Diarrhea is simply the most common little demon on the way to raising a baby, and even battle-hardened mothers still struggle with: should children with diarrhea take antidiarrheal medication or not? I heard that viruses or bacteria will be excreted from the body with the stool, so shouldn’t we let our children poop more to get better faster?
First of all, let’s look at the main causes and pathological basis for the appearance of diarrhea. Diarrhea is generally divided into four types in terms of pathogenesis.
1. osmotic diarrhea
It refers to diarrhea caused by high osmotic pressure of fluid in the intestinal tract of the child, the most common being lactase deficiency, when the lactose and other components entering the intestine cannot be decomposed, leading to an increase in osmotic pressure in the intestinal cavity, and water will ooze out from the side with low osmotic pressure to the side with high osmotic pressure, thus leading to a large amount of water entering the intestinal cavity, thus causing watery diarrhea.
2.Secretory diarrhea
It refers to the action of some bacterial secretion of enterotoxins on intestinal mucosal cells, resulting in the hyper-secretory function of intestinal mucosal cells, which actively secrete a large amount of fluid and electrolytes into the intestinal lumen, thus causing dilute watery stools.
3.Exudative diarrhea
It refers to some invasive bacteria that directly destroy the intestinal mucosal cells, causing the intestinal mucosa to become inflamed and congested, edematous, exudative, and even ulcerated, thus causing mucus and blood stools.
4, abnormal intestinal peristaltic function function
The pathogenesis of this type is similar to the accumulation of food in Chinese medicine, which is mainly related to improper eating. When the child eats too much or improper diet composition, the food cannot be fully digested and absorbed, it will accumulate in the upper part of the small intestine, causing the acidity in the intestinal lumen to drop, leading to the upward movement and multiplication of bacteria in the lower part of the intestine, and the short-chain organic acids produced by the decomposition of food after fermentation and decay can increase the osmotic pressure in the intestinal lumen (osmotic diarrhea), while the toxic products of decay will stimulate the intestinal wall and increase intestinal peristalsis, leading to diarrhea. leading to diarrhea.
Well, whichever type of diarrhea mentioned above involves the exudation of active or passive fluid from the intestine, leading to diarrhea, because the exuded substances are mainly water and electrolytes, so the child often has watery stools with secondary dehydration and electrolyte disturbances. So should we stop diarrhea after a child has diarrhea or not?
Since diarrhea is a disease, and if a large amount of watery stool can easily lead to dehydration and electrolyte disturbances in children, even life-threatening, then stopping diarrhea is the right thing to do. Or in fact, no matter what measures are taken for a child with diarrhea, the ultimate goal is to make the child stop having diarrhea, so antidiarrheal treatment is needed. However, there are different mechanisms of action of antidiarrheal treatment or antidiarrheal drugs, depending on what is suitable and what is not.
Mucous membrane protectors
First of all, the most commonly used and effective medication is still montelukast (Simethicone). Montelukast is more accurately called an intestinal mucosal protector.
First of all, look at its mechanism of action. Montmorillonite has a laminar structure and a non-uniform charge distribution, which can adsorb viruses, bacteria and toxins produced by these pathogens in the digestive tract, thereby fixing and inhibiting them, just like a police officer catching a thief to prevent him from doing damage; at the same time, it has a covering effect on the mucosa of the digestive tract, just like a brush that brushes the mucosa of the intestine with a layer of burnt, so that those active or passive mucous membranes mentioned earlier can be protected by the intestinal mucosa. The process of secreting water or electrolytes into the intestinal cavity, either actively or passively, will be cut off, so that the intestinal cells can maintain their normal absorption and secretion functions. In addition, it can bind to mucus glycoproteins in the intestine to enhance the barrier function of the intestine and prevent the attack of pathogenic microorganisms. After the pathogens in the intestine and their secreted toxins and other attacking factors are caught by montelukast, they will be expelled from the body with the normal peristaltic process of the intestine.
Therefore, montelukast does not stop diarrhea by preventing intestinal movement, but helps the pathogens in the intestinal tract to be expelled faster while reducing watery stools and avoiding dehydration.
If your child has diarrhea, your first choice is montelukast. Of course, the usage of montelukast has certain requirements, otherwise it may affect the efficacy.
1, according to the requirements, strict proportioning. Each sachet (1g) with 50ml of water, if the dosage is reduced or increased, then the amount of water should also be reduced or increased accordingly, for example, half a sachet with 25ml of water. If the water is too much, then the char is too thin, it will not reach the role of char, and the water will continue to seep out, while if the water is too little, the char is too little, it can only char a small part of the intestinal wall, and the rest will continue to seep out, so pay attention to the amount of water.
2, do not take with milk or other drugs, because montmorillonite has adsorption effect, but its adsorption effect does not depend on the specific things, see what will be adsorbed, if put in milk or taken at the same time with other drugs, it may be combined with the protein components of milk or other drug components, thus affecting the role of montmorillonite or other drugs.
3, in addition, for children, the recommended dose is generally three times a day, once 1/3 bag, but personal experience, this dose basically does not play a big role, so it is recommended that according to the child’s stool water situation, appropriate adjustments. Montelukast is not too much of a drug overdose problem, and the dosage can be adjusted at any time after the child’s stool shape is restