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Symptom Management of Diarrhoea Report

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Updated: May 5th, 2022

Introduction

Gastroenteritis is a health condition of the human body. It affects both the stomach and the small intestine. It may also be referred to as the stomach virus. This usually causes inflammation of these parts of the body and may result in vomiting, diarrhea and pains in the abdominal region. When it occurs in younger individuals, it is mostly caused by the rotavirus (Velázquez, 2009). In older individuals (adult), the main causes are the campylobacter and the norovirus (Patel, Hall, Vinjé, & Parashar, 2009). However, there are other rare cases where the cause of gastroenteritis involves bacteria or parasites (Viswanathan, Hodges, Hecht, 2009).

Overview

Eckardt and Baumgart (2011) pointed out the main symptoms and signs of this medical condition as vomiting and diarrhea. They appear a while after an individual contract the infectious agent (Rupnik, Wilcox, & Gerding, 2009). Sometimes, only one of the symptoms appears. For example, the patient may experience only diarrhea. Abdominal pain may also be experienced by the patient suffering from gastroenteritis. Webber (2009) proposed that this duration might be any time between 12 hours and 72 hours.

When caused by a virus, this condition may show symptoms including headache, muscle pain and fever (Finkbeiner et al., 2008). In some cases, the victim’s stool may be bloody. This is one indication that the infectious agent is not a virus but a bacterium (Navaneethan, & Giannella, 2008). In areas where treatment is available, a child suffering from gastroenteritis (caused by rotavirus) may recover within a week (Meloni, Locci, Frau, Masia, Nurchi, & Coppola, 2011). In other countries, however, the treatment may be unaffordable to many. In such cases, diarrhea is usually more common and may persist for longer periods.

This medical condition may be transmitted when one consumes contaminated water. Webber (2009) also proposed that it could be transmitted when individuals share some of their personal items. Webber argues that the type of season (dry or wet) greatly influences the time of the outbreak of the disease. He said that it is worse during the wet season as compared to the dry season. Infants may also suffer from the same condition if their bottles are not sanitized.

The diagnosis of gastroenteritis is usually clinical (Pawlowski, Warren, & Guerrant, 2009). This is usually based on the individual’s symptoms and signs. Physicians usually do not need to know the exact cause of the issue. This is because it would not change the management of the condition. However, more attention should be paid to those with bloody stools. This should be accompanied by the performance of stool cultures to ascertain the exact cause. It has been argued that this may be necessary especially if one has been exposed to food poisoning. They add that those who have traveled abroad recently may also be good candidates.

Diarrhea

This is said to have occurred if an individual has had at least three loose bowel movements within 24 hours. This has been determined to be a big cause of death especially in the developing countries (Zilberberg, Shorr, & Kollef, 2008). It is also one of the main causes of infant mortality throughout the world. Generally, there are six types of diarrhea. The first one is the secretory diarrhea. This usually occurs when there is an increase in the active secretion. This could also occur if the absorption process has been inhibited. When this occurs, there is rarely any structural damage. The other type is the osmotic diarrhea. This usually results in the drawing of too much water into the bowels. This usually occurs when one takes in fluids that have a lot of sugar or salt. They draw water from the body during bowel movements. Another type of diarrhea is the exudative diarrhea. This is said to have occurred if the feces contain pus or blood. This usually occurs when someone is suffering from inflammatory bowel disease. These include diseases such as the Crohn’s disease, among other similar diseases.

The other type is the motility-related diarrhea. This usually occurs when the food in the intestine moves in a rapid motion. This is referred to as hypermotility. When this occurs, the body would not have sufficient time to absorb the necessary amounts of water and nutrients. The other type of diarrhea is inflammatory diarrhea. This occurs if the brush border or the mucosa lining has been damaged (Greenberg & Estes, 2009). The causes are diverse. It may be due to infection by bacteria, viruses or parasites. It may also be caused by other inflammatory bowel diseases. The other form of diarrhea is dysentery. In such a situation, blood would be found on the human feces.

Management of Diarrhoea

Diarrhea is dangerous because of the loss of body fluids. This usually causes dehydration. It may also cause electrolyte disturbances. This imbalance is brought about due to loss of the solute. This includes salts such as potassium. Diarrhea claims millions of lives annually. In 2009 alone, about 2.6 million people lost their lives due to the condition. The majority of these victims were children of ages five and below (Checkley et al., 2008).

