ACUTE DIARRHEA IN CHILDREN

Acute diarrhea (enteritis)

The diarrhea, notoriously, is the emission of feces not perfectly formed, defeats, sometimes frankly liquid, usually several times a day. To this must be accompanied by an impairment of growth for any loss or non-absorption of nutrients in the gut. This last point is important because if you were considering only the diarrhea stools liquid would run the risk, as often happens, to interpret as the diarrheal watery stools, sometimes greenish and frothy, issued, often explosively from small infants fed Breast vice versa which represent an event of absolute normality.
Diarrhea can be acute (enteritis, enterocolitis) or persistent or chronic depending on its duration.
During diarrhea, whether acute or chronic, is often put in place measures dietary that if they are sometimes justified, as in celiac disease or diarrhea due to cow's milk may not always be necessary.
The diarrhea is usually related to infectious agents, most viral, bacterial, and often is accompanied by other symptoms such as abdominal pain, the vomiting (gastroenteritis), fever.
The problem of acute diarrhea, in cases where there are no also manifestations of generalized infection (sepsis) as can happen in salmonella enteritis, is mainly to dehydration. The main task of the physician and the child's parents is therefore to avoid dehydration waiting for this, spontaneously, the diarrhea ceases.
fact usually acute diarrhea (enteritis) tends to limit itself within a certain number of days (usually up to 5-6 ) and requires no other treatments.
In acute diarrhea, with the exception of special shapes in lattantino very small, antibiotics are not needed nor utility demonstrated appear the so-called lactic ferments (Enterogermina and similar). Only a cosmetic function, also have some drugs based on kaolin (Streptomagma) or diosmectite (Diosmectal) which if on the one hand determine a consolidation of faeces sent by the other do not act on the authentic problem that is represented by the losses intestinal water.
So it is essential that the child drink at will so as to rebalance the water losses; solutions are available from glucosaline dissolve in water that allow to integrate also the losses of electrolytes that occur in the course of diarrhea. The solutions are prepared, as mentioned offers at will if possible with at least 100 ml. solution for evacuation.
suspension power is only required at the earliest stage in which provision is made ??for rehydration of the child, and only for a few hours. After the brief suspension of the child, which must continue to rehydrate orally, can rialimentarsi if he wants to and can do so quite freely. In practice, in reality, since among other things the child with diarrhea in the acute phase refuses the food, the power outage is not the case at all.
In children with acute diarrhea, and, except in a few months lattantino ( less than three), should not be changed power previously followed and should not be given any milk diet for diarrhea.
Yet everyday is finding that small children with enteritis are for periods of days fed only liquids, and that when, belatedly, are replenished this is usually done with diets without cow's milk and specialty milk. These behaviors were explained by their opinions that over time have proven to be unfounded.
- The power outage is not of any use but there are many evidence that early refeeding after a few hours of rehydration, shortens the duration of diarrhea.
- The reason why many children were and still are made ??in the course of the episode acute diarrheal, a milk-free diet is not related to an alleged harmful effect of milk or a role in the occurrence of acute diarrhea. The reason I was recommended the suspension of the milk was the fear that, in the course of acute diarrhea, with inflamed bowel wall, intake of formula or center could induce a state of milk intolerance resulting in persistence in time of diarrhea.
This mechanism is real but is only effective in very small infants under three months, for reasons related to the immaturity of the wall of his intestine. In the older child the mechanism of intolerance to milk (protein or sugar, lactose, contained therein) acquired in the course of acute diarrhea does not exist. Indeed as regards the so-called lactose intolerance after acute enteritis and responsible for the persistence of diarrhea it is not realized practically never, at any age. Do not have any milk rationality characterized by little or no lactose milks as advertised and prescribed diet for diarrhea (HN25, AL110).

How do you treat acute diarrhea?

The acute diarrhea and then does not care, in the sense that there are no drugs that somehow can block or significantly reduce the times of the disease. In acute diarrhea then
- are not necessary, except in special cases, intestinal disinfectants or antibiotics, enzymes, drugs that ispessiscano, that make the appearance of the stools more solid without the other hand, reducing leakage in the pipe bowel
- is not useful as prolonged withdrawal of power, or rather the re-feeding early, after a few hours (4-5) of rehydration, diarrhea ensures times less long;
- what is needed is not only the oral re-hydration therapy in order to control or prevent dehydration while waiting for the diarrhea spontaneously ends ("diarrhea is a fire that goes out with the water.")
- can be useful to counter any vomiting that prevents the administration of fluids by mouth antivomito the use of drugs (anti-emetics) and sometimes the relief of symptoms of abdominal pain with intestinal antispasmodics.
- intestinal antibiotics may be useful when the diarrhea persists beyond normal limits and you might suspect as the cause of its persistence supervening infection by particular germs (anaerobic bacteria) at the upper part of the small intestine (bowel syndrome or chronic diarrhea postenteritica infected or colonized upper small intestine), but only after a period of days usual duration of acute diarrhea.

It 'important to the diet in acute diarrhea?

Only in some cases and depending on the age of the child. - In infants under three months is possible that in the course of acute diarrhea, viral or bacterial infection, it can lead to a condition of acquired intolerance to cow's milk protein. Cow's milk, that cow is the food which are prepared industrially infant formula with which they are fed infants. For this reason, in these children is appropriate to suspend the formula usually taken and fed with special milk without milk proteins or protein hydrolysates same, that is fragmented and in a manner as to reduce the ability to induce intolerance or allergy.
- In children Largest this mechanism of intolerance acquired hardly realizes nor, on the other hand, there is any other reason to suspend the cow's milk. Which is why in children over three months with acute diarrhea is not necessary to change the type of power, but after the phase of rapid oral rehydration in which, in a few hours, trying to replenish the fluids lost child, the child wanting, can rialimentarsi early with the same food and the same milk that was taking before. It 'important that at this stage the child over to feed normally continue to repair leaks of liquids assuming always at least 100 ml of solution glucosaline for each download diarrheal.