Diarrhoea

Introduction

Diarrhoea is defined as loose or liquid stools three or more times per day. There are three clinical types of diarrhoea, including acute diarrhoea, persistent diarrhoea and chronic diarrhoea. Prevalence of diarrhoea is the highest in children under five years old, and decreased significantly with increased age. Being the leading cause of child mortality and morbidity in the world, it is responsible for 525,000 deaths every year (WHO, 2017).

The most severe complication posed by diarrhoea is dehydration, which can be life-threatening. During an episode of diarrhoea, water and electrolytes including sodium, chloride, potassium and bicarbonate are lost through liquid stools, vomit, sweat, urine and breathing. Diarrhoea can also lead to malabsorption and malnutrition.

Causes

Infection through contaminated food or water
- Viral infections, such as norovirus, rotavirus
- Bacterial infections, such as Escherichia coli, Clostridioides difficile, shigella species
- Parasitic infections, such as Cryptosporidium parvum, Entamoeba histolytica, Giardia lamblia
Side effects of medicines such as antibiotics, anti-cancer drugs and antacids with magnesium
Malabsorption
- Food allergies and intolerances: Some people may have trouble digesting certain food such as lactose, fructose and sugar alcohols
- After a gastrectomy surgery
- Digestive tract disorders such as celiac disease, cystic fibrosis, and short bowel syndrome
Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
Weakness and incoordination of sphincters

Risk Factors

Age: older individuals have a slower metabolism and weaker muscles along their digestive tract
Gender: female is more prone to constipation due to changes in hormones during pregnancy and after childbirth
Getting little physical activities
Possessing a mental illness, such as an eating disorder or depression

Risk Factors

Age: children tend to put objects in their mouths and may not have developed good handwashing habits
Lack of access to clean water supply for drinking, cooking and cleaning
Inadequate sanitation
Poor hygienic conditions

Symptoms

Abdominal pain and cramping
Bloating
Nausea and vomiting
Fever
Urgent need to have a bowel movement
Blood and mucus in stool
Dehydration

Graph + description of effects + citation, incl. studies for different age groups if applicable

L. reuteri significantly reduced the duration of diarrhoea in children aged between 3 and 60 months with acute watery diarrhoea (Dinleyici, 2014). By the 48th hour of L. reuteri supplementation, the number of children experiencing diarrhoea had reduced by 50% (Dinleyici, 2014), suggesting L. reuteri is effective in treating diarrhoea.

Treatment

Rehydration
- Oral rehydration salts (ORS), which contain salt and glucose, replenish the water and electrolytes lost in the stool
- Intravenous fluids in severe cases
Alteration in diet
- Consume foods and liquids rich in potassium, such as dried fruits, beans and potatoes.
- Consume foods and liquids rich in sodium, such as nuts, olives and pickles.
- Consume more soluble fiber such as avocado, oatmeal and sweet potatoes to thicken the stool.
- Limiting foods that may worsen diarrhoea, such as dairy, caffeinated drinks, fatty foods and artificial sweeteners.
- Zinc supplementation: Taking zinc supplements reduces the duration of a diarrhoea episode by 25% and stool v Replenish lost fluids with at least one cup of liquid after each episode of diarrhoea.
olume by 30% (WHO, 2017).
Probiotic supplementation: Probiotics can help restore a healthy balance to the gastrointestinal tract by suppre olume by 30% (WHO, 2017).
ssing the growth of harmful bacteria and repopulating beneficial gut bacteria to reduce occasional or non-persistent diarrhoea. In addition, probiotics can help regulate immune cell function and enhance intestinal immunity to prevent gut infections.