Since prevention is better than cure, certain measures could be undertaken in order to prevent individuals from experiencing diarrhea (Hempel, Newberry, Maher, Wang, Miles, & Shanman, 2012). It has been determined that the rate of diarrhea can be greatly decreased with the use of the rotavirus vaccine (White, Buttery, Cooper, Nokes, & Medley, 2008). Other vaccines against other causes of diarrhea are also underway. Probiotics have also been used to reduce cases of diarrhea (Hempel et al., 2012). This is especially for those taking antibiotics. Various institutions and organizations have promoted the simple act of washing the hands (Ejemot, Ehiri, Meremikwu, & Critchley, 2008). This is important since it may lead to significant reduction in cases of diarrhea.

However, if one is already suffering from diarrhea, management interventions may be undertaken. The simplest and most common solution is the replacement of the lost minerals and fluids. These elements are mostly taken by mouth. Other severe cases require the use of intravenous therapy, which may be administered by nurses. Previously, certain diet restrictions were widely used. This includes the BRAT diet. However, it has been argued that this is no longer recommended. Some forms of medication that may be used in such a situation include bismuth subsalicylate and loperamide. However, it has been argued that these medications may be withheld in certain situations.

Due to the huge loss of bodily fluids, dehydration occurs. When this condition is caused by the bacteria Escherichia coli, it causes problems with the blood (Lucas, Duncan, O’reilly, McIlvenny, Nelson, 2008). It affects the normal functioning of the kidney and causes a reduction in the number of platelets and red blood cells. This is because of the fact that the erythrocytes were broken down in the process.

Dehydration may become dangerous if not properly managed. Therefore, this calls for proper symptom management (diarrhea). One of the commonly used solutions is the Oral Rehydration Solution (ORS). This has helped save many lives. However, this solution may not always be readily available at home. Therefore, this may call for the use of readily available interventions. The use of homemade solutions such as chicken soup or unsweetened tea may be used. Plain water is also commonly given to the patients. There are commercial solutions that provide fast solutions for dehydration. One such solution includes Pedialyte.

World Health Organization (WHO) recommends that 1 teaspoon of salt and 2 tablespoons of sugar should be added to a liter of water and used for hydration purposes (Desselberger & Huppertz, 2011). Others recommend that 2 tablespoons and a half a spoon of salt should be used in the same quantity of water. Therefore, both of these experts agree that drinking fluids with excesses of these solvents only deteriorate the situation. Minerals such as potassium and zinc may also be supplemented in the victim’s diet. However, WHO recommends that rehydration should be the top on the list.

The WHO also recommends that a person who is having diarrhea should continue to eat. This is because this would speed up the recovery process and normalize the processes in the intestine. If it is a child, the child should continue to breastfeed. In contrast, drinks with excess sugars (simple sugars) should not be taken especially by children under five. This is because it is likely to increase diarrhea. Plain water may be used instead. Experts believe that small children might require the use of a nasogastric tube during the administering of these fluids.

Apart from these management procedures, there is also treatment available for diarrhea. This is in the form of certain antibiotics. Antibiotics are usually most beneficial when the condition is acute. However, other experts have argued that these antibiotics are usually done only in specific situations (Allen, Martinez, Gregorio, & Dans, 2010). This is because there is likelihood that they may increase the chances of occurrence of hemolytic uremic syndrome. Some bacteria have been determined to develop resistance and this discourages the use of antibiotics. Funny enough, certain antibiotics have been determined to cause diarrhea. This type of diarrhea is referred to as the antibiotic-associated diarrhea (Kale-Pradhan, Jassal, & Wilhelm, 2010). Cancer patients undergoing chemotherapy may also experience this. Proper management of the symptom, which is diarrhea, is the best way to ensure quick recovery of the victim and to avoid further complications arising from the effects of diarrhea.

Conclusion

Diarrhea is one of the symptoms associated with various illnesses such as gastroenteritis, which is a condition that affects both the stomach and the small intestine. Diarrhea is the situation where an individual has several loose bowels in a day. This causes loss of body fluids in large quantities and usually leads to dehydration. It may also lead to electrolyte disturbances. The immediate solution to these issues includes rehydration, which is the taking of fluids by mouth or through intravenous therapy. Another solution is the taking of supplements of potassium and other minerals. Various other symptom management practices should also be employed in order to ensure that diarrhea is kept at bay and death is prevented.

