In the eyes of many people, diarrhea is a minor problem, just like a cold or fever, and who has never had diarrhea in their life? According to the World Health Organization, the number of people suffering from diarrhea is as high as 1.4 billion per year worldwide. Although diarrhea is common, it is not the same as a minor problem. Surveys show that 10 million people in developing countries die each year from acute diarrhea. In China, 836 million people suffer from diarrhea each year, with a high proportion of children and elderly people. In such a situation, the most worrying thing for doctors is that many patients tend to take drugs indiscriminately based on experience, especially the abuse of antibiotics. Hou Xiaohua, Department of Gastroenterology, Wuhan Union Medical College Hospital, has diarrhea, commonly known as “diarrhea”, when the stool is passed more than three times a day and the stool is thin. Diarrheal diseases account for most of the infectious diseases, and the number of diarrhea cases in China is 830 million per year. Summer is the high incidence of diarrheal diseases, dysentery in Beijing, concentrated in June 25 to September 12, this time to be particularly alert to poisoning type bacillary dysentery. Poisonous bacillary dysentery is fast changing and fierce, if not rescued in time, there is a risk of life, from onset to death in a few hours at the earliest. Therefore, the prevention and treatment of diarrheal diseases, especially in the summer, is an important public health problem in China. Acute diarrhea, mostly caused by various viruses, bacteria, protozoa and other microorganisms, is collectively known as infectious diarrhea. Common diarrhea-causing microorganisms are rotavirus, Shigella, Campylobacter jejuni, laxative Escherichia coli, Vibrio parahaemolyticus. In addition, there are also Vibrio cholerae, Salmonella, Cryptosporidium, etc. Antibiotics are needed for bacterial infections. 70% of diarrhea does not require antibiotics. Many patients ask their doctors to prescribe antibiotics when they have diarrhea. Do all patients with diarrhea need antibiotics to be cured? According to a study by Chinese scholars, about 30% of diarrhea patients in China need antibiotics, while 70% do not need and should not be treated with antibiotics. Non-abuse of antibiotics is an important principle of diarrhea treatment. In other words, 30% of diarrhea that needs antibiotics must be used, if not applied in time, the diarrhea will not be cured, and even life-threatening. At the same time, the abuse of antibiotics will also lead to the increasing number of drug-resistant strains. A lot of clinical data shows that the efficacy of various antibiotics gradually decreases after several years of application, making the treatment of diarrhea more difficult. Misuse of antibiotics may also sometimes lead to dysbiosis of intestinal flora, secondary mycosis fungoides, pseudomembranous enteritis, and in severe cases, methicillin-resistant Staphylococcus aureus enteritis (MSRA enteritis) with positive plasma coagulase, with high mortality. What kind of diarrhea requires antibiotics The diarrhea that requires antibiotics are: bacillary dysentery, cholera, salmonella enteritis in infants and children, various severe diarrhea, and diarrhea in immunocompromised people. So, before the report of the stool test results is available and the diagnosis is not yet clear, how can we generally determine whether antibiotics should be used? First, look at the stool properties. If the stool is purulent and bloody, antibiotics must be used. Second, children under 12 years old with diarrhea, sudden fever, pale face, cold limbs and tight muscles, such dysentery, must use powerful antibiotics, such as ciprofluoperazine, ceftazidime, etc. Third, some special people with diarrhea, such as severe diabetes, leukemia, cirrhosis of the liver, patients with advanced cancer and the elderly. Of course, what antibiotics should be taken and how to take them need to be done under the guidance of a doctor. Not using antibiotics is not the same as not treating 70% of diarrhea patients do not need antibiotics, which is not the same as not needing medication, some drugs are effective for this group of patients. One type of medicine is the intestinal mucosa protector, commonly known as Simethicone. After oral administration, the drugs are widely covered on the surface of intestinal mucosa, forming a protective film, fixing and adsorbing harmful pathogens and their toxins, making it difficult for pathogens to invade the intestinal wall, protecting and promoting the regeneration and repair of intestinal mucosa. Another class of drugs is micro-ecological regulators, common ones are Pefikon. There are many normal bacteria in the human body, such as bifidobacteria, the number of which is ten times the total number of human cells, mainly in the intestinal tract, which is indispensable for human life activities. If the number of normal bacteria decreases or the ratio is out of balance, diarrhea will occur, and diarrhea will further aggravate the dysbiosis. Microecological preparations are normal bacteria, mainly Bifidobacterium, which can be taken orally to promote the recovery of the normal flora for the purpose of treating diarrhea. One of the important principles of diarrhea treatment is to insist on dietary therapy even when diarrhea is present. According to the traditional view, patients with diarrhea need to fast, called starvation therapy, which results in patients being in a long-term starvation state, aggravating malnutrition and forming a vicious circle of diarrhea and malnutrition. In recent years, a large number of studies at home and abroad have shown that one must continue to eat when one has diarrhea, one cannot carry out starvation therapy, and one cannot rely on infusions, tonic drugs and nutrients instead of eating. Only in this way can the nutritional status of the patient be improved and the recovery from diarrhea be accelerated. So, what kind of meals should be eaten during diarrhea in order not to aggravate diarrhea but also to prevent and control malnutrition? This is a concern for diarrhea patients and an important topic of research by experts at home and abroad. In principle, the diet is required to be easily digestible, nutritious, high in calories, high in protein, and not too much oil and lactose, but not an oil-free and lactose-free diet either. The concentration of white sugar should not be too high, a little sweetness is enough. General fruit (except bananas and other easy to slip intestines) can also be eaten, but fresh and clean, do not eat frozen. Now some hospitals in China have developed dairy products suitable for children with diarrhea, with comprehensive nutrients and good results in preventing diarrhea and malnutrition. Patients who are treated at home can eat thin rice and egg noodles. If available, add broth, chopped beef and chicken, cook for 1 to 2 hours on a gentle fire, remove the dregs and cool, then skim off the upper layer of oil. If necessary, drink fresh fruit juices such as watermelon juice. Three points of treatment at home Patients with mild cases can be treated at home, but three issues should be noted, the most important being drinking enough fluids to prevent and control dehydration. There are three ways to prevent and treat dehydration. One is rice soup with salt, 500 ml of rice soup with 1.75 grams of salt, that is, half a cap of a beer bottle. one bottle per day for those under 2 years old, 2 to 4 bottles per day for those over 2 years old, and 4 to 8 bottles per day for adults. How much is appropriate to drink, mainly depending on the amount of urine and normal as much as possible. Second, salt and sugar water, 500 ml of plain water, add 10 grams of sugar or glucose (2 small spoons), and then add 1.75 grams of fine salt. The third is to take oral rehydration salts (ORS), which can be bought in major pharmacies and taken with water as prescribed. The second is to continue eating and encourage eating thin meals. The third is to know what condition should be sent to the hospital immediately. After three days of treatment, the patient is still not well, one of the following six manifestations, should immediately go to the hospital: ① increased stool; ② can not eat; ③ frequent vomiting; ④ obvious thirst; ⑤ fever; ⑥ blood in the stool. If the mouth is very dry and cannot drink, little urine, hoarse voice, no tears and no sound when crying, and poor skin elasticity, it means that it has developed into serious dehydration, and the family should send it to the hospital immediately.