The Prevention and Treatment of Diarrhea in Children at Home

Diarrhea remains a national health problem because of the incidence and death rates are still high. Toddlers in Indonesia on average will experience diarrhea 2-3 times per year. With the introduction of ORS, the death rate from diarrhea has greatly decreased.However, children who experience malnutrition is still high, which among others can be the result of diarrheal diseases in children. Here will be explained in brief about the prevention and treatment of diarrhea at home.

The pattern of bowel movements in children

In general, children defecate as often as 3 times a day, frequent and infrequent sejarang-once every 3 days. The poo depending on water content in feces. In normal circumstances, stool shaped like a banana. Viewed from the water content of faeces varied from "liquid" (the highest water content, usually occurs in acute diarrhea), "soft" (like porridge), "shaped" (normal feces, such as bananas), and "hard" (content little water as in the state of constipation). In infants aged 0-2 months, let alone who drink milk, the frequency of bowel movements more often, which can be 8-10 times a day with watery stools, bubbly and sour smelling. During the baby's weight increased to normal, it is not classified as diarrhea, but it is a temporary lactose intolerance due to incomplete development of the gastrointestinal tract.

Normal stool color is greenish yellow, but can vary depending on the food consumed by children. Noteworthy is when the red stools (possibly blood) or black (probably old blood / frozen), or white like putty (on heart disease).

When is called diarrhea?

Children diagnosed with diarrhea when the amount of waste water "thinner" and "more often" than usual. Feces of children diarrhea may contain mucus and blood, depending on the cause. Another follow-up symptoms are fever and vomiting. Sometimes symptoms of vomiting and fever precede mencretnya symptoms.

The symptoms of diarrhea disease

Because the occurrence of diarrhea and vomiting continuously, at first the child will feel thirsty because there have been dehydration (lack of body fluids) light. If not helped, dehydration and weight increase arises symptoms: children seem whiny, insecure, and could not unconscious in severe dehydration. The eyes appear sunken, sunken fontanel (in infants), dry lips and tongue, does not appear to cry tears though, turgor decreases ie when the stomach was pinched skin remains wrinkled, weakened until no palpable pulse, hands and feet felt cold, and decreased urine . In the state of severe dehydration appear shortness of breath because the body lacks substance base (suffering from acidosis). If there is a lack of electrolytes can occur seizures.

The principle of treatment of diarrhea

Diarrhea can cause dehydration death if not treated properly and can trigger growth disorders (malnutrition) if not given adequate nutritional therapy. Most of diarrhea in children will heal itself (self-limiting disease), provided that prevented the occurrence of dehydration which is the cause of death. Therefore, the principle of treatment of diarrhea are:

Rehydration: replace lost fluids, can by mouth (drinking) or through an IV (in case of severe dehydration).

Providing adequate food: do not memuasakan children, feeding as given before the illness should be continued, including breastfeeding. In mild diarrhea that are not needed replacement formula.

Administration of drugs to a minimum. Most of diarrhea in children will recover without antibiotics and antidiarrheal. Even antibiotics can cause chronic diarrhea.

Treatment begins at home?

When children suffer from diarrhea and have not suffered from dehydration, give drink as much as 10 ml per kilogram of body weight every time passage for fluids lost with feces may be replaced to prevent dehydration, thus preventing the occurrence of death. ORS should be given fluids that have been available in the market today such as 200 ml of oral rehydration salts, ORS I liter, and Pharolit ORS-200-200 and also ready to drink ORS solution such as Pedialyte and Renalyte. If not available, can also be used solvent that can be made at home, such as saline solution or saline-sugar-starch (see Table 1).

Table 1. How to make a solution of salt, sugar and salt-solution starch

Salt-sugar solution

Salt-starch solution

Material consists of 1 teaspoon sugar, one-fourth teaspoon salt and 1 cup (200 ml) of boiled water.

After being mixed on a glass obtained by salt-sugar solution that is ready for use.

Materials consist of 6 (six) Munjung tablespoons (100 grams) rice flour, 1 (one) teaspoon (5 grams) salt, 2 (two) liters of water. Once cooked until boiling will be obtained salt-starch solution that is ready for use.

If there have been dehydration, ORS minumkanlah 50-100 ml (depending on the severity of dehydration) per kilogram of body weight in 3 hours to treat dehydration and diarrhea if still continue to be given ORS as above, ie 10 ml per kilogram of body weight every passage (see Table 2).

How to know the state of the child improved and did not need to be brought to the doctor? Of course, by looking at the improvement of the symptoms mentioned above.Awareness of children improved, his thirst will disappear, the mouth and lips started to moist, peeing a lot, and improved skin turgor stomach.

When was referred to a clinic or a doctor?

Children referred to a clinic or doctor if:

Vomiting continuously so that no benefit is expected to giving ORS

Severe diarrhea and continuously so that the estimated provision of ORS less successful

There are signs of dehydration (sunken eyes, lack turgor, hands and feet cold, unconsciousness).

Prevention of diarrhea

Diarrhea is generally transmitted through 4 M, namely Food, Feces, Fly and Finger.Therefore, practical efforts to prevent diarrhea is to break the transmission chain. Some efforts are easy to implement are:

Hygienic food preparation

The provision of clean drinking water

Personal hygiene

Wash hands before eating

Exclusive breastfeeding

Defecate in place (toilet, toilet)

Place adequate trash

Fight flies so as not to descend food

Healthy environment

Table 2. Treatment of diarrhea at home

The degree of dehydration

Type

fluid

Total

fluid

Schedule delivery

Not to dehydration

Household fluids or oral rehydration salts

10 ml per kg body weight every time diarrhea

24 hours

Mild dehydration

ORS

50 ml per kg

10 ml per kg per diarrhea

3 hours

24 hours

Dehydration is

ORS

100 ml per kg

10 ml per kg per diarrhea

3 hours

24 hours

Severe dehydration

Immediately taken to a health center or hospital because children need to receive intravenous

Cover

Diarrhea in children can cause mortality and malnutrition. Death can be prevented by preventing and treat dehydration with ORS administration. Malnutrition can be prevented by adequate feeding during diarrhea. The role of drugs is not so important in dealing with children.


sources : idai.or.id