1, the causes of pediatric diarrhea
The digestive system is not well developed and prone to digestive disorders: less secretion of gastric acid and digestive enzymes, lower activity of digestive enzymes, poor tolerance of food, unable to adapt to the large changes in food quality and quantity; at the same time, children grow and develop quickly, require relatively more nutrients, the digestive tract is heavily burdened and often under stress, so it is easy to occur digestive disorders.
When overfeeding or inappropriate food composition, the digestive process is impaired, and the food cannot be fully digested and absorbed, stagnating in the upper part of the small intestine, while the acidity decreases, which is conducive to the upward movement and reproduction of bacteria in the lower part of the intestine, causing food poisoning to produce fermentation and corruption processes, and the decomposition products not only stimulate the intestinal wall and increase intestinal peristalsis, but also increase the osmotic pressure of the intestine, which together cause diarrhea and dehydration and electrolyte disorders.
Poor defense of the organism, invasion of pathogenic microorganisms, low acidity in the stomach and weak ability to kill bacteria that enter the stomach. The immune protein of the gastrointestinal tract is low and cannot form an effective barrier. Resulting in the invasion and multiplication of various pathogenic microorganisms.
Viruses: rotavirus, norovirus, adenovirus, echovirus
Bacteria: Escherichia coli, Campylobacter jejuni, Aspergillus, the more serious S. typhimurium, dysbiosis of the intestinal flora caused by the long-term application of broad-spectrum antibiotics can induce abnormal reproduction of bacteria and fungi such as Candida albicans, Staphylococcus aureus and Pseudomonas aeruginosa.
Parasites: Pear-shaped flagellates or colonic pouch worms
Infection with viruses and bacteria is common. Pathogenic microorganisms mostly enter the digestive tract with contaminated food poisoning or water, and can also be transmitted through contaminated daily necessities, hands, toys or carriers. These microorganisms attach and invade the intestinal epithelial cells in the intestine, causing lesions such as congestion, edema, inflammatory cell infiltration, ulceration and exudation in the intestinal mucosa. The normal absorption and excretion of the intestine are affected. As a result, symptoms such as fever, abdominal pain, pus and blood in the stool and urgency.
2, the clinical manifestations of pediatric diarrhea
Gastrointestinal symptoms: loss of appetite, vomiting and overflowing milk, increased number of stools, thin or watery stools, yellow or yellow-green, sour taste, white or yellowish milk flaps and foam are common. In severe cases, there will be pus and blood stools, and a lot of mucus discharge.
Systemic symptoms: Less severe children have no obvious systemic symptoms, but severe children may have severe reactions of dehydration, electrolyte disturbance, fever, abdominal pain, depression or irritability, and even coma.
Laboratory tests: Stool microscopy may reveal fat globules, white blood cells, pus cells, and in severe cases, red blood cells and macrophages.
Severe diarrhea may show a decrease in blood pH, an increase in ketone bodies, and a lack of trace elements such as potassium, calcium, magnesium and phosphorus in the blood.
3, pediatric diarrhea treatment methods
Liquid therapy: Used to replenish lost body fluids and correct acidosis. Mildly ill children can use oral rehydration to replenish the lost body fluids within 8-12 hours. Based on 50-80 ml/kg body weight for mild dehydration and 80-100 ml/kg body weight for moderate dehydration
Severely ill children need intravenous rehydration in hospital.
Anti-infection treatment: select appropriate antibiotics according to the results of bacterial drug sensitivity test.
Symptomatic treatment: such as beneficial bacteria to help digestion, montmorillonite to repair intestinal mucosa.
4.The advantages and methods of pediatric tuina treatment for diarrhea
The advantages of pediatric tuina treatment for diarrhea: simple method (without any equipment and drugs, only need to push the child’s limbs and trunk acupuncture points, it can play a therapeutic role), less pain, easy for the child to accept (no pain of medicine, pain of injection), avoid intolerance of the gastrointestinal tract to oral drugs, non-absorption, (compared to drug therapy), small side effects, high clinical efficacy (within half a year old mostly cured in 7 days, from half a year old to one year old mostly in 3 days. Most children between half and one year old are cured in 3-7 days, and most children over one year old are cured within 3 times).
