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Diarrhea is a disorder in which an artificially fed child passes three or more stools a day, or a single stool that contains blood, mucus or pus. When a baby is fed with its mother’s food, we will call diarrhea the appearance of looser and more frequent stools. If diarrhea lasts no longer than 10 days, it is called acute, if it is prolonged, it is called chronic diarrhea.
What causes diarrhea?
There are many causes of diarrhea in children. The most common are viral infections (Rotaviruses, Caliciviruses, Astroviruses, Adenoviruses), bacterial and parasitic gastrointestinal infections. Food poisoning, medications and many other diseases are an important factor contributing to the appearance of diarrhea.
The most common pathogens causing diarrhea in children are viruses, and among them the most common one is rotavirus, which is responsible for approximately 25-40% of acute gastroenteritis in children. Hospitalization due to rotavirus infection accounts for 5% of all hospitalizations of children.
Who gets diarrhea most often?
The most common diarrhea is children between the ages of six months and two years, when the mother’s immune antibodies disappear and the child’s own immunity is not yet fully developed. In patients of this age, the infection is most severe. Almost all children under five are infected, and the risk of dehydration is highest in children under one year of age. The virus, which usually attacks in winter and autumn, is the cause of milder acute gastroenteritis also in adults.
How can i get diarrhea?
Viral infections, which are highly infectious, are quickly transmitted through the fecal-oral route. The virus, excreted with the stool, enters the gastrointestinal tract of the next individual, most often as a result of neglecting basic hygiene rules. The transmission of viruses is favored by contacts with people we know have diarrhea (the virus is in the stool in high concentration) and human clusters such as nurseries, kindergartens and hospitals (the virus is present on toys and various other objects). The consumption of infected food or water also predisposes to infection with Kalicivirus.
The first symptoms of infection appear as early as 12 hours after infection.
The virus multiplies in the cells of the small intestine, causing them to break down and flake off. As a result, intestinal villi are shortened, the area of absorption of fluids with electrolytes in the intestine is reduced and their secretion into the intestinal lumen increases. The damage to the intestinal mucosa is also associated with the disturbance of the proper activity of enzymes such as, for example, lactase, which are on its surface, causing secondary lactose intolerance. Several mechanisms are responsible for the development of rotavirus infection.
What are the symptoms of an infection?
The spectrum of symptoms manifested by rotavirus infection is wide. From completely asymptomatic viral release to dehydration, seizures, and even death in immunocompromised children. In the vast majority of sick patients, the infection is limited to: vomiting, diarrhea without blood, abdominal pain or fever. Each person may have symptoms in a different constellation. In 10% of children hospitalized with diagnosed rotavirus infection, the reasons for admission were vomiting and fever. In almost half of the patients, the above symptoms are accompanied by respiratory disorders. Sometimes the number of loose stools or episodes of vomiting can be as high as twenty a day. A very high loss of water and electrolytes from the body results in quick dehydration, especially with the accompanying reluctance to drink and eat in a child. The symptoms last for two to eight days, when the intestinal epithelium regenerates.
How to recognize?
Based on the above symptoms, we cannot clearly distinguish a viral infection from a bacterial one. Additional markings are necessary. In the case of viral infection, no significant abnormalities were observed in laboratory tests. Sometimes there are features of metabolic acidosis, slightly elevated levels of liver enzymes or decreased levels of calcium. It is possible to identify some viruses, such as Rotavirus in the stool, based on enzyme immunoassays, latex or PCR.
How to Treat Diarrhea?
The result confirming infection does not change the treatment strategy, which is the same for all viral diarrhea in children and is based on effective oral or intravenous rehydration in a hospital setting.
Once the hydration is successful, the child should return to his daily, age-appropriate diet. Breastfeeding is also beneficial in reducing the amount and volume of loose stools, so it should be continued. Preparations containing probiotic bacteria, the so-called probiotics. For children, those in the form of drops, such as LactoDr, will work best. drops that you can buy on Medonet Market. We also recommend Pro + Pre Biotic For children – Doctor Life dietary supplement in the form of capsules that can be opened and the powder dissolved in water or with a meal.
How not to cure diarrhea?
There is no need to administer antibiotics in viral diarrhea. Moreover, drugs that stop diarrhea should also not be used due to the risk of serious side effects in the absence of evidence of their effectiveness. There are reports in the literature about the beneficial effects of zinc, but they mostly refer to malnourished children from developing countries. In the European population of children with acute diarrhea, the positive effects of using this element have not been proven.
How does the infection spread?
Infected people are a factor contributing to the spread of infection, and at the same time only slightly symptomatic or asymptomatic. The concentration of virus they excrete may be so low that it cannot be detected. In addition, the virus is shed a few days before symptoms appear and a few days after symptoms resolve. Usually, strict hygiene measures are not followed until symptoms appear, which contributes to the spread of infection.
How can we prevent diarrhea?
Methods of preventing viral infection:
- Hand washing,
- maintaining careful hygiene when changing diapers (washing hands, tight bags),
- isolation of people who manifest symptoms of infection,
- appropriate and effective methods of drinking water treatment – mainly in developing countries,
- preventive vaccinations – rotavirus vaccination is recommended.
Rotavirus vaccines contain live attenuated viruses. They are administered orally to infants from six weeks of age to prevent rotavirus-induced diarrhea. The effectiveness in preventing severe gastroenteritis is estimated at about 84-98%. The entire vaccination course (2 or 3 doses) should be completed before the child is XNUMX weeks old. These vaccines can be used alone or together with inactivated pediatric vaccines.
Text: lek. Jagoda Kumik