References

Allen, S.J., Martinez, E.G., Gregorio, G.V., & Dans, L.F. (2010). Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev, 2010(11), 30-48.

Checkley, W., Buckley, G., Gilman, R.H., Assis, A.M., Guerrant, R.L., & Morris, S. (2008). Multi-country analysis of the effects of diarrhoea on childhood stunting. Int J Epidemiol, 37(4), 816-830.

Desselberger, U., Huppertz, H.I. (2011). Immune responses to rotavirus infection and vaccination and associated correlates of protection. The Journal of Infectious Diseases, 203(2), 188–195.

Eckardt, A.J., & Baumgart, D.C. (2011). Viral gastroenteritis in adults. Recent Patents on Anti-infective Drug Discovery, 6 (1), 54–63.

Ejemot, R.I., Ehiri, J.E., Meremikwu, M.M., & Critchley, J.A. (2008). Hand washing for preventing diarrhoea. Cochrane Database Syst Rev, 21(1), 42-65.

Finkbeiner, S.R., Allred, A.F., Tarr, P.I., Klein, E.J., Kirkwood, C.D., & Wang, D. (2008). Metagenomic analysis of human diarrhea: viral detection and discovery. PLoS Pathog, 4(2), 100-111.

Greenberg, H.B., & Estes, M.K. (2009). Rotaviruses: from pathogenesis to vaccination. Gastroenterology, 136(6), 1939–1951.

Hempel, S., Newberry, J., Maher, A.R., Wang, Z., Miles., J.N., & Shanman, R. (2012). Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. Journal of the American Medical Association, 307(18), 1959-1969.

Kale-Pradhan, P.B., Jassal, H.K., & Wilhelm, S.M. (2010). Role of Lactobacillus in the prevention of antibiotic-associated diarrhea: a meta-analysis. Pharmacotherapy, 30(2), 119–126.

Lucas, M.L., Duncan, N.W., O’reilly, N.F., McIlvenny, T.J., Nelson, Y.B. (2008). Lack of evidence in vivo for a remote effect of Escherichia coli heat stable enterotoxin on jejunal fluid absorption. Neurogastroenterol Motil, 20(5), 532-538.

Meloni, A., Locci, D., Frau, G., Masia, G., Nurchi, A., & Coppola, R. (2011). Epidemiology and prevention of rotavirus infection: an underestimated issue. The journal of maternal-fetal & neonatal medicine, 24 (2), 48–51.

Navaneethan, U., & Giannella, R.A. (2008). Mechanisms of infectious diarrhea. Nature Clinical Practice, Gastroenterology & Hepatology, 5(11), 637–647.

Patel, M.M., Hall, A.J., Vinjé, J., & Parashar, U.D. (2009). Noroviruses: a comprehensive review. Journal of Clinical Virology, 44(1), 1–8.

Pawlowski, S.W., Warren, C.A., & Guerrant, R. (2009). Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology, 136(6), 1874–1886.

Rupnik, M., Wilcox, M.H., Gerding, D.N. (2009). Clostridium difficile infection: new developments in epidemiology and pathogenesis. Microbiology, 7(7), 526–536.

Velázquez, F.R. (2009). Protective effects of natural rotavirus infection. Pediatr Infect Dis J., 28(3), 54-60.

Viswanathan, V.K., Hodges, K., Hecht, G. (2009). Enteric infection meets intestinal function: how bacterial pathogens cause diarrhoea. Nature Reviews. Microbiology, 7(2), 110–119.

Webber, R. (2009). Communicable disease epidemiology and control : a global perspective (3rd ed.). Wallingford: Oxfordshire.

White, L., Buttery, J., Cooper, B., Nokes, D.J., & Medley, G.F. (2008). Rotavirus within day care centres in Oxfordshire, UK: Characterization of partial immunity. J R Soc Interface, 5(1), 148.

Zilberberg, M.D., Shorr, A.F., & Kollef, M.H. (2008). Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000–2005. Emerg Infect Dis, 14(6), 929-931.

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