Diarrhoea – Blood Is Thicker Than Water, And So Is Diarrhea

The affected individual may become weak and malnourished. His body’s capacity to work as well as the resistance to disease is lowered considerably.

In children, the physical and mental growth may also be affected. Diarrhoea if neglected, can lead to dehydration due to excessive loss of electrolytes from the body. This may prove fatal in infants and young children.

Diarrhoea is not a disease in itself but a symptom. It does not spare any age or sex. Diarrhoea is most common amongst population living in unhygienic condition due to the prevalence of infections and poor standards of hygiene. 

TYPES OF DIARRHOEA

• Acute Diarrhoea
• Chronic Diarrhoea

Acute Diarrhoea is characterized by sudden onset and frequent passage of watery and unformed stools. The patient may even pass several stools in an hour. Other symptoms include abdominal pain, cramps, weakness and sometimes vomiting and fever. Acute diarrhoea lasts for 24 to 48 hours. Due to the danger of dehydration, replacement of water and electrolyte is of prime importance and meeting the nutritional requirements becomes secondary.

Chronic diarrhoea Unlike the acute type, chronic diarrhoea persists for a longer time, even several weeks and the patient may pass 4 to 5 unformed stools in a day. The rapid passage of food through the intestines does not allow sufficient time for the absorption of nutrients and thus nutritional deficiency symptoms may develop. Therefore, meeting the nutritional needs and providing extra allowance to compensate for the nutrient losses becomes the major objective for treatment. 

DIETARY MANAGEMENT

ACUTE DIARRHOEA

It leads to excessive loss of water and electrolytes resulting in dehydration, which if not controlled may prove fatal. This can be easily prevented if timely steps are taken to rehydrate the patient by giving oral rehydration therapy. 
Oral rehydration salt (ORS) and sugar solution should be given to the child as frequently as possible, the general rule being one glass for every stool passed. 
Other fluids which maybe given along with ORS are:

• Coconut water
• Barley water
• Weak tea
• Whey water
• Albumin water
• Buttermilk
• Carbonated beverages 
• Cereal waters
• Pulse waters

The main treatment of acute diarrhoea, therefore, is to replenish the fluid and electrolyte loss

CHRONIC DIARRHOEA

The dietary modifications in chronic diarrhoea are 

• Energy requirements are increased by 10 to 20 % to meet the losses during diarrhoea as well as overcome weakness and loss of weight 
• Protein A high protein intake is essential to build up body tissue and replace the tissue breakdown which has occurred. It is advisable to increase the protein intake by as much as 50%
• Carbohydrate The intake of carbohydrate should be increased to meet the high energy requirements. However, the fiber intake is kept to a minimum (1 to 2 grams per day) to give rest to the intestines. 
• Fats Due to the increased motility of the intestines, fats are not completely digested and therefore there intake needs to be restricted. Emulsified fats like butter and whole milk are given as they are easy to digest.
• Minerals The absorption of calcium and iron in the intestines is lowered as they form insoluble salts with free fatty acids. Therefore calcium and iron rich foods should be included in the diets.
• Vitamins Greater amount of B group vitamin have to be provided to compensate for the losses that occur due to diarrhoea. Fat soluble vitamin like vitamin A is impaired and therefore sufficient amount should be provided in the diet.
• Residue Low residue foods should be given to the patients of diarrhoea