Diarrhea

Diarrhea is a condition in which the stool is dilute or watery with a frequency more often than usual. Generally, the cause of diarrhea is food or drink that is dirty and contaminated with microorganisms.

Many people suffer from diarrhea once or twice a year. Usually diarrhea lasts 2-3 days and can be treated with over-the-counter medications. But in special cases, diarrhea can last for weeks.

Diarrhea is still a major health problem in developing countries, including Indonesia. This is due to the morbidity rate (comparison between sick and healthy people in a population) and mortality is high. Diarrhea is ranked thirteen causes of death in general in Indonesia with a proportion of 3.5 percent. As for the category of infectious diseases, diarrhea ranked third.

The largest age group experienced diarrhea was toddlers, which was 16.7 percent. The prevalence of diarrhea was slightly higher in boys (14.8 percent) than girls (12.5 percent). The results also show that the highest prevalence of diarrhea occurs in children who live in homes without access to clean water is 18.4 percent.

(Data taken from research result of RI Department of Health in 2007)

Generally, diarrhea can last up to a week and can heal without any treatment. However, if the condition you are experiencing is severe enough, immediately consult a doctor.

To find out if the patient has diarrhea and the cause, the doctor first gathers information about the symptoms experienced. The doctor will ask for the texture of the stool, the frequency of defecation, the daily habits of the patient. In addition, you should also inform your doctor if any other symptoms are present (high fever), unusual food intake, psychological factors, and certain medications that may be underway. These may include stool sample analysis, blood tests, and rectal examination .

There are several checks that can be done to diagnose diarrhea, among others:

1. Fecal analysis

The doctor will ask you to submit a stool sample for analysis. It aims to identify possible infections. This analysis is done if you have experienced diarrhea for more than two weeks, there is blood or pus in the stool, or there are other symptoms that accompany. In addition, this examination is also necessary if you have diarrhea after hospitalization or due to a weak immune system (people with HIV).

2. Blood tests

Your doctor will ask you to take a blood test if diarrhea is suspected as a symptom of another illness. For example, blood test results show inflammation. This is one of the symptoms of inflammatory bowel disease.

3. Rectal examination

If the patient is over 50 years old or has diarrhea that is difficult to recover, the doctor will perform a digital rectal examination. How to check is to insert a finger into the rectum to check for abnormal conditions. This examination aims to diagnose diseases associated with the rectum and intestines.

4. Additional checks

The doctor may also suggest the following checks to help conclude the diagnosis:

• Sigmoidoscopy, insert sigmoidoscope tool (thin and flexible tube with camera at the end) into the rectum up to the intestine

• Colonoscopy, the procedure is similar to sigmoidoscopy but larger tubes are used (colonoscopy) to examine overall bowel conditions

Symptoms

In each patient, the symptoms of diarrhea are different. Some people secrete very dilute stools, while others secrete feces that are less dilute. However, there are some symptoms that are often associated with diarrhea. These symptoms include stomach cramps, nausea and vomiting, headaches, and loss of appetite.

Generally in adults, diarrhea will recover within 2-4 days. In children, longer recovery time is 5-7 days. If the diarrhea lasts more than a week or the condition gets worse, check your doctor immediately. Beware also signs of dehydration during the recovery period.

Diarrhea and Dehydration

Fluid secretion through excessive feces coupled with loss of appetite can affect dehydration. This condition should be addressed as it can be fatal. Dehydration itself is easier to occur in children. This is because the resistance of children to dehydration is lower than adults.

Symptoms of dehydration in children include:

• Rarely urinate

• Her mouth is dry or cry without tears

• Bloody stool, red or black

• Seemed to be drowsy and unresponsive

• Looks concave to eyes or stomach

• If the pinched skin does not return (turgor decreases)

While signs of dehydration in adults include:

• Fatigue and lack of energy

• Missing appetite

• Nausea

•Dizzy

• The tongue feels dry

• The eyes look sunken

•             Muscle cramp

•             Heart beat

Treatment

The symptoms of diarrhea will generally disappear by itself without any treatment assistance. Usually diarrhea lasts up to 7 days. In certain cases, diarrhea may last longer depending on the cause. You can do the following to relieve the condition that is being experienced:

Expand fluid intake

When you have diarrhea, you should consume more fluids. Especially if accompanied by vomiting. This is needed to avoid and handle dehydration. Drink a little but often. Better to enter the liquid slightly than not at all. If enough fluid intake, urine will be light yellow or almost clear. Avoid giving fruit juice or soft drinks because it will make diarrhea worse.

Eat

At the time of diarrhea, experts recommend that you do not eat solid foods first. At least until you are able to eat normally. Eat smaller portions than usual. Also avoid fatty and spicy foods.

Do not give solid foods to children if they are dehydrated. Wait until they consume enough fluids. New foods can be given after they no longer show signs of dehydration. If the child is not dehydrated, give the food as usual.

Oralital fluid

For people with diarrhea who are susceptible to dehydration, doctors will recommend the use of ORS. Those of you who are weak-minded, aged over 60 years, and have a history of serious health are strongly advised to consume ORS.

Oralite is sold freely in pharmacies. You just mix it with water. The function of ORS is to replace the salt, glucose, and other essential minerals that may be lost when experiencing fluid shortage.

For patients with children, doctors will suggest oralit if visible signs of dehydration. Oralite can be given every time the child defecates. The amount depends on the child's weight.

Use of drugs

Antidiarrheal drugs can reduce the symptoms of diarrhea and shorten its duration. However, actual medication is not necessary because the immune system will fight it naturally. The most commonly used antidiarrheal drug is loperamide because it can reduce bowel movement so that the fluid will be more absorbed. This can help overcome diarrhea.

Do not take antidiarrheal medication if diarrhea is accompanied by other symptoms such as high fever and there is blood or pus in the stool. You should immediately consult a doctor.

Use of antibiotics for diarrhea

Usually doctors will recommend the use of antibiotics if the cause of diarrhea is confirmed bacteria or if the diarrhea is very severe. It is not advisable to use antibiotics if the cause of diarrhea is not known for sure. This is because antibiotics will not work if the cause of infection is a virus. And if used for minor ailments will reduce the effects of antibiotics against more serious conditions.

Pain relief medication

The painkiller can not cope with diarrhea. However, administration of paracetamol or ibuprofen may help relieve symptoms that accompany diarrhea such as fever and headache. Make sure you provide the appropriate medication symptoms and follow the instructions for use.

Treatment of the main condition

If you have previously been diagnosed with certain diseases that can cause diarrhea, you should first treat the disease. This will alleviate the condition of the diarrhea. If the main condition is not handled appropriately, then the diarrhea as a symptom will continue.

Cause

Diarrhea generally occurs when fluids from food can not be absorbed intestine well. Or there is too much fluid secreted into the intestine. Normally, the colon will absorb the liquid from the food we consume and leave the stool (feses) half solid. If the liquid from the food is not absorbed well, then the result of the stool will be dilute or even liquid. This condition is influenced by many factors so that diarrhea can be short or long.

Short-lived diarrhea

Usually this diarrhea is a symptom of intestinal infection, caused by:

• Viruses, such as rotavirus

• Bacteria, such as campylobacter

• Parasites, such as intestinal giardia

Other causes include psychological factors (feel anxious), consume alcohol, food allergies, appendicitis, or side effects of drugs.

Long-term diarrhea

Can be caused by:

• Colon syndrome

• Celiac disease, a disease that causes the body to reject gluten protein

• Crohn's disease, inflammation of the lining of the digestive system

• Chronic inflammation of the pancreas

• Colon cancer

• Side effects of abdominal removal (gastrectomy)