TREATMENTThere are 2 types for treatment of diarrhea One of them isPHARMACOLOGICAL TREATMENTThe other is NON-PHARMACOLOGICAL TREATMENT

A)diet all patients should receive their normal diet or

breast-feeding during bouts of diarrhea as these don’t make the diarrhea worse and may actually improve the condition :however, fatty foods, foods rich in simple sugars and spicy foods should be avoided.

1 )Non-pharmacological treatment

Non-pharmacological treatment

b)Fluids

the most impotant part of treating acute diarrhea is the replacement of lost fluids and electrolytes

1)if the patients experience mild to moderate fluids loss,fluid replacement can be achieved with oral – rehydration solution )ORS).

2)if fluids loss is severe ) > 10% loss of body weight)and/or severe vomiting persists ,then patients may need intravenous rehydration before oral maintenance fluids can be administreted

1)Pharmacological treatment

*antidiarrheals are classified on the basis of their chemical class or pharmacologic mechanism of action

into :

1)miscellaneous agent

2)antiperistaltic drugs

3)adsorbents

Pharmacological treatment

1)miscellaneous agents: a.Bismuth subsalicylate

b.Lactobacillus

c.Lactase

d.Anti-infective agents

e-Anticholinergics

Pharmacological treatment

a)bismuth subsalicylate: it works as adsorbent but also believed to decrease secretion of water

into the bowel.

bismuth preparations have moderate effectiveness against the prevention and treatment of the travelers

diarrhea

Contraindications

*patients with black or bloody stools.

*children or teenagers during or after recovery from chickenpox or flu because of the possible association of salicylates with reyes syndrome.

*patients with documented allergies to salicylates shouldn’t take this product.

*pregnant or breast feeding patients

.

Pharmacological treatment

b.lactobacillusproducts containing nontoxic strains of

lactobacillus.

acidophilus are intended to replace the normal bacterial flora that is lost during the administration of oral antibiotics.

Pharmacological treatment

Pharmacological treatment

c.lactase enzyme:it is indicated for individuals who have insufficient amounts of lactase enzyme in the small intestine )lactose intolerance).

Accumulated lactose draws water into GIT and diarrhea results.

Pharmacological treatment

Pharmacological treatment

d.anti-infective agents

depending on the suspected origin of the infectious diarrhea ,prescription antibiotics and antiprotozoal medications can be used to eradicate the organism and decrease the duration of symptoms.

Example: nifroxazide

Pharmacological treatment

Pharmacological treatment

e.anticholinergics:decrease bowel motility ,which result in an increase of fluid absorption from the intestinal tract and a decrease in abdominal cramping.

These products are found in combination with adsorbents or opiatesExamples:

 Atropine and hyoscyamine

 Adverse effects:

Dry mouth,blurred vision and tachycardia. 

WarningThese products shouldn’t be used in patients with narrow-angle

glaucoma.

Oral replacement therapy established by the WHO

SODIUM CHLORIDE (TABLET SALT )(0.5 Teaspoonful )

Potassium chloride (potassium salt)(0.25 teaspoonful)

Sodium bicarbonate(baking soda )(0.5 teaspoonful)

Glucose (sugar) 20 g (2 teaspoonful)

Water (enough to make 1 L of solution)

-all of these solutions are considered safe but have no effect on the duration of diarrhea .