DIARRHEA

MODULE FOR TEACHERS

OBJECTIVES

• Define diarrhea• Present major causes and symptoms

associated with diarrhea• Provide guidance as to when to seek

medical attention for diarrhea

Students should know:• When diarrhea requires medical attention• When to recognize and manage

dehydration

DEFINITION

Diarrhea is “an abnormal increase in the frequency and liquidity

of one’s stools”

SCOPE OF THE PROBLEM

• Incidence of diarrhea varies significantly in different countries

• In the Philippines, as of January 2006 per FHSIS Annual Report - diarrhea is the No. 1 cause of morbidity (illness) in the Philippines

CAUSES OF DIARRHEA

• NON-INFECTIOUS– Certain medications– Stress– Changes in diet – Other medical

conditions

• INFECTIOUS– Viral– Bacterial– Parasitic

COMMON SIGNS & SYMPTOMS OF DIARRHEA

• Nausea and vomiting• Loss of appetite• Bloating and gas• Abdominal cramps and pain• Fever

COMMON SIGNS & SYMPTOMS OF DIARRHEA

• General weakness or feeling faint• Malaise and headache• Blood in stool• Mucus in stool

When MUST a person with diarrhea consult a doctor?

• If there is blood or mucus in the stool• If the patient has fever• If the patient has diarrhea lasting > 24

hours• If the patient has persistent vomiting• If the patient has signs of dehydration

(dehydration is the most common complication of diarrhea)

What are the signs of dehydration?

• Dryness of the mouth

• Thirst

• Reduced amount of urine

• Weakness and lightheadedness

TREATMENT

All diarrheas are “treatable”. Dehydration can be avoided with

adequate fluid replacement.

TREATMENT

Give Oral Rehydration Therapy (ORT). It is important to start early

and continue giving

ORT throughout the

diarrheal illness

How to prepare ORT

Ingredients:

1 liter of treated or clean water

2 tablespoons of sugar

½ teaspoon of salt

Dissolve sugar and salt in water. Advise the patient to drink 1 cup after

each loose bowel movement

TREATMENT

• Give small, frequent and soft feedings as tolerated.

• Avoid milk, milk products, alcohol, caffeine and oily foods.

• If diarrhea persists for more than 24 hours or is severe at the onset, consult a physician.

PREVENTION OF FOOD AND WATER-BORNE DISEASES

MODULE FOR TEACHERS

BACKGROUND AND OBJECTIVES

• Primary strategy in preventing diarrhea is the avoidance of food and water contaminated with bacteria from stools.

• Students should understand the following:– All untreated water and food that was not

properly prepared are probably contaminated and could be dangerous to your health.

– Be aware of water and food-borne diseases and how transmission occurs.

– Know the proper methods of food and water preparation.

BASIC PREVENTIVE MEASURES

• Always wash your hands before handling food (preparation or consumption).

• Keep your hands away from your mouth.

• Always wash your hands after using the bathroom!

• Dispose of waste properly.

WATER PREPARATION

• Tap water may be contaminated unless it is known to be safe: i.e., potential bacteria are removed or inactivated.

• Bottled water may be the best advice.

WATER PREPARATION

• Two preferred methods of water disinfection – effective against all pathogens– Boil for at least 3 minutes.– Filter using a 1-2 micron pore-size

filter FOLLOWED by treatment with iodine or chlorine

• Chlorine bleach 2 drops/liter, let stand for 15 minutes

• Iodine 2% 5 drops/liter, let stand for 15 minutes

• Iodine tablets ½ tablet/liter, let stand for 15 minutes

FOOD PREPARATION

• Fresh fruits and vegetables– All fruits and vegetables that can be peeled

are safe once washed and peeled.– Any fruit or vegetable that is not or cannot be

peeled should be washed and soaked.– Soak items in a solution of strictly one tbsp.

(15 ml) household bleach per gallon for 15 minutes and then rinse in treated water.

FOOD PREPARATION

• Meat preparation

– All meats should be cooked thoroughly.

– Adequate cooking will prevent parasitic and bacterial infections.

FOOD PREPARATION

• Milk products– Bring all fresh (unpasteurized) milk to boil

before consuming.

• Other tips:– Canned foods are generally safe if consumed

before the expiration date.– Freezing does not disinfect food.– Food should be eaten immediately after

cooking and should be protected from flies and other sources of recontamination.

REFERENCES

• “Diarrhea” module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services

• “Food and Water Preparation” module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services

• Protocare Corporation 1997

The Philippine College of Physicians wishes to acknowledge the following for their invaluable

efforts in the preparation of this module

Philippine Society of Gastroenterology

Ma Lourdes O. Daez, MD