2023-04-24 07:02:34
diarrhea in children
Diarrhea is a common problem in children under 5 years of age, and the number of patients with diarrhea tends to increase every year. It was found that children under 5 years old had 33.36 cases of diarrhea per 1,000 population in 2010, an average increase of 33.79 cases per 1,000 population per year during 2015-2019 or increasing. Approximately 0.43 cases per 1,000 population in the past 10 years.
Characteristics of diarrhea
stools that are more liquid than normal or having bloody mucus more than or equal to 3 times a day, or in the case of fecal mass measurement, i.e. stools greater than 10 g/kg/day in infants or young children or stools greater than 200 g/day in older children and adults
frequency of defecation
In most cases, babies can have normal bowel movements 3-10 times a day, depending on the milk that the child eats. In which children who are breastfed tend to have more frequent bowel movements than children who are fed formula milk or formula. For toddlers and older children, they are usually taken 1-2 times a day depending on the food they eat.
the color of the stool
➮ yellow or brown is normal stool color
➮ Green color may be caused by eating too many green vegetables or beverages, ingesting iron, or having diarrhea that makes your bile unable to digest and turn yellow in time.
➮ Black color can be caused by iron intake. eating black foods such as black licorice or gastrointestinal bleeding
➮ Redness can be caused by consuming red foods such as beetroot, tomato juice, etc., from certain antibiotics. or bleeding from the gastrointestinal tract
➮ Pale color, be careful because it may be caused by a blockage in the bile ducts. Or it may be caused by taking large amounts of certain medications, such as aluminum hydroxide antacids, bismuth subsalicylate, etc.
duration of liquid defecation
➮ Acute diarrhea is diarrhea that lasts less than 7 days.
➮ Protracted diarrhea is diarrhea that lasts 8-13 days.
➮ Chronic diarrhea is diarrhea that lasts more than 14 days.
which acute diarrhea Causes of acute diarrhea in children Most often it is caused by a viral infection. followed by bacterial infection and side effects of antibiotic disinfectants And there may be other causes that occur outside the gastrointestinal tract but are less common.
Therefore, when the baby has diarrhea, it should be assessed first to determine how severe dehydration is, such as dry mouth, sunken eyes, and crying without tears. Less urination, rapid pulse, restlessness Unusual fussiness or lethargy weight loss, etc. If you are not confident, you should hurry up and bring your child to see a doctor for examination at the hospital.
Diarrhea treatment
Initial treatment at home if your baby has diarrhea Oral fluids such as electrolytes may be given at 10 ml/kg per 1 watery defecation (maximum 240 ml per time). The loss of water and mineral salts each time may be due to excessive vomiting, being unable to eat at all, or having loose stools several times in large quantities. because if left to cause severe dehydration for a long time May cause acute renal failure. and can cause shock
Proper diet for children with diarrhea
1. Babies who are breastfed It is advisable to continue breastfeeding. If the stools are still loose several times after consuming milk Or mother’s milk is released in large amounts at a time. Consider eating the latter part of the milk first. Then squeeze the front milk and keep it in the refrigerator to eat when diarrhea is gone.
2. Eat a normal diet according to age.
3. Switching milk to a lactose-free formula, in which case it may not be necessary in all patients with acute diarrhea.
4. In case of severe watery defecation suspected to have lactose intolerance, it may be considered to change milk to a lactose-free formula. But change the milk temporarily. You don’t have to stop forever.
5. It is recommended to eat foods according to age that are easy to digest. Eat in small amounts and eat often. Drinks that are high in sugar should be avoided. But it is not necessary to abstain from food.
in terms of treatment Initially, taking medicines according to the symptoms, drinking mineral salts, and antibiotics, antibiotics will be considered for use when there are indications. Because acute diarrhea can occur for many reasons. Unnecessary use of antibiotics In addition to not being useful There may also be side effects from the drug.
prevention of diarrhea
1. Wash your hands regularly for both the child and the caregiver.
2. Eat cooked, clean and complete food from the 5 food groups.
3. If diarrhea occurs Caregivers should be careful of the spread of infection. by taking care after excretion to be clean and tidy Keep pampers away in the garbage can completely. Do not take the patient to the swimming pool. and refrain from going to school or daycare until they recover
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Reference:
1. Miguel G O’Ryan, MD, Jason Levy, MD, RDMS. Pateint education: Acute diarrhea in children(Beyond the Basics). UpToDate Feb 2023
2. Acute diarrhea. AMERICAN COLLEGE OF GASTROENTEROLOGY, Advancing Gastroenterology, Improving Patient Care 2023
3. Clinical Practice Guidelines for the Treatment of Acute Diarrhea in Children B.E.2562; Guidelines for Pediatric Gastrointestinal and Liver Diseases 5
4. Andi L. Shane, MD, Rajal K. Mody, MD John A. Crump, MD et al. 2017 Infectious Disease Society of American Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. CID 2017:65( 15 December)
5. Busara Charoenwat, Kunanya Suwannaying, Watuhatai Paibool, Sumitr Sutra, et al. Burden and pattern of acute diarrhea in Thai children under 5 years of age: a 5- year descriptive analysis based on Thailand National Health Coverage(NHC) data. BMC publish health (2022)22:1161
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