Diarrhea

Diarrhoea is loose or watery stools 3 or more times a day. Most acute diarrhoea is from a virus or contaminated food/water and settles in a few days. The main danger is dehydration — particularly in children, the elderly, and people with other illness.

Red flags — dial 112 or go to hospital

• Blood in stool, or black tarry stools.
• Severe abdominal pain.
• High fever.
• Signs of dehydration — very dry mouth, no urine for many hours, drowsiness, fast heartbeat, dizziness on standing.
• Diarrhoea in a young child who is lethargic or refusing fluids.
• Diarrhoea lasting more than 5-7 days.
• Diarrhoea in pregnancy, or in someone with kidney disease, diabetes, or on immune-suppressing drugs.

The most important treatment — ORS

• Oral Rehydration Solution (ORS) is the single most effective treatment for diarrhoea and has saved millions of lives.
• 1 ORS sachet in 1 litre of clean (boiled and cooled, or bottled) water. Sip often.
• Home mix if ORS isn't available: 6 level teaspoons sugar + half teaspoon salt in 1 litre of clean water.
• Severe dehydration — IV fluids in hospital.
• Zinc supplement for 10-14 days in children under 5 — reduces severity and recurrence.

Eat and drink through it

• Keep eating — plain foods: khichdi, curd-rice, dalia, banana, boiled potato, toast.
• Breastfeeding should continue normally in infants.
• Avoid very sugary drinks, fruit juice, soft drinks (they can worsen diarrhoea).
• Don't use anti-motility drugs in dysentery (blood in stool) or in small children — they can cause harm.
• Antibiotics are only needed for specific bacterial causes — not for the common viral diarrhoea. Don't self-prescribe them.

Prevention — India context

• Wash hands with soap before food and after toilet.
• Drink only clean water — boiled, filtered or bottled.
• Avoid cut fruit and ice from street vendors in unfamiliar places.
• Eat freshly cooked, hot food when travelling.
• Rotavirus vaccine (part of UIP for children) prevents a major cause of severe childhood diarrhoea.
• During a gastrointestinal illness in the household, clean surfaces and don't share towels or water bottles.