Sunday, May 21, 2017

DIARRHEA - Symptoms, causes and treatment

Diarrhea is a condition characterized by diluted feces released by frequent bowel movements (BAB) more often than usual. In general, diarrhea occurs due to consumption of foods or beverages contaminated with bacteria, viruses, or parasites. Usually, diarrhea lasts only a few days, but in some cases extends for weeks.
Patients with diarrhea in US
Diarrhea is one of the biggest health problems in Indonesian society. Based on research conducted by the Ministry of Health of the Republic of Indonesia in 2007, diarrhea was ranked as the thirteenth cause of death of all ages with a proportion of 3.5 percent. Meanwhile, based on the category of infectious diseases, diarrhea is the third cause of death after pneumonia and tuberculosis. From these data, the age group that experienced the most diarrhea was a toddler with a prevalence of 16.7 percent.
Diarrhea can be fatal if the patient is dehydrated due to loss of fluid from the body. Therefore diarrhea should not be taken lightly even if this condition is common.
Symptoms of diarrhea
Diarrhea symptoms vary, ranging from those who only feel a short stomach pain with stool that is not too thin to have stomach cramps with very dilute stools. In the case of severe diarrhea, the possibility of sufferers will also experience fever and severe stomach cramps.
Causes of diarrhea in general
The causes of diarrhea in adults and children are generally intestinal infections. Intestinal infections can occur when we eat dirty or contaminated food or drink. Microorganisms that often cause intestinal infections are bacteria, parasites, and viruses such as norovirus and rotavirus.
Diarrhea may also arise due to the following factors:
§  Side effects of certain drugs,
§  Psychological factors, such as anxiety,
§  Consumption of alcoholic beverages and excessive coffee.
Diarrhea Diagnosis
In diagnosing diarrhea , the doctor will usually ask about the symptoms experienced and perform physical examination, including finding whether there is dehydration. In some cases, doctors need to perform rectal examination, examine stool samples, or even blood tests.
Regarding the treatment of diarrhea
If severe, diarrhea may lead to dehydration. Dehydration has fatal consequences and potentially claimed the lives of patients, especially if it occurs in children. This is because the body's resistance to dehydration is much lower than that of adults. Therefore, parents are advised to be wary of signs of dehydration in children. Patients are also advised to drink lots of fluids during diarrhea is still ongoing.
Oralit may be taken to avoid dehydration, but consult with your doctor or pharmacist first, especially if you have certain diseases, such as heart disease .
Antidiarrheal drugs are usually not very necessary, except for those who have solid activity or who want to travel long distances. One of the most effective and fast antidiarrheal drugs in stopping diarrhea is loperamide However, loperamide should not be given to children.
Most people with diarrhea recover after several days without treatment . In adults, diarrhea usually heals after 2-4 days. While in children, diarrhea usually lasts longer, ie between 5-7 days.
If your child has severe, persistent diarrhea, or if he or she begins to show signs of dehydration, consult your doctor immediately. Diarrhea as much as six or more times in a 24-hour period in children should also be consulted to a doctor.
Likewise with diarrhea that makes your body condition decreased drastically should be consulted to the doctor, especially if there is blood or pus in your stools.
Laboratory stool examination may be necessary as part of further research. Diarrhea lasting more than a few weeks in adults can be caused by irritable bowel syndrome, colon cancer , or Crohn's disease .
How to prevent diarrhea
Diarrhea not only affects the patient, but also has the potential to spread, especially to family members. Therefore, diarrhea should be prevented from the first contact to the spread.
Here are the preventive measures of diarrhea caused by contamination:
§  Wash hands before eating.
§  Steer clear of food that is in doubt and does not drink tap water.
§  Separate the raw food from the ripe.
§  Prioritize fresh food.
§  Store food in the refrigerator and do not let food fall under sun exposure or room temperature.
If you have diarrhea, you may take the following steps to prevent diarrhea from  spreading to those around you.
§  If staying one house, make sure the patient avoids the use of the same towel or cutlery as other family members.
§  Cleaning the toilet with disinfectant after each bowel movement.
§  Stay home at least 48 hours after the last diarrhea period.
§  Wash hands after using the toilet or before meals and before preparing food.

