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Treatment of acute diarrhea
Consists of the following:
• Appropriate diet
• Supplements: Probiotic and zinc
• Anti diarrheal medicines
• Antibiotics: empiric or specific
Out of these, rehydration and appropriate diet are considered mainstay treatment for acute diarrhea with other options considered for specific situations.
As 70% of your body is made up of water and the diarrhea results into loss of water, it becomes very important to replenish the lost fluids and electrolytes. This can be done by drinking plenty of water and other fluids such as coconut water, diluted juices, broth or soup. Apart from water, drinking coconut water and fruit juices helps in replenishing potassium while soups helps in replenishing sodium. You can use oral rehydration solution (ORS) to replenish lost fluid and electrolytes.
A homemade ORS can also made consisting of 1 liter of water, 6 tsp sugar and 1/2 tsp salt.
If you have a severe diarrhea or vomiting you would need to get fluids via IV line directly into your blood.
For your children, ORS is advisable to provide required amount of water and salts.
Low fiber diet may help in making stools firmer.
You may use bland diet called “BRAT” consisting of bananas, rice (white rice) applesauce and toast. Use of khichaddi (rice cooked with pulses) is also found to be well tolerated and helpful to relive symptoms in many. Other food items that can be eaten are oatmeal, boiled potatoes and soup/broth.
Avoid diet rich in fibers such as salad or raw vegetables.
Avoid milk and milk products
Avoid eating fried, fatty, or spicy food items
Avoid fruits, such as mangoes, pineapple, orange, apple and others
Avoid having too much salt or seasoning
Avoid beverages such as apple juice, Gatorade, and soft drinks
Probiotic supplements may help to reduce the severity and duration of diarrhea. It is especially found useful in children where it can reduce the severity and duration of the diarrhea by 1 day
They are considered to work by stimulating your immune system and by covering the binding sites on intestinal surface.
Are found to be effective in treating and preventing acute diarrhea in children. Your doctor may prescribe 20mg of zinc per day in a child above 2 months of age. It has been shown to reduce the risk of dehydration and reduce the duration and severity by 20 to 40%.
Consists of anti-secretory or anti-motility agents which may help by reducing the frequency of stools and duration of the disease. However, it should be avoided if you have diarrhea with blood or high fever as they can worsen severe intestinal infections.
You may take loperamide tablets orally: 4 mg initially, followed by 2 mg after each unformed stool not exceeding 8mg/day if self administered or 16mg/day if given by your doctor.
As acute diarrhea is mostly self limiting and often caused by viruses, routine use of antibiotics is not recommended in everyone. Moreover, non judicious use of antibiotic may also result into development of resistance, damage to useful gut bacterias or prolongation of illness.
Empiric antibiotic therapy
Given when the causative microbe is not known. This would be usually prescribed if you have following features associated with diarrhea:
• Bloody diarrhea, fever, abdominal pain or dysentery
• Severe diarrhea
Your doctor may prescribe you an oral fluoroquinolone such as ciprofloxacin orally: 500 mg every 12 hours for 5 days to 7 days (adult dose)
Specific antibiotic therapy is prescribed by the doctor according to the microbe detected. Antibiotics such as ceftriaxone, ciprofloxacin, azithromycin and others may be given.
Treatment of drug induced diarrhea
if the cause of your diarrhea is found to be a medicine such as an antibiotic you have been taking, your doctor would reduce the dose of the medicine or switch to another medicine.
Treatment of chronic diarrhea:
The treatment is specific to the underlying cause The first step is to categorize diarrhea into watery, fatty or inflammatory. After this further tests are done accordingly to conform the cause of the diarrhea which is treated specifically.
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