Diarrhea is a disease that cause by toxins, microorganisms and other substances, which do not usually occur common in the gastrointestinal tract (GIT). These foreign agents and organisms are causing the GIT to react violently, through faster peristalsis, to either eliminate them or purge them.
When the substance or organism is too many to eliminate diarrhea will be prolonged and dehydration will be the consequence. Also when a patient has diarrhea regular eating habit will not meet and the body will be deprived from nutrients and energy coming from food. Thus, treatment should be given to avoid dehydration, weakness, vomiting and worst death.
First Line Treatment:
1. Oral Rehydration Solution (ORS) – This is the first and foremost supportive treatment when diarrhea occurs. Either infant or adult is the victim ORS must not be abandoned as the first line supportive treatment, because it rehydrates the body with balanced and proper electrolytes, energy and fluids. ORS comes with the combination of sodium, chloride, potassium, and citrate (bicarbonate in some formula) electrolytes for cellular function to continue, including glucose for source of energy and purified water for hydration. Oral Rehydration Solution will be given during the course of the diarrhea. As long as diarrhea is there ORS should also present, unless the patient is brought to hospital where intravenous fluids are given to him/her.
Examples of brands of ORS:
- Pedialyte Mild 30 and other variance and flavor.
- Glucolyte
- Other generic ORS
- Hydrite
- Gatorade (Note: It is not advisable to use it as rehydration solution alone! It should be still combined with the above ORS products.)
2. Loperamide and other gastrokinetic drugs – Loperamide is used to reduce the movement of the intestines during loss bowel movement. Because of this effect, sometimes Loperamide is not advisable to use, because it impedes the elimination of toxins or microorganisms that causing the diarrhea. It is advisable to use when muscle cramps or spasms occur to pacify the pain in the GI muscles. Hyoscine is also used for spasms or cramps. When vomiting is occurring metoclopramide is given to stop the puking. Hyoscine and metoclopramide must be given with prescription order through oral (at home) or IV in hospital. Sometimes dicycloverine is given but it depends on the doctor’s order. Loperamide can be procured in pharmacy over-the-counter. Ask the pharmacist regarding the use of it.
Example of brands:
- Loperamide – Imodium, Lomotil, Diatabs and so on.
- Hyoscine (HNBB) – Buscopan
- Metoclopramide - Plasil
3. Antisecretory agent and Probiotics – Antisecretory agent such as Racecadotril which can prevent the secretion of fluids in the GIT that adds more to the fluidity of the diarrhea. When this drug is administered it will stop the site of production of fluids in the intestines. Probiotics can help to rebalance the normal bacterial flora in the intestines. Microorganisms will absolutely purge also when diarrhea occurs, which reduces their number in the tract or especially when antibiotic treatment is administered. Good bacteria keep the GIT balanced by fighting the bad bacteria, and neutralizing the toxins and some substances that preventing the normal function of the GI system. Remember to take these drugs with proper physician’s order.
Example of Brands:
- Racecadotril (Antisecretory agent) – Hidrasec
- Bacillus clausii (Probiotic) – Erceflora
4. Antibacterial Prescription Drugs – Such as Metronidazole and Cotrimoxazole. These drugs can be given when bacteria are the main cause of the diarrhea. There are more antibacterial drugs that can be prescribed but these are the common ones.
Conclusion:
Diarrhea is a serious case disease that when left untreated it will lead to death. There are many types of it, in which it depends on the causative agent. When diarrhea occurs supportive treatment should be given only at home. However, when diarrhea does not stop within 12 - 24 hours from its commencement the patient should be brought to hospital for proper treatment and IV fluids to be administered. Especially when vomiting is occurred do not hesitate to bring him/her in the hospital or clinic. Do not self-diagnose or self-medicate. Follow the emergency treatment in which if the treatment is not effective visit a physician or bring the patient to the nearest hospital.