Symptoms of diarrhea vary, there is only a brief abdominal pain with stools that are not too thin, so there are also experiencing abdominal cramps with very dilute stools. Usually long-term diarrhea makes people often feel the need to defecate.
Some other diarrhea symptoms are:

  • Missing appetite
  • Headache
  • Nausea
  • Gag

Diarrhea usually recovers within two to four days. But you are advised to see a doctor if you have diarrhea for more than a week or diarrhea to disturb your sleep. In addition, see a doctor if you have diarrhea accompanied by vomiting, blood in the stool or bleeding in the anus, severe diarrhea leading to dehydration , weight loss, or if you have diarrhea after taking antibiotics and undergoing hospitalization .
In children, diarrhea generally lasts about five days to a week. If longer than this time or diarrhea they are accompanied by vomiting, there is blood in the stool, and diarrhea badly, immediately consult her doctor. Doctor's checks also need to be done immediately if your child (especially baby) defecates six or more times a day.
Dehydration as a result of diarrhea
Severe or sustained diarrhea can lead to dehydration. Dehydration should not be taken lightly because it can result in death.
In children, symptoms of dehydration may include fussiness or rapid drowsiness and decreased body condition. In addition, rarely urinate, feet and hands feel cold, and pale skin and spotted can indicate dehydration as well. Parents are advised to be aware of the symptoms of dehydration in their child.
While in adults, symptoms of dehydration include loss of appetite, nausea and dizziness , fatigue or lack of energy, as well as dizziness when standing. In addition, heart palpitations, muscle cramps, sunken eyes, and dry tongue can indicate the occurrence of dehydration.

When a person has diarrhea, the stool becomes dilute because of the amount of fluid secreted into the intestine. Or vice versa, fluid in the intestines can not be absorbed and circulated throughout the body. This condition is influenced by many factors that can also make diarrhea lasted short or long.
Short (short-term) diarrhea may be caused by:
  • Bacterial infections can also cause food poisoning ( campylobacter, clostridum difficile, escherichia coli , salmonella, and shigella ).
  • Viral infection ( rotavirus and norovirus ).
  • The intestinalis giardia parasite .
  • Appendicitis  .
  • Food allergies .
  • Damage to the intestinal lining due to radiotherapy.
  • Psychological problems (eg anxiety disorders).
  • Foods that contain artificial sweeteners.
  • Fructose intolerance (a natural sweetener in honey and fruits) and lactose intolerance (in milk and similar products).
  • Excessive consumption of alcoholic beverages.
  • Drug side effects (statins, chemotherapy drugs, laxatives, antibiotics, magnesium-containing antacids, selective serotonin reuptake inhibitor drugs / SSRIs, and nonsteroidal anti-inflammatory drugs / NSAIDs).
While long-term diarrhea (long-term) is usually caused by:
  • Crohn's disease , inflammation of the lining of the digestive system.
  • Ulcerative colitis , a condition that affects the large intestine.
  • Irritable bowel syndrome or disruption of normal bowel function.
  • Disease celiac or disease that causes the body rejects gluren protein.
  • Microscopic colitis or a type of inflammatory bowel disease that causes watery diarrhea.
  • Cystic fibrosis or a hereditary disease that affects the lungs and digestive system.
  • Bowel cancer .
  • Chronic pancreatitis.
  • Side effects of abdominal removal (gastrectomy).

