DIARRHOEA is a common disease that can affect the general public regardless of age and gender.
According to the World Health Organisation (WHO), diarrhoeal disease is one of the leading causes of death in children under the age of five. It is responsible for almost 525,000 deaths among children annually.
Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than usual for the individual).
Frequent passing of formed stools is not diarrhoea, nor is it the passing of loose, "pasty" stools by breastfed babies.
Diarrhoea is usually a symptom of an infection in the intestinal tract which can be caused by bacterial, viral or parasitic organisms.
The condition is spread through consumption of contaminated food or drinking water, or from person-to-person as a result of poor hygiene.
An individual who suffers from diarrhoea will have accompanying symptoms which include nausea, vomiting and stomach spasms.
HYGIENE ISSUES
Diarrhoea is typically associated with hygiene. Most cases involve developing countries, where the practice of drinking contaminated water is known to be one of the leading causes.
Besides that, an ineffective sanitation system will increase the risk of having diarrhoeal disease.
Children are more susceptible to diarrhoeal disease as their digestive and excretory systems are not fully developed.
Untreated domestic water supply may be contaminated with various diarrhoea-causing microorganisms, which include bacteria such as Escherichia coli, Vibrio cholera, Shigella spp., Salmonella spp., and Campylobacter spp.
These microorganisms are well recognised for causing infections in the digestive tract.
ENSURE HYDRATION
Children experiencing a diarrhoeal episode will lose water and electrolytes (sodium, chloride, potassium, and bicarbonate) through stools, vomit, sweat and urine.
When the loss of water and electrolytes occurs continuously, it will result in dehydration.
The primary treatment for children experiencing diarrhoea is to ensure adequate rehydration, which can be achieved through the use of oral rehydration salts (ORS).
ORS is made up of important electrolytes and sucrose. The electrolytes will ensure that there is no further loss of fluids and the sucrose provides energy.
Products containing ORS found in Malaysia are typically packed in sachets of 55 grams and normally need to be mixed with 250 ml of water before consumption.
WHO recommends that the dosage of ORS for children under two years of age as between a quarter to half of a glass of water mixed with ORS.
As for older children, it is between half to a full glass of water mixed with ORS.
ORS should be administered as soon as an individual starts showing signs and symptoms of diarrhoeal disease and be given after each episode of diarrhoea or vomiting.
However, for severe cases of diarrhoea, ORS alone will not be able to ensure complete rehydration.
In such situations the individual may need to be admitted into a healthcare facility and provided with additional administration of fluids through an infusion.
LET DOCTORS DECIDE
Recently, there has been widespread misconception regarding the use of antibiotics for treating diarrhoea.
With the significant increase in antibiotic resistance over the past decade, it has become more critical now than ever to determine if antibiotics are needed to treat an infection.
The decision to administer antibiotics should be based on careful assessment and proper medical tests by doctors.
In general, when a child exhibits mild signs and symptoms of diarrhoeal disease and seems to be improving with time, there is no need to administer antibiotics.
The choice of giving antibiotics depends on the severity of the diarrhoeal disease, as well as the type of microorganism responsible for the infection in the digestive tract.
For instance, in cases where the individual has diarrhoea due to a bacterial infection, antibiotics can be administered if deemed necessary.
Supplements such as zinc can also be used to aid malnourished children who are suffering from acute diarrhoeal disease.
WHO associates zinc deficiency with the risk of children contracting digestive tract infections.
Zinc is also essential in protein production as well as maintaining the body's defence system.
Zinc supplementation at a dose of 20mg per day for children and infants older than six months, or 10mg per day in those younger than six months, for 10-14 days is recommended.
Recent studies have shown that taking probiotics in recommended doses can also be beneficial in children with diarrhoea.
Probiotics contain Lactobacillus GG and Saccharomyces boulardii, which can be beneficial in the treatment of acute watery diarrhoea in children and babies.
Nevertheless, medical experts have concluded that more research is needed on the effectiveness of probiotics and that probiotics should not be considered a primary form of treatment for diarrhoea.
It is worth remembering that the management of a diarrhoeal disease should be comprehensive.
Always ensure continuous rehydration, and remember that the use of antibiotics is only warranted if deemed necessary by a healthcare professional.
The treatment for diarrhoea has to be well-managed to ensure the patient recovers quickly without any further complications.
For enqquiries regarding the use of medicines, the toll-free line for the National Pharmacy Call Centre (NPCC) is 1800-88-6722 (weekdays from 8am to 5pm).
* The writer is a pharmacist with the Ministry of Health.