhea. That medicine can be use as therapy for non specific diarrhea (not caused by germ) e.g., diarrhea that caused by food allergy. But if the diarrhea is not going abate after two days of this medicine usage or the condition is getting worst, Best call your doctor for further help.

4. Antibiotic
Antibiotic is usually not widely used to cure diarrhea except the cause has been clearly known (for example in cholera) or If found co-exist disease (for example middle ear and throat infection).


Diarrhea without dehydration

Marking :
• Defecates liquid less than four times a day
• There is no vomit or Only a little
• Child doesn’t feel thirsty
• Urine volume and color is still normal
• The child looks well
• The eye is normal with tear
• Lip and tongue are wet
• The skin is still elastic
• Normal fontanel in infant

Handling:
• Give household liquid, like : Keep Breastfeeding or formula milk .
• Keep feeding the child with appropriate food for their age.


Diarrhea with light or medium dehydration

Marking:
• Defecates liquid 4-10 time a day
• Vomit many times
• Child felts thirst
• Decrease in Total urine volume and Rust colored
• The child looks weak and Restless
• Concave eye, Dry Tear
• Dry Lip and Tongue
• The skin less elastic (slow returns after pinched)
• The infant fontanel is concave

Handling
• Give Oralit
• Give household liquid
• Keep on breast-feeding
• Give appropriate food for age. Choose soft food, easy to digest and doesn't stimulate the digestive track.
• Give diarrhea medicine when needed (suitable with doctor instruction)
• When diarrhea persistent or goes heavier, Bring the child to hospital or clinic that equipped well for advance treatment.


Diarrhea with heavy dehydration

Marking:
• Defecates liquid more than 10 time a day
• Vomit repeatedly
• Child felts very thirsty or Can not drink
• The total urine volume is very small and Rust colored
• Pale child, Unconscious
• The eye very concave, Dry tear (not exist) .
• Very Dry Lip and Tongue.
• The skin is very less elastic (slow returns after pinched)
• The fontanel in infant is very concave

Handling:
• Bring the child soon to hospital or clinic with treatment facilities.
• Keep on gift Breastfeeding or Household liquid if child or Baby is still can drink.

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