Diarrhea is a common problem among children. It’s when one’s bowel movements or stools are loose and watery. Speaking to Dr. Kosala Karunaratne, Consultant Pediatrician, Lady Ridgeway Hospital, the Health Capsule learned how diarrhea can lead to dehydration and make patients suffer from malnutrition and lactose intolerance in the long run. Dr. Karunaratne explained how this diarrhea can be treated and what measures should be taken when a child suffers from this condition.  

Causes
Speaking about the causes of diarrhea Dr. Karunaratne said, “ Diarrhea can be caused by infections, viruses and even bacteria. Out of these, the most common causes are infections and viruses. There is also a virus called rotavirus which can cause diarrhea. There is a vaccine for this virus that is given as a preventive measure,”said Dr. Karunaratne. 

He further stated that there are a variety of ways these viruses, infections and bacteria can enter a child’s system. “They can contract it orally. So if you don’t wash your hands and don’t keep clean then viruses can spread when food is ingested. Some viral diarrhea can be caused due to influenza. The most common way to contract it is orally,” he added. 

“Practicing good hygiene, washing, boiling water, proper preparing of food etc. are very important. Infections are the most common causes for diarrhea, but at the same time you can get diarrhea due to food poisoning. Food poisoning is caused by the toxins released into the foods by bacteria. These toxins cause diarrhea. So the symptoms can appear immediately after eating the bad food.” he said.

  
Symptoms
Speaking of the symptoms Dr. Karunaratne said, “Usually watery stools, which are more frequent than is usual for the child is the main symptom. Sometimes watery stools are normal in some children. If it is more than what is normal for that child it is called diarrhea. This can differ from child to child. Diarrhea can also be associated with vomiting”.   

Complications
According to Dr. Karunaratne, dehydration is the worst complication that can occur from diarrhea. “The most serious complication is dehydration. Children die not due to the diarrhea, but due to dehydration. Which is why we have to focus on how to prevent the child from getting dehydrated when the child has diarrhea,”said Dr. Karunaratne. 

“Sometimes the child can get complications due to electrolyte abnormalities. When the child has diarrhea, it can lose sodium and potassium, and this can cause complications in the electrolytes,” he added.  Dr. Karunaratne further stated that the long term problems that can occur are malnutrition and lactose intolerance. “Later on, a child who has diarrhea can suffer from malnutrition. The child’s nutrition can reduce, so under nutrition or malnutrition can set in the child long term because of the diarrhea. Another small complication is that some diarrhea can be persistent and can last for some time. That is due to what is called lactose intolerance. That is when children get diarrhea due to absence of an intestinal enzymes that break down lactose. Then they become intolerant to milk based products. Thus the long term problems are malnutrition and lactose intolerance,”he said. 

Treatment
Dr. Karunaratne stated that the main treatment is the prevention of dehydration. “For that there is a wonder medicine, which is ORS (Oral Rehydration Solution) like jeevani. The person who found out ORS received a Nobel Prize. It was one of the greatest advances in medicine as it was about how to prevent dehydration. Earlier children died due to dehydration and now you can prevent it by giving ORS. When a child is dehydrated and you give jeevani or ORS it will be absorbed by the body very fast, due to its composition,” explained Dr. Karunaratne. 

“You suffer from diarrhea because the viruses and bacteria prevent the absorption of water into the body. And the toxins of the bacteria and even the virus prevent the absorption of water. So that water passes on. The ORS reverses that. It makes the body absorb water. That is why it is one of the greatest advances in medicine. Thus, one of the main stages of treatment is ORS,” he said  
He further explained, “You don’t really have to stop the diarrhea itself as it is self-limiting, which means that it will reduce on its own and the child will recover. What you have to do is prevent dehydration. Zinc can be given to reduce duration due to the diarrhea as it contains vitamins and is highly recommended. Now it is thought that probiotics, which is the good bacteria, may stop the duration of diarrhea. But that is a controversial theory. Some people give yoghurt. If you think that the child is suffering from bacterial diarrhea you can give antibiotics. It is difficult to say whether a child has a bacterial or a virus diarrhea, but there are ways of testing it. This will be prescribed by a pediatrician. The unnecessary use of antibiotics can also be harmful for the child. If you taken antibiotics when you have a virus diarrhea you can knock off the good bacteria, which can make the diarrhea worse. Which is why  decisions should be taken by a doctor, specialising with children,”he explained. 

Diet
Speaking of a diarrhea patient’s diet he said, “Give a nutritional diet that the child can tolerate. When the child is suffering from diarrhea there will be loss of appetite. So the child will not be hungry, thus you will have to give such patients fruits and things that are tolerable and easily absorbed. You mustn’t stop giving nutrition to the child because otherwise the child can get malnourished. This is because the child can lose a lot of nutrition. And you shouldn’t try to rest the bowel, which is what was done in the olden days. If you do this the child will lose nutrition. That is why you have to give the child to eat, especially things that are easy to absorb. You must feed the child as much as possible,”he affirmed.