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Wednesday, May 5, 2010

Diagnosis of Acute Diarrheal Disease

How is it Diagnosed?
Stool specimens or rectal swabs should be sent to the laboratory in a transport medium (e.g. CB medium, VR medium, Alkaline Peptone water).
Specimens should be collected before the patient has received any antibiotics.
The specimen is cultured on TCBs media.
Facilities for diagnosis are available at district and sub district laboratories.
Treatment of Acute Diarrheal Disease
The most important part of treatment of diarrhea, basically involves maintaining the fluid–electrolyte balance in the body. Since a lot of fluid is lost in intermittent passage of stools, the fluid and electrolytes are restored through various methods. The second part of treatment involves the stoppage/reduction in the frequency of stools.


Intravenous rehydration
Intravenous infusion is usually required only if the child is severely dehydrated. After the initial fluid and electrolyte deficit has been corrected (i.e. the signs of dehydration have gone) oral fluid should be used for maintenance therapy.

Breast Feeding during Diarrhea
If the diarrhea is mild (few watery bowel movements), then breast feeding should not be withheld.

Not only does breast milk help the infant to recover from an attack of diarrhea both in terms of the nutrients if supplied, and its rehydrating effect, but it helps to prevent further infection because it has protective properties.

Antibiotics and diarrhea
Antibiotics should not be routinely prescribed in the treatment of diarrhea. They are useful in certain specific conditions such as typhoid, cholera, and shigella diarrheas. It is possible that they may do harm .For e.g. neomycin can damage the intestine lining and cause malabsorption.

Role of Anti–motility Agents
Anti–motility agents such as loperamide, tincture opium, should not be used to control diarrhea. They may slow down the intestinal motility and give more time for the replication of the organisms. On the other hand, agents to purge the gastrointestinal tract also should not be used as it may make the diarrhea worse. Other anti–diarrheal agents such as kaolin, pectin also are generally not useful.

Home Remedies
If the WHO mixture of salts is not available, a simple mixture consisting of table salt (5g) and sugar (20g) dissolved in one liter of drinking water may be safely used until the proper mixture is obtained.

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