Description
Acute diarrhea (AD) is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. Diarrhea can be of sudden onset and lasting for less than two weeks (acute) or persistent. As dehydration and negative nutritive balance are the main complications of AD, the compensation of lost body fluids and adequate diet form the basis of the child's treatment.
Résumé
- ORS is a game-changer in reducing deaths from diarrhea in children. GOBI-FFF, a WHO primary healthcare package, includes growth monitoring, ORS, breastfeeding, immunization, family planning, food supplements, and female education. UNICEF launched a child survival development revolution concentrating on growth monitoring, ORS, immunization, and food supplementation. The British Medical Journal hailed ORS as a crucial 20th-century medical advancement in combating diarrhea.
- Management of gastroenteritis involves oral rehydration and rapid reintroduction of regular feeding after initial fluid replacement. ORS's effectiveness is attributed to the sodium-glucose co-transport system (SGLT1) in the jejunum, facilitating salt and water reabsorption. Principles of ORS therapy include replenishing lost fluids and electrolytes, with sodium being a key component, and leveraging glucose and amino acid absorption for enhanced sodium uptake.
- Various types of ORS exist, including sodium bicarbonate-based, trisodium citrate-based, reduced osmolar, super ORS, and modified ORS. RISO-MAL ORS is designed for malnourished children, featuring low sodium content to prevent cardiac failure. Rice-based ORS uses rice polymers to improve sodium and water transport. Super ORS contains amino acids, reducing stool volume and diarrhea duration, but requires cooking and has a short shelf life.
- Ingredients in ORS play specific roles: sodium chloride maintains osmotic balance, potassium chloride functions intracellularly, glucose aids absorption, and trisodium citrate corrects acidosis. Zinc plays a vital role in rehydration, intestinal regeneration, and immune response during diarrhea, and probiotics help in excluding pathogens, reducing pH, and promoting mucus production.
- Conventional and low osmolar ORS differ in glucose, sodium, and osmolarity levels. Low osmolarity ORS is favored for lowering stool volume, reducing vomiting, and shortening diarrhea duration without causing hypernatremia. ORS therapy is ineffective in cases of hypersalemia, uncontrolled vomiting, severe dehydration, shock, or electrolyte imbalances.
- Administering ORS involves gradual intake in small children and larger amounts in older children, encouraging continued breastfeeding. Different types of ORS are available, including RISO-MAL for malnourished children and super ORS for cholera. Assessment of diarrhea includes stool analysis, duration, and associated symptoms. Risk groups for diarrhea include newborns, infants, underweight babies, and severely malnourished children.
- Assessment of dehydration is based on sensory status, mouth moisture, skin turgor, capillary refill, and pulse volume. Management involves oral rehydration for mild to moderate dehydration, and intravenous fluids for severe cases. Electrolyte imbalances, like hyponatremia and hypernatremia, require tailored approaches to treatment. Clinically classifying diarrhea based on duration and content aids in effective management.
Exemple de certificat
À propos des intervenants
Dr.Bharat Parmar
Consultant Radiation Oncologist and Pain and Palliative Care PhysicianYashoda Hospitals
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