Sunday 7 July 2013

treatment of diarrhea - children

Always rehydrate.
Rehydration solutions are available and if diarrhea is not severe, rehydrate as needed. DO NOT over rehydrate with plain WATER. This may cause eletrolyte imbalance which can be dangerous as well.

Rehydration solution calculation (with rehydration solution)
Home-made rehydration solution - 1 teaspoon (5mL) of salt AND 8 teaspoon of sugar (40mL) in 1 litter of water. DO NOT use pop or certain juice, due to large amount of sugar. 

for mild-moderate dehydration,
50mL/kg over the first 4 hours (NOT ALL TOGETHER in one dose) 
moderate-severe dehydration, (must seek medical attention)
100mL/kg over the first 4 hours

rehydration should continue beyond 4 hours if needed. 

Plain water is harder to absorb than rehydration solution in case of diarrhea and plain water has no eletrolytes to replenish the loss.


Drugs

In case of suspected infectious causes - ex. unsanitized food, house hold, school, work place outbreak. Some drug therapy may not be used.

DO NOT use,
bismuth subsalicylate - Pepto Bismo - contains salicylate, not recommended in children. In addition, efficacy data is not firmly established.

Loperamide, Imodium - not approved to be used in children <2. Must consult physician <12. Risk of mental side effects with Imodium. 

Psyllium, metamucil - can be used with physician's guidance. Do not use products with laxative. 

Attapulgite - not recommended. very weak efficacy data.