By Doris Obinna

Diarrhoea is having more frequent, loose, watery stool. Someone may get diarrhoea after having contact with someone else who has it, or from food poisoning. Almost everyone has had diarrhoea at some point in his or her life.

Experts say that diarrhoea that comes  suddenly and lasts for no longer than a couple of days are referred to as “acute diarrhoea.” Most people with acute diarrhoea recover on their own. Diarrhoea that lasts more than two weeks is refered to as “chronic diarrhoea.” Typically, chronic diarrhoea requires medical care to find the underlying cause and treat complications, such as dehydration.

Dr Gabriel Omonaiye said diarrhea is a symptom of several disese entities. It is not a diagnosis. “It is an increase in the frequency, fluidity , volume and mass of stool (faeces) or bowel movement of an individual. It could also be described as an increase in the volume, fluidity and mass of excreta above 200g per day. In severe cases, up to 14 liters of fluids may be lost in a day.

He said there are different ways of classifying diarrhoea. There are also numerous causes of diarrhoea and could be classified as follows:

Secretory: it persists during fasting and the stools are isotonic with the body plasma.

Osmotic: are stools that contain unabsorbed solutes. It reduces or stops with fasting.

Malabsorptive: due to the different malabsorption disorders and it stops with fasting.

Exudative: due to inflammatory disease and the stools are commonly bloody and purulent. It persists during fasting.

He continued: “Diarrhoea can occur in all the age groups. However, diarrhoea in children is of public health concern as result of the associated mortality if not promptly and adequately treated.

“The causes of diarrhoea are many. In children, viruses are the cause of a large percentage of diarrhoea cases. Examples include, rotavirus, adenovirus, norovirus, coxachie virus. Viral diarrhoea tends to be self-limiting and is comparatively easy to treat.

“Different types of bacteria can cause diarrhoea e.g staphylococcus in staphylococcal food poisoning), salmonella species, escherichia coli, yersinia enterocolitica, campylobacter jejuni. Parasites are known to also cause diarrhoea.”

Explaining further, he said that in our environment, malaria fever in children may cause frequent watery stooling. Drugs including antibiotics, laxatives, magnesium-containing antacids can induce diarrhoea.

“Medical and surgical conditions may precipitate diarrhea, for example, thyrotoxicosis, intestinal hurry, zollinger-ellison syndrome, post vagotomy, surgical removal of part of the stomach, small intestine or large intestine, surgical bypass of part of the intestine.

“Some tumors (carcinoid tumors for instance) can cause diarrhoea. Stress in certain people causes it as well. Also, some food items are responsible for diarrhoea e.g; sugar in persons with sucrose intolerance, apple juice and pear juice in fructose intolerance. Milk, ice cream, yogurt, chocolate in persons suffering from lactose intolerance.

“Lactose, fructose, and fructose intolerance are due to the deficiency of the enzymes that are needed in the metabolism of the respective monosaccharides,” said Omonaiye.

He said: “The symptoms include frequent stooling of watery, loose feces. There may be abdominal pain or cramps. There may be fever, weakness, thirst, lethargy, and restlessness. There may or may not be vomiting.

“The color of the stool can range from clear to brown, with or without mucous. The patient may clinically be weak, dehydrated, dry and furry tongue. The eyes may be sunken. Loss of skin turgor may be seen. The output of urine may decrease.  There could be abdominal tenderness and changes noticed in the bowel sounds.

“Diarrhoea alias abdominal flu tends to be self limiting. The patient should take copious amounts of fluids, and oral salt sugar solution.”

However, he continued, some over the counter (OTC) medicines always come in handy.

“But if the symptoms are not abating, then the patient should URGENTLY seek for proper medical attention, as delay may be fatal.

“The best way to manage it is to go to the doctor, who will assess the clinical state of the patient and outline the most suitable management plan, which may entail admission, investigations, intravenous therapy, other medicines and perhaps dietary restrictions.”

The doctor admonished on personal and community hygiene. “Washing of hands regularly, especially after visiting the toilet, before and after meals. Good and adequate supply of portable water. Cessation of the use of human excreta as farm manure.

“Regular food handlers’ tests should be routinely done for food vendors, caterers.

Washing of fruits and vegetables before eating them. Keep toilets and bathrooms clean. Refrigeration of meat.”

He said: “Dehydration is one of the most critical complications of diarrhoea. Dehydration if not well corrected in good time, can cause fluids and electrolytes imbalance with drop in the levels of sodium (hyponatriemia), potassium, bicarbonate. The kidneys could be adversely affected, resulting into acute renal failure. Metabolic acidosis can follow the low potassium levels.

“Severe dehydration (loss of weight equal to or greater than 10 percent of the body weight) can rapidly lead to death. Diarrhoea diseases constitute one of the major killers of children under the age of five years.

“Another, that is travellers diarrhoea is a form of diarrhoea found among international travellers and one of the causative organisms is campylobacter jejuni.”

Record with the U.S department of Health and Human Services Centres for Disease, shows that diarrhoea kills 2,195 children every day more than AIDS, malaria, and measles combined. Diarrhoea diseases account for one in nine child deaths worldwide, making diarrhoea the second leading cause of death among children under the age of five. For children with HIV, diarrhea is even more deadly; the death rate for these children is 11 times higher than the rate for children without HIV. Despite these sobering statistics, strides made over the last 20 years have shown that, in addition to rotavirus vaccination and breastfeeding, diarrhea prevention focused on safe water and improved hygiene and sanitation is not only possible, but cost effective.

