DIARRHEA

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DIARRHEA

• MODULE FOR TEACHERS

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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

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DEFINITION

• Diarrhea is an abnormal increase in the
  frequency and liquidity
• of ones stools

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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

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CAUSES OF DIARRHEA

• INFECTIOUS
• Viral
• Bacterial
• Parasitic

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

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COMMON SIGNS SYMPTOMS OF DIARRHEA

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

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COMMON SIGNS SYMPTOMS OF DIARRHEA

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

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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 gt 24 hours
• If the patient has persistent vomiting
• If the patient has signs of dehydration
  (dehydration is the most common complication of
  diarrhea)

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What are the signs of dehydration?

• Dryness of the mouth
• Thirst
• Reduced amount of urine
• Weakness and lightheadedness

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TREATMENT

• All diarrheas are treatable. Dehydration can
  be avoided with adequate fluid replacement.

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TREATMENT

• Give Oral Rehydration Therapy (ORT). It is
  important to start early
• and continue giving
• ORT throughout the
• diarrheal illness

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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

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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.

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PREVENTION OF FOOD AND WATER-BORNE DISEASES

• MODULE FOR TEACHERS

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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.

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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.

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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.

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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

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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.

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FOOD PREPARATION

• Meat preparation
• All meats should be cooked thoroughly.
• Adequate cooking will prevent parasitic and
  bacterial infections.

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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.

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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

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• 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