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Management of acute diarrhoea
1National Institute of Cholera & Enteric Diseases, Calcutta.
Insights
Acute diarrhoeal diseases require prompt management. Oral rehydration therapy (ORT) is key for watery diarrhoea, while antibiotics are vital for invasive types like shigellosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Acute diarrhoeal diseases are a significant global health concern, contributing to substantial morbidity and mortality, especially in pediatric populations.
- Diarrhoea presents in two main forms: watery, characterized by dehydration, and dysenteric, involving blood and mucus in stools.
Purpose of the Study:
- To outline the essential management strategies for acute diarrhoeal diseases.
- To differentiate treatment approaches based on diarrhoea type and severity.
Main Methods:
- Review of established therapeutic guidelines for acute diarrhoeal diseases.
- Emphasis on rehydration therapy (oral and intravenous) and targeted antimicrobial or antiparasitic use.
Main Results:
- Oral rehydration salt solution (WHO formula) is recommended for oral rehydration therapy (ORT).
- Intravenous Ringer's lactate is the preferred fluid for severe dehydration.
- Antibiotics are indicated for cholera and shigellosis; antiparasitics for amoebiasis or giardiasis.
- Antidiarrhoeal medications offer no benefit; appropriate feeding is encouraged.
Conclusions:
- Effective management of acute diarrhoea hinges on appropriate rehydration and judicious use of antimicrobials.
- Distinguishing between watery and dysenteric diarrhoea guides treatment decisions, optimizing patient outcomes.
Abstract:
Acute diarrhoeal diseases are an important cause of morbidity and mortality, particularly in children. Acute diarrhoea may be watery, where features of dehydration are more prominent or dysenteric, where the stools contain blood and mucous. Rehydration therapy is the key to the management of acute watery diarrhoea, whereas antibiotics play a vital role in the management of acute invasive diarrhoea, particularly shigellosis. Rehydration may be done either by the oral or intravenous routes depending upon the degree of dehydration. Oral rehydration salt solution of WHO formula is recommended for oral rehydration therapy (ORT). Ringer's lactate is the ideal intravenous fluid for correction of severe dehydration due to diarrhoea. Antibiotic therapy is beneficial for cholera and shigellosis only. Antiparasitic agents are indicated only if amoebiasis or giardiasis is present. Antidiarrhoeals are of no benefit for the treatment of acute diarrhoea. Appropriate feeding during diarrhoea is recommended with beneficial outcome.