Meanwhile, a recent epidemic of diarrhea was said to have broken out at one of the schools in Lagos, leaving no fewer than 50 pupils on admission on different hospital while two pupils died after taking ill in the school. It was gathered that the school water had been polluted for some time. Some of the pupils who were boarding students ate spaghetti and drank the suspected polluted water served in the school.

Research also shows that a number of non-infectious medical conditions may cause diarrhoea, too. These include; inability to digest certain foods, including a lactose intolerance (difficulty digesting the type of sugar found in dairy products); coeliac disease (a reaction to gluten in wheat and some other grains); and pancreatic problems, such as those caused by cystic fibrosis, which interfere with production of important digestive substances.

Surgery to remove part of your intestine; a shortened intestine may be unable to absorb all the substances you eat. This is referred to as short-bowel syndrome. Also, the after-effects of surgery to remove the gallbladder are an increase in bile in the colon may result in watery stools.

There are certain diseases of the endocrine (hormonal) system, including thyroid disease, diabetes, adrenal disease, and Zollinger-Ellison syndrome. While, certain rare tumours (including carcinoid tumour and pheochromocytoma) that produce diarrhoea-causing substances.

Inflammation in the intestinal tract, which can result in chronic diarrhea; If you have inflammatory bowel disease (such as ulcerative colitis or crohn’s disease), you will have bouts of diarrhoea during flare-ups of your disease.

Again, pouches of the intestinal wall in diverticular disease can lead to diarrhoea, especially if they become infected and inflamed (diverticulitis).

Irritable bowel syndrome, which may cause alternating bouts of diarrhoea and constipation.

Bowel cancer produces a change in bowel habit that may include diarrhoea or alternating diarrhoea and constipation.

Rotavirus vaccination

Related News

Experts say that rotavirus is a virus that commonly causes diarrhoea in children. A vaccine that helps protect children against rotavirus is now part of the routine childhood vaccination schedule.

This vaccine is given as a liquid that is dropped into a baby’s mouth. It is given in two doses, with the first given at two months and another at three months.

Most diarrheal deaths are preventable using simple, low-cost interventions

Facts on diarrhoea

It causes death by depleting body fluids resulting in profound dehydration.

Diarrhea can have a detrimental impact on childhood growth and cognitive development.

About 88 percent of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and insufficient hygiene.

Rotavirus is the leading cause of acute diarrhea and causes about 40 percent of hospitalizations for diarrhea in children under five.

Most diarrheal germs are spread from the stool of one person to the mouth of another. These germs are usually spread through contaminated water, food, or objects.

Also, water, food, and objects become contaminated with stool in many ways:

People and animals defecate in or near water sources that people drink.

Contaminated water is used to irrigate crops.

Food preparers do not wash their hands before cooking.

People with contaminated hands touch objects, such as doorknobs, tools, or cooking utensils.

 


 

TIPS ON HEALTHY LIVING : Weight loss tips that are evidence-based (4)

By Patience Boulor

People are advised to do all sorts of crazy things, most of which have no evidence behind them.Over the years, however, scientists have found a number of strategies that seem to be effective.

Here are some weight loss tips that are actually evidence-based.

Eat more protein

Protein is the single most important nutrient when it comes to losing weight.

Eating a high protein diet has been shown to boost metabolism by 80 to 100 calories per day, while helping you feel so satiated that you eat up to 441 fewer calories per day.

One study also showed that protein at 25% of calories reduced obsessive thoughts about food by 60%, while cutting the desire for late night snacking in half .This is the single most important tip in the article.

Simply adding protein to your diet (without restricting anything) is one of the easiest, most effective and most delicious ways to lose weight.

Supplement with whey protein

If you struggle to get enough protein in your diet, taking a supplement can help.

One study showed that replacing part of your calories with whey protein can cause weight loss of about 8 pounds, while increasing lean muscle mass.

Don’t drink calories, including sugary soda and fruit juices

Sugar is bad, but sugar in liquid form is even worse. Studies show that liquid sugar calories may be the single most fattening aspect of the modern diet.

For example, one study showed that sugar-sweetened beverages are linked to a 60% increased risk of obesity in children, for each daily serving. Keep in mind that this applies to fruit juice as well, which contains a similar amount of sugar as a soft drink like coke. Eat whole fruit, but use fruit juice with caution (or avoid it altogether).

Eat whole, single ingredient foods

If you want to be a leaner, healthier person, then one of the best things you can do for yourself is to eat whole, single ingredient foods.These foods are naturally filling, and it’s very difficult to gain weight if the majority of your diet is based around them.

Keep in mind that real food doesn’t need a long list of ingredients, because real food IS the ingredient.

Here is a list of the 20 most weight loss-friendly foods on earth.

Don’t “diet”, eat healthy instead

One of the biggest problems with “diets,” is that they almost never work in the long term. If anything, people who “diet” tend to gain more weight over time, and studies show that dieting is a consistent predictor of future weight gain (53).

Instead of going on a diet, make it your goal to become a healthier, happier and fitter person. Focus on nourishing your body, instead of depriving it. Weight loss should follow as a natural side effect.