Treatment regimen for acute diarrhea in children

Acute diarrhea causes a heavy burden of disease and is a major cause of death in children under 5 years of age. To minimize the consequences of acute diarrhea, it is necessary to clearly identify the cause and have a timely treatment plan.

Diarrhea is the passage of 3 or more loose stools in 24 hours. However, the condition is difficult to identify in young and breastfed infants. Therefore, to determine whether diarrhea is correct or not, in addition to considering the change in stool properties, it is necessary to monitor the number of bowel movements during the day.
Acute diarrhea in children is further defined by the duration of the illness. Time will be counted when diarrhea does not exceed 14 days.
Causes of acute diarrhea include:
Intestinal infection with the main agent Rotavirus causes severe and possibly life-threatening diarrhea in children under 2 years of age. In addition, this condition may appear due to a number of other agents such as Adenovirus, Norwalk virus... The cause may be caused by bacteria such as E.coli, including cases such as E.coli producing toxins. , pathogenicity, bleeding, penetration and adhesion; or caused by bacteria Shigella , cholera , Campylobacter , Salmonella ... The cause of the disease may be extra-intestinal infections , including respiratory or urinary tract infections , meningitis . Use certain antibiotics or laxatives. Due to food allergies such as cow's milk protein, soy milk, eggs, shrimp... Acute diarrhea can occur with some rare causes, including digestive or absorption disorders, intestinal inflammation through chemotherapy/radiotherapy, surgical-related diseases such as intussusception, acute appendicitis,... Predisposing factors for children to have acute diarrhea:
The younger the child, the higher the rate Acute diarrhea is higher, accounting for about 80% and especially high in the age from 6 to 18 months. Children suffering from diseases that cause immunosuppression such as malnutrition, measles or HIV/AIDS... Children weaned early or because of contaminated food or water...

2.1. Electrolyte rehydration treatment for acute diarrhea Electrolyte rehydration is considered the most important and necessary treatment regimen for acute diarrhea in children.
Rehydration and electrolyte regimen A:
When performing the treatment of acute diarrhea in children without dehydration, parents can give the child more water to drink than usual. How to help children drink water effectively will depend on the amount of water in the pipe, the time for the child to drink after each bowel movement. For children under 24 months of age, the amount of Oresol taken for each bowel movement is from 50 to 10ml and not more than 500ml/day. For children from 2 to 10 years old, the amount of oresol taken after defecation is higher, about 100 to 200 ml and not more than 1000 ml. For children aged 10 years and older, they can drink until their thirst is gone, equivalent to 2000ml/day. Electrolyte rehydration regimen B:
Treatment of acute diarrhea with moderate and mild dehydration. Pediatric patients will be given Oresol based on weight or age. Amount of Oresol given in the first 4 hours. The amount of water to be compensated for the patient can be calculated based on weight and multiplied by 75ml. In this case, after 4 hours, the dehydration can be re-evaluated, or if there are symptoms of dehydration, switch to regimen A. If the child still has moderate and mild signs of dehydration, then treatment according to the regimen should be carried out. plan B. But in case of severe disease, it may be necessary to switch to regimen C for treatment. Electrolyte rehydration regimen C:
Usually applied to cases of severe dehydration in pediatric patients. In this case, an intravenous infusion of 100ml/k of Ringer Lactate solution or physiological saline will be performed daily. Dosage: Children under 24 months can be used at first for 1 hour with a concentration of 30ml/kg/. Then increase to 70ml/kh and do it within 5 days. At 1 to 2 hour intervals, a reevaluation of the patient should be performed. If the radial pulse is still weak and cannot be caught, this solution can be given, the more complicated the dehydration situation, the faster method can be applied. If the infusion cannot be done, depending on the case, the patient can be transferred to a higher level for infusion or inserted a nasogastric tube with Oresol solution with a concentration of 20ml/kg/hour. How to use the drug:
For children under 2 years old, it can be given by spoon, older children can drink it with the core. In case the child vomits, parents should stop and wait for 5 to 10 minutes and then give the drink again.

2.2. Use of antibiotics in the treatment of acute diarrhea in children In all situations, do not arbitrarily prescribe the use of drugs. However, antibiotics will be prescribed by a doctor and prescribed for people with bloody diarrhea, dehydration accompanied by cholera or caused by Giardia.
Antibiotics are also indicated in the treatment of children with acute diarrhea accompanied by body infections such as pneumonia, bacteremia and urinary tract infections....
2.3. Zinc supplementation Pediatric patients should be supplemented with zinc during the treatment of acute diarrhea.
Dosage is as follows:
For children under 6 months old, use 10mm/day for 10-14 days. Children over 6 months, the dose is 20mg / day for 10 to 14 days. 2.4. Reasonable nutrition for children with acute diarrhea Parents need to change the diet for cases of acute diarrhea. If your baby is still nursing, you can continue to feed him more often. If the child is not breastfed, check the milk used for the baby before; milk should not be diluted or used with lactose; Avoid foods that are high in energy, protein, low electrolytes and high in carbohydrates.
Acute diarrhea in children is very dangerous, treatment and prevention of dehydration are very important to help children recover quickly and avoid dangerous complications. If the diarrhea symptoms are not relieved or persisted, the child should be taken to a medical facility for timely treatment.
With many years of experience in examining and treating diseases in children, now the Pediatrics Department at Vinmec International General Hospital has become one of the major health care centers, capable of examining , screening and treatment of many specialized diseases in children. Therefore, if a child has diarrhea that does not go away for a long time or shows signs of respiratory infection, parents can take the child to Vinmec International General Hospital for examination and support and advice. consultations from medical professionals.