Diarrhea

Passing of stools, of a normal consistency few more times than usual , is not diarrhea. Diarrhea can be said to be the passage of three or more loose or watery stools within a period of 24 hours. This definition will not apply to newborn babies who may have 8 to 10 watery stools as a normal occurrence. If the loose stools contain blood and mucus, the diarrhea is called dysentery. Diarrhea may be associated with other symptoms such as vomiting, fever, or abdominal pain. Though the discussions below pertain mainly to childhood diarrhea, the basic principles are applicable to adults as well. Diarrhea continues to be a major cause of death and debility among children under 5 years of age in developing countries. In many third world countries, most children under 5 years of age have had 2 to 3 episodes of diarrhea per year, resulting in about 15 deaths per 1000 children under 2 years every year. Moreover, even when they survive an attack, they often suffer a nutritional setback, which retards their growth and weakens resistance to infections. This problem will continue as long as people have to live in poverty and in conditions of poor hygiene. However, there are effective measures that one can take today to combat diarrhea. 

Diarrhea in children may be acute or chronic. When the abnormal stools last for less than 2 weeks the diarrhea is said to be acute, and when the duration is over 2 weeks it is referred to as chronic or persistent diarrhea. Acute diarrhea is also referred to as acute gastroenteritis (“gastro" refers to stomach, and “enteritis” means an inflammation of the intestine). Diarrhea, though often due to an infection, may also be due to noninfectious causes such as faulty feeding, allergic reactions, drugs and toxins. The commonest type of diarrhea is where the child passes copious amounts of watery stools. This is most often due to an infection of the small intestine cause by virus or bacteria. In children under 2 years of age, about 50% of the watery diarrhea is caused by viruses (in the same way that the common cold is due to an infection with viruses). In both the common cold and diarrhea, the disease gets cured on its own within three to four days. However the difference between them is that in diarrhea there is the loss of a large amount of water and salts from the body, which results in dehydration. 

When the diarrhea is predominantly associated with frequent small stools with blood and mucus, it is the large intestine that is the site of infection, and the condition is known as dysentery. Dysentery is most often caused by bacteria called Shigella, and rarely by Amoebae and other infective agents. Worms, very rarely if ever, cause diarrhea. Whipworms, however, occasionally cause diarrhea with blood and mucus. Another infrequent cause of diarrhea is infection with Giardia. Yet another rare cause of a severe form of watery diarrhea is cholera; this is due to a bacterial infection. Cholera is endemic in some countries. Infecting organisms (usually viruses and bacteria) get into the intestine as follows: contaminated food (whether solids or fluids), milk, unboiled water, unwashed fingers, unclean nipples of the mother, unclean bottles and teats (in bottle feeding), unclean clothes, through flies and picking up, and putting inside the mouth, food, fruits, toys, etc, from the floor or garden. A common problem in infants is that they crawl all over the floor, and then put their fingers in the mouth. Toddlers too tend to put objects into the mouth.