To find out if a patient has diarrhea and what factors cause it, first the doctor will ask some questions to the patient, such as how often the patient has diarrhea, what kind of dirt texture is issued, whether the diarrhea is accompanied by symptoms of fever , whether the patient likes to eat in Anywhere, and whether the patient has had any contact with diarrhea sufferers.
In addition, the doctor may also ask whether the patient is taking a medication (may be a result of side effects), how much coffee or alcohol he consumes, or whether the patient has recently been restless and under stress.
Further examination
Further examination can be done if the answer given by the patient has not been enough to help the doctor in drawing conclusions. Some types of examination methods for diarrheal cases include blood tests, stool sample analysis, and rectal examination.
Blood tests are usually recommended by a doctor if diarrhea is suspected to be due to a specific disease, such as inflammatory bowel disease.
While the stool sample analysis step is performed if the doctor suspects diarrhea caused by bacteria or parasites, or if the patient:
  • Have other symptoms, such as the presence of blood or pus in the stool.
  • Experiencing prolonged diarrhea for more than a week.
  • Have symptoms that affect your whole body, such as fever and dehydration.
  • Recently treated in hospital or taking antibiotics.
  • Have a weakened immune system, for example because you have HIV.
If you are over 50 years of age or if the cause of diarrhea is unknown, your doctor may advise you to undergo a rectal exam. Through this examination, the doctor will examine whether diarrhea is caused by a problem or abnormality in the rectal or colon canal. A digital rectal examination is performed by a doctor by inserting a finger that has a glove protected into the rectal opening.
If the cause of diarrhea is still unknown, an examination such as a colonoscopy or sigmoidoscopy may be performed. This examination is usually rarely present in clinical practice clinics and should be done at the hospital. In a colonoscopy examination, your doctor will insert a special flexible tube called a colonoscope to check the condition of your entire intestine. Whereas in sigmoidoscopy, intestinal examination is done by inserting a device called a sigmoidoscope from the rectum. This tool is almost similar to a colonoscope, but its size is smaller and comes with a camera and lights at the ends.
In children, the symptoms of diarrhea usually disappear within 5-7 days or under two weeks. While in adults, diarrhea usually heal within 2-4 days. The human immune system will fight diarrheal infections naturally. However, diarrhea may last longer depending on the cause, for example:

  • Diarrhea caused by campylobacter and salmonella bacteria usually lasts for 2-7 days.
  • Normal norovirus- induced diarrhea lasts about two days.
  • Diarrhea caused by rotavirus usually lasts 3-8 days.
  • Diarrhea caused by ordinary giardasis lasts several weeks.

Although diarrhea can heal by itself, you can relieve the symptoms by following some suggestions. This advice also applies to diarrhea sufferers who are pregnant or breastfeeding.
Increase fluid consumption
Replacing fluid and electrolyte / ion losses is one of the important keys in the treatment of diarrhea. This is necessary to avoid or handle  dehydration . You or your child is advised to take a few gulps of fluids as often as possible despite symptoms of vomiting. A little liquid is better than nothing. Avoid fruit juices and soft drinks because it can aggravate the condition of diarrhea, especially in children.
If your child shows signs of dehydration , such as rarely urinating , pale or freckled skin, drastically decreased body condition, cold feet and hands, and fussiness and drowsiness, you are advised to consult a doctor immediately.
The factors below make a child more at risk of dehydration:
  • Experiencing more than six times diarrhea in one day.
  • Vomiting more than twice a day.
  • Stop suckling abruptly.
  • It's less than a year old, especially if you're under six months old.
  • Being less than two years old with a weight below the average at birth.
Keep giving your baby milk or eating normally even if they have diarrhea. When breastfeeding, you yourself should continue to increase your own fluid intake to keep the supply of milk always awake.
Food when experiencing diarrhea
If you have diarrhea, make sure you eat solid foods after being able to eat. It is also suggested by health experts. You should not eat too large portions and avoid foods that are too heavy, spicy, or fatty.
Do not give solid foods to your child if they are dehydrated. Give them enough fluids and make sure the signs of dehydration stop. Then you can feed them normally. If your child refuses to eat, keep fluids until their appetite returns.
Overcome diarrhea with ORS
For those susceptible to dehydration, doctors usually recommend the use of ORS. Diarrhea sufferers who are recommended to drink ORS are those who have serious health problems, such as heart disease , weakness, and those over sixty years of age.
Oralite consists of a mixture of water with sugar and salt. This fluid serves to replace carbohydrates, electrolytes / ions, and other essential minerals lost in the body to avoid dehydration. Oralit can be purchased at pharmacies without prescription.
If your child has diarrhea and has a risk of dehydration , doctors usually recommend giving ORS. You can see the instructions or dosage of oralit contained on the package. The dose given usually depends on the size and weight of the child, but the general recommendation for oral administration in children is one sachet for each time after toilets. Oralite itself can not cure diarrhea or cope with the cause, but only useful to prevent and restore dehydration .
If you or your child is seriously dehydrated from diarrhea, then hospitalization by administering fluids through an IV line will be required.
Overcoming diarrhea with drugs
There are several types of antidiarrheal drugs, and generally antidiarrheal drugs can reduce symptoms, as well as shorten the duration of diarrhea by one day. The most commonly used antidiarrheal drug is loperamide .  This drug has been shown to be effective and has few side effects. Loperamide is able to make your stool more dense and reduce the frequency of your bowel movements.
A number of antidiarrheal drugs can be purchased at pharmacies without prescription from a doctor. You are advised to read the instructions on the packaging to know the correct dose dosage and know if the drug is suitable for you. Antidiarrheal drugs are not really necessary unless you are pressed for important activities.
Do not take antidiarrheal medication if you have a high fever or there is blood and pus in your stool. Immediately consult a doctor.
Use of antibiotics for diarrhea
Antibiotics are usually recommended if the cause of diarrhea has been confirmed as a bacteria or if the symptoms of diarrhea are very severe. Diarrhea sufferers are advised not to take antibiotics if the cause is unknown. In addition to antibiotics can cause bad side effects, antibiotics also have no effect if diarrhea caused by a virus. If too often used for mild disease, the positive effects of antibiotics will be reduced when later used to treat more serious conditions. Antibiotics are also recommended for those who have weak immunity and are susceptible to infection.
Pain relief medicines
Although painkillers are not going to treat diarrhea, but you should take paracetamol or ibuprofen if your diarrhea accompanied by headache and fever. The use of ibuprofen is prohibited for people with asthma and for those who have liver or kidney disease. Children may take paracetamol  or ibuprofen if necessary. To find out if the drug is suitable for your child, check the instructions for using the drug on the package. Aspirin is not suitable for children under 16 years of age.
Treatment of basic conditions
What is meant by treatment of the basic condition here is the treatment given when the diarrhea you are experiencing is caused by a pre-existing disease based on the doctor's diagnosis. For example, if your diarrhea is caused by inflammation of the intestines, then the disease should be treated thoroughly before it can cure diarrhea. Because if the basic conditions are not handled properly, then the possibility of diarrhea as a symptom will continue.


Basically, prevention of diarrhea depends on one's discipline in maintaining food and drink hygiene. Special care is required in managing food and beverages from cooking to storage. Thus, one can avoid the development of microorganisms, such as bacteria that can cause diarrhea. In conclusion, the higher your hygiene standard, the less your risk of diarrhea.
Here are the preventive measures of diarrhea caused by contamination:
  • Wash hands with soap and warm water before eating, after handling raw meat, after using the toilet, and after playing with pets.
  • Keep your nail clean, especially if you have long nails.
  • Steer clear of food and drink that its cleanliness is in doubt.
  • Do not drink tap water.
  • Keep the kitchen and bathroom clean.
  • Separate the raw food from the ripe.
  • Eat foods cooked from fresh ingredients.
  • Store food in the refrigerator and do not let food fall under sun exposure or room temperature.
  • Discard food and drinks that have expired.
To prevent the spread of diarrhea to those around you, you can do the following:
  • Clean always toilets with germicides after use.
  • Always wash your hands before eating or preparing food.
  • Do not move first until at least two days after the last diarrhea.
  • If staying one house, make sure you avoid using the same towel or cutlery as other family members at home.
  • Avoid pool use for two weeks after the last diarrhea, if the cause of diarrhea comes from cryptosporidium parasites.
  • Many still do not realize how diarrhea can be fatal, especially for children in Indonesia. Personal hygiene and food needs to be considered in order to prevent diarrhea.

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