Diarrhoea

Loose, watery feces that come more frequently than usual are referred to as diarrhea. Everyone gets sick with diarrhea occasionally. Diarrhea frequently results in more frequent bathroom visits and larger amounts of feces. The majority of the time, diarrheal signs and symptoms persist a few days. However, occasionally, diarrhea can last for weeks. In these circumstances, diarrhea may indicate a less serious condition like irritable bowel syndrome or a more serious disorder like inflammatory bowel disease.

Symptoms

Signs and symptoms associated with diarrhea may include:

• Frequent, watery, loose stools
• Stomach pains
• Continent pain
• Fever
• Bloating Blood in the Stool

Causes

• Harmful bacteria and parasite
  •  Salmonella
  •  Giardia lamblia
  •  E.coli
• Virus
  •  Cytomegalovirus
  •  Rotavirus
• Drugs
  •  Antibiotics

Risk factors

• Feeding from a bottle
• Suitable supplemental food
• Bad hygiene
• Contaminated liquids and meals
• Malnutrition
• Stomach infection
• Foodborne illness
• An allergic response to a particular chemical.

Pathophysiology

Diarrhea is brought on by microorganisms entering the GI tract;

• Production of enterotoxins that encourage water and electrolyte secretion
• Intestinal epithelial cells are directly invaded and destroyed, 
• The organisms also cause localized inflammation and systemic invasion.

Physiologic disturbances linked to severe diarrheal diseases, however, include the following:

• Dehydration
• Acidosis's acid-base imbalance
• The shock that develops when dehydration gets severe enough to seriously impair circulatory status.

Assessment of dehydration

• No dehydration
  • Generally speaking, alert
  • Eyes: typical
  • Moisturized tongue and mouth
  • Drink regularly instead of being thirsty.
  • Skin pinch—quickly turns around.
• Some dehydration
  • Condition- restless, irritated
  • Eyes- sunken
  • Mouth and tongue- dry
  • Thirsty- thirsty, drink eagerly
  • Skin pinch- goes back slowly
• Severe dehydration
  • Condition- lethargic or unconscious
  • Eyes- very sunken and dry
  • Mouth and tongue - very dry
  • Thirst- drinks poorly or not able to drink
  • Skin pinch- goes back very slowly.

Tests and Diagnosis

• Physical exam: To look for dehydration symptoms, your blood pressure and pulse may also be taken. Your doctor might check your abdomen for any signs of abdominal pain.
• Review of your medications: Any medications you are taking, including over-the-counter medicines, may be brought up by the doctor. Inform your doctor of any supplements you take as well.
• Blood test: An examination of your complete blood count can help identify the source of your diarrhea.
• Stool test: To determine whether a bacterium or parasite is the cause of your diarrhea, the doctor may advise a stool test.

Treatments and Drugs

Without medical intervention, the majority of diarrhea cases resolve on their own in a few days. Your doctor might suggest medications or other treatments if you've tried lifestyle modifications and home remedies for diarrhea without success.

• Antibiotics
  By using antibiotics, diarrhea brought on by bacteria or parasites may be treated. Antibiotics will not relieve diarrhea if a virus is to blame.
• Treatment to replace fluids
  Your doctor will probably suggest that you take action to replenish the fluids and salts lost as a result of diarrhea. Most people replace fluids by consuming juice, water, or both. Your doctor can advise intravenous fluids if consuming liquids upsets your stomach or causes diarrhea.
  Water is a fantastic way to replenish lost fluids, but it is deficient in salts and electrolytes, which your body needs to maintain the electric currents that keep your heart pumping. An electrolyte imbalance that results from disturbances in your body's fluid and mineral balances can be quite dangerous. By consuming soups for salt or fruit drinks for potassium, you can assist manage your electrolyte levels.
• Introduction of zinc tablet
  A sort of nutrient is zinc. It can be found in both plant and animal sources, such as red meat, cereal, and almonds. Children who receive zinc in addition to ORS recover more quickly, experience diarrhea less frequently and with less severity, and have better intestinal absorption of ORS or other fluids.
• Treating underlying conditions
  Your doctor will seek to control the underlying illness if it is the cause of your diarrhea, such as inflammatory bowel disease. A expert, such a gastroenterologist, may be recommended to you so they may help you create a treatment plan.

REFERENCE

Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).

Dr.Suwal S.N. & Tuitui R. (2063) A Textbook of Community Health Nursing, 1st edition, Vidyarthi Prakashan (P). Ltd. Kamalpokhari, Kathmandu

HealthLine. 2005. 2017 http://www.healthline.com/symptom/diarrhea

Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.

MedicineNet. 1996. 2017 http://www.medicinenet.com/diarrhea/article.htm

Tuitui, Roshani. Community Health Nursing. Kathmandu: Vidyarthi Prakashan (P.) LTD., 2067.

Web MD. 2005. 2017 http://www.webmd.com/digestive-disorders/digestive-diseases-diarrhea#1