The Child Clinic

Here are symptoms, cause & treatment of Diarrhoea

Hi I am Dr JP Singh, Senior consultant in pediatrics and neonatologist at Tirath Ram Hospital Civil Lines Delhi. Today Vishal will discuss a very common problem in children that is Diarrhoea and how we can prevent its complication and also how we can prevent diarrhoea.

Diarrhoea is one of the most common problems which you see in all children and newborn specially in 3 to 5 years of age. Now it is associated with loose motions which may be either totally watery or may have blood. The number of stool and frequency can also vary. Diarrhoea can lead to serious problems like dehydration and if accompanied with blood it can frequently progress to septicemia and severe infections. In addition to loose motions the child may also have fever, cramps, nausea and vomiting. Now the next question is what are the causes of diarrhoea and why do they occur. The main causes of diarrhoea can be either infectious or noninfectious. Among the infections, viral infections are the commonest and out of the viruses it is the rotavirus diarrhoea which is most common now. This is the diarrhoea which causes a lot of dehydration because here the stools are copious and in larger number. In addition there is frequently associated when vomiting.

So when the child is unable to take adequate fluids. If he is not able to take adequate fluids, the urine output also goes down. If there is severe dehydration it can affect the Kidneys, leading to acute renal failure and therefore inability to pass urine. However the majority of viral Diarrhoeas and rotavirus diarrhoeas are self limiting and if you take care of adequate hydration and keep on giving the child Fluids by mouth they get controlled by itself. Other infectious causes can include bacteria infections and things like amoebiasis and Giardiasis. There are also some non infectious causes of diarrhoea which would include Cow's milk protein allergy, crohn's disease and other problems. In India nearly two million people suffer from rotavirus diarrhoea annually.

Out of this 6 to 8 million children needs hospitalization and nearly about 1 to 1.5 lacs children died because of this disease. That is why it is very important to prevent this diarrhea. Now talking about prevention of rotavirus diarrhoea alone we have a very effective vaccine which is available. This is a oral vaccine and therefore need no injection. This is given at monthly intervals and three doses are required. The starting age for this vaccine is between 6 to 13 weeks. This vaccine has also been added into the Government of India, national immunization programme and has been given in some States. Somehow Delhi still does not have this vaccine from the government of India. Teerathram Shah Hospital and Triveni turbine limited has combined to act and prevent the rotavirus diarrhoea. We are giving free rotavirus vaccination to all newborns between 6 to 13 weeks at Tirath Ram Shah Hospital.

I would like to end by mentioning that in case you want any more information about diarrhoea rotavirus diarrhoea and its prevention you are free to contact us at Teerath Ram Shah Hospital Civil Lines, New Delhi or contact us through lybrate.

Here are symptoms, cause and treatment of Diarrhea

Namaskar! I am Dr. Charu and I have The Head of Department and senior consultant, Department of Pediatrics in Teerath Ram Shah Hospital Dr. J.P Singh and Dr. Sunil Gupta, senior consultant In the Department of Pediatrics in Teerath Ram shah Hospital. Today we’ll be talking about Diarrhea.

So Sir my first question is, tell us something about Diarrhea.

In kids, diarrhea is quite a common problem. There are multiple reasons due to which loose motions occur. Some are infections while others are non-infections. Now if we first talk about infections then the most common infection is Rautavaara Diarrhea or Rotavirus infection. Other than this some bacteria can also lead to an infection along with parasites like Amoebiasis and Giardiasis. Under the noninfectious causes, the major reason is what we call ‘Cow’s milk Protein allergy’ which is when the child is unable to digest cow’s milk or any other sourced milk.
What are the symptoms of Diarrhea? In case of a child there are loose motions, vomiting is quite common and stomach ache, low or high fever and sometimes there is blood along with loose motions. Other than this if there is an acute case of dehydration then sunken eyes may happen, skin turns less pliable and the child passes less amount of urine. If the loose motion persists then there can be a chance of acute renal or kidney failure as well which could lead to death.

My next question is to Dr. Sunil. Sir What is Rotavirus virus? Tell us something about that.

Rotavirus is that type of virus where it is found most commonly in children of 5 years or less of an age which causes diarrhea and in 40% of the cases, this virus is the cause. Overall in India 2.5 crores of children get affected by Rotavirus which causes the disease and out of that, 20 lakh children end up needing OPD consultancy and out of that almost 8.5-9 lakh children end up with admission in hospitals with 2.5 children suffering death. It has been noticed that Rautavaara diarrhea is a very severe diarrhea and often causes dehydration. As Dr. Sunit told us, this is a very common disease. Another way of looking at it is that every day 335 children die due to this particular disease which makes a total of 14 kids each hour and 1 kid in each minute. Hence, you can understand that this is a very serious problem in India.

As you said that this is a very serious problem, so Dr. Sunil I would like to know that what are the steps which could be taken to prevent this complication from occurring?

See Rotavirus Diarrhea is where there is an acute loss of water and this is mainly found in children so obviously the first treatment would be to provide the child with ORS and large quantity of fluids. However amount of liquid the child is passing through loose motion, there should be an increased amount of water intake in forms of ORs, Coconut water, rice water or even just water; as compared. And if the problem of dehydration can be curbed then further complications can also be controlled. In Rotavirus’s case Antibiotics are not required and the mother can continue with her feed but when dehydration occurs then the child should be admitted into the hospital because it will need IV fluids. Through these steps, in most of the cases, diarrhea can be controlled in hospitals as well as houses.

Sir you told us about managing the disease but are there any methods to prevent it?

Now we have a oral vaccine available for Rotavirus which is a pain free method without any injections. This is in the form of a liquid which we can provide a baby for a time period of 6-13 weeks. This dose is given thrice every month to the newborn which provides the child a protection from the Rotavirus. The Government of India has also approved the vaccine to be included in the National Immunization Programme but till now it has not been sent out to every state. Other than this, the main things is to follow through with the Priminister’s ‘Swacch Bharat Abhiyaan’, if we excrete inside bathrooms and not outside, maintain basic hygiene by washing our hands before and after using the toilet, cleaning our hands before feeding the child, and drink clean water then to an extent we can prevent rotavirus as well as various types of diarrheas.

Teerath ram shah Hospital and Triveni together have started a programme to help children from Rotavirus. Here in his hospital, we provide the vaccine at free of cost which newborns will be provided with for a time period of 6-13 weeks.
I’d like to thank both of you for providing us with this information and if you want to know more about this then you can contact us through the hospital or through Lybrate.