The treatment of diarrhea by pediatric tuina: firstly, according to the cause of the child’s illness, it can be divided into the evidence of injury, wind-cold, damp-heat, spleen deficiency, Yang deficiency and so on. Then, according to the main part of the lesion, it can be subdivided into stomach, small intestine, large intestine, spleen, kidney, and so on. The specific nature of diarrhea is then summarized, and the principles of treatment and acupuncture points are proposed.
For example, if food injury is in the stomach, we can use treatment methods such as eliminating food and guiding stagnation, taking acupuncture points to clear the stomach meridian, rubbing the Pan Men, transporting the Bagua, moving the Zhong Gua, and rubbing the Spleen and Stomach Yu.
Wind-cold in the small intestine can be treated by warming yang and dispersing cold, taking points such as rubbing a nest of wind, rubbing the abdomen, clearing the small intestine, and pushing the keystone.
Damp-heat in the large intestine can be treated by clearing heat and relieving dampness, taking acupuncture points to clear the large intestine, retreating the six internal organs, pushing the lower seven bones and rubbing the upper giant market.
For diarrhea with spleen deficiency, we can use points to tonify the spleen meridian, knead the spleen yu, and knead the foot three li.
Kidney Yang deficiency diarrhea can be used to tonify the kidneys and strengthen the yang, taking points to tonify the kidney meridian, rubbing the eight, rubbing the kidney yu, and mo Guanyuan.
5.Family care for children with diarrhea
Dietary contraindications.
Severe vomiting temporary fasting for 4-6 hours, but do not abuse fasting, especially for a longer period of time, is not good for the child. There are reports of children with acute diarrhea who eat as usual, although the amount of stool increased, but their weight growth rate can still be close to normal, while those who eat less increased less or even decreased, so in addition to severe vomiting temporary fasting, breastfeeding continue to feed breast milk, suspend complementary foods. Artificial feeders can suspend milk and other foods, replaced by the same amount of rice soup, porridge, noodles, etc.. Avoid eating too greasy (meat and fried food), sticky (dumplings, oil cakes, sticky cakes) and cold food. Suspend dairy feeding in suspected viral enteritis and switch to soy-based milk substitutes, or fermented milk. Use glucose with caution. Do not force feeding if the child loses appetite. Diet should be fresh, clean and at the right temperature.
Supplemental fluids: Those with severe vomiting must be fed water or rice soup in small amounts several times. Other children should be fed water or oral rehydration salts on time.
Hip care.
Change diapers regularly and rinse the buttocks with warm water after defecation, wipe dry and put on talcum powder. Keep the skin clean and dry. For redness or ulceration around the anus, apply tannic acid ointment, erythromycin ointment, fragrance oil, etc.
Eye, ear and nose care: prevent vomiting and accidental aspiration.
Close observation of the condition.
Pay attention to vomiting, defecation and urination. The number of stools, their color, nature, odor and their mixture should be recorded daily. Observe the child’s systemic symptoms in detail, take the temperature on time, and pay attention to the occurrence of heavy and variable evidence.
6.Prevention of pediatric diarrhea
Summer is the season when bacteria multiply most rapidly, so in summer, we should pay special attention to water and food hygiene, and the diet should be fresh, clean and at the right temperature. Avoid eating too greasy (meat and fried food), sticky (dumplings, oil cakes, sticky cakes) and cold food.
Cultivate good hygiene habits in children, wash hands before and after meals, and disinfect food, tableware, diapers, toilets, toys and other items that children come into contact with on a daily basis.
During the epidemic period of infectious diarrhea, attention should be paid to timely disinfection in public places where children gather, and children with diarrhea or carriers should be isolated.
Breastfeeding should be advocated, especially in the first few months after birth, avoid weaning in summer, add complementary foods should be in accordance with the thin and thick, from less to more, from a single to a variety, pay attention to reasonable flow feeding. Pay attention to climate change at all times to avoid the child getting cold or overheating. Feed more water in summer.
Avoid long-term abuse of broad-spectrum antibiotics to avoid causing intestinal flora imbalance.
7, other therapies for pediatric diarrhea: physiotherapy, cupping, umbilical cord application.