Pediatric acute diarrhea is a common disease in pediatrics, second only to respiratory tract infections. How to view pediatric acute diarrhea correctly and treat it reasonably is the concern of every pediatrician and parents. This article summarizes the treatment misconceptions of children with diarrhea that I encountered in the pediatric gastroenterology clinic for parents’ reference as follows. 1. Misuse of antibiotics: There are many causes of diarrhea, which are divided into infectious and non-infectious. Infectious diarrhea is not necessarily caused entirely by bacteria. Most pediatric diarrhea is caused by viral infections and indigestion (more than 80%), bacterial infections that cause diarrhea only account for a minority, but many pediatricians often do not ask questions and use antibiotics across the board. This practice is not only a waste of medicinal materials, more serious is to make many children needlessly suffer from antibiotics toxic side effects, and even deafness, kidney damage, serious allergic reactions, etc.. For example, the common autumn diarrhea in children is caused by rotavirus, at this time, if you use antibacterial, not only can not cure diarrhea, but also aggravate the disorder of intestinal flora, prolonging the course of the disease. For some non-infectious diarrhea caused by sudden changes in weather or improper feeding, there is no need for antimicrobials at all, but some intestinal mucosal protectors are generally sufficient. As long as the child is a watery stool, generally do not need to take antibiotics. 2, do not pay attention to rehydration: due to frequent diarrhea, children are prone to dehydration. Parents just busy feeding medicine, forget to give their children supplemental fluids, do not know that rehydration is the most important treatment, do not have enough patience. In fact, oral rehydration saline can be fed in the early stage, and should be fed patiently, in small amounts and many times, every 2-3 minutes, with a spoon of 10-20 ml each time; so that the dehydration can be corrected in about 4-6 hours by accumulating less into more. If the child’s diarrhea is heavy and dehydration is obvious, you should take the child to the pediatrician and use intravenous fluids to replenish fluids. 3, diarrhea should fasting: In the past, children with diarrhea, in order to allow the gastrointestinal tract to rest, more emphasis on restricting the diet, or simply fasting. In recent years, experts believe that fasting is harmful and unhelpful. Especially in the case of diarrhea with a large loss of water, it can aggravate dehydration and acidosis; at the same time eating too little, the child is in a state of hunger, which will increase the secretion of digestive juices in the intestinal wall and aggravate diarrhea. Therefore, when a child has diarrhea, there is no need to fast, and more water should be added, especially nutrient-rich liquid or semi-liquid diet, such as rice porridge and noodles. As long as the child can eat, the spirit is good, give the appropriate diet, the child will gradually get better even if the number of diarrhea is more. 4, diarrhea to immediately stop the drainage: many parents are eager to cure the disease, requiring the child to immediately stop the drainage, otherwise you think you level is poor. In fact, diarrhea is like a fever, is also a defense of the body’s response, the body has “dirty things”, it will try to discharge, for example, children with dysentery, if the powerful antidysenteric drugs, the intestinal “pus” is not completely discharged, but will For example, if a child has dysentery, if you use strong antidysenteric medicine, the “pus” in the intestines will not be completely drained, but will aggravate the disease. Another example is autumn diarrhea, is a self-limiting disease, general diarrhea to about a week, it is impossible to immediately good, hospitalization is mainly rehydration treatment, to prevent complications caused by dehydration. Some parents do not understand and have strong opinions, as they believe that hospitalization is not effective. In addition, compound phenylephrine is occasionally used clinically to stop diarrhea. Phenelzine is an anti-intestinal motility drug with good antidiarrheal effect.
However, the “Achilles heel” of phenylephrine has not been appreciated, and that is its serious neurotoxicity. The use of phenylephrine to stop diarrhea can affect the development of brain function in children whose central nervous system has not yet developed. At present, the World Health Organization has issued a call to national health authorities to take measures to stop the clinical application of the drug. 5, diarrhea is to play the suspension: the World Health Organization recommended oral rehydration salts, referred to as ORS liquid (pharmacies have to buy, very cheap), is the treatment of pediatric acute diarrhea dehydration effective a preferred therapy for mild to moderate dehydration have a very good effect. As long as it is fed properly, the child is completely spared the pain of the skin. However, it should be used with caution in small infants, diluted and preferably under the guidance of a doctor. According to the condition, the general diarrhea symptoms only need to be hydrated orally, while infusion is only for children with dehydration symptoms, the purpose is not to stop diarrhea, but to replenish water. 6, diarrhea is a minor problem, after eating their own medicine. This behavior, such as improper treatment, will lead to chronic diarrhea and malnutrition. 7, the number of stools is diarrhea: infants under 6 months, especially some breast-fed infants, although the daily stool up to 6 to 7 times, or even on ten times, yellow-green, more dilute, containing white particles or small milk flaps, or even mucus, but no pus and blood, microscopic examination only see fat globules without red blood cells, white blood cells, infants with good spirit and appetite, no fever, vomiting and other symptoms often associated with diarrhea, normal weight growth The weight growth is normal. At this time, there is no need to worry, there is no need to use medicine, and there is no need to change the stool properties and change to milk. Generally after the addition of complementary foods physiological diarrhea naturally healed. 8, live bacterial preparations and antibiotics with: Pefikang, Mamma Love, Gold Shuangqi, etc. are live bacterial preparations, into the intestinal tract, directly supplement the normal physiological live bacteria, adjust the intestinal flora, antibiotics or other causes of chemically induced dysbiosis has a significant effect. But many parents of children, and even some doctors, often use antibiotics at the same time as the application of this writing, thinking that the “double-pronged” effect is better. In fact, antibiotics kill the intestinal pathogenic bacteria while also killing these useful live bacteria. The two used at the same time not only can not strengthen the efficacy, but will reduce the efficacy, delaying the treatment of children, so must be separated from the time to eat. 9, Similac water to drink: the clinical found that the drug is more effective in the treatment of some diarrhea. The main component of this product is double octahedral montmorillonite. After taking this product orally, the drug can evenly cover the entire intestinal lumen surface and maintain it for as long as 6 hours. Semicarb can adsorb a variety of pathogens and fix them on the surface of the intestinal lumen, and then expel them with intestinal peristalsis, thus avoiding intestinal cell damage by pathogens.
It is mainly used for acute and chronic diarrhea, especially for acute diarrhea in children. However, it must be dispensed according to the instructions and must be drunk on an empty stomach for good results. Generally speaking, it is 50 ml of water for one packet. Some parents do not read the instructions, flush a lot of water to feed their children, and even with milk, are not effective. 10, children available haloperidol: animal experiments have proved that the drug has an effect on the development of cartilage in children, so it is easy not to give clinical use to children under 18 years old. Butalbital kana is also abolished, because there is ototoxicity. Clinically, if you consider invasive bacterial infections, generally use the third generation cephalosporins, please select according to the recommendations of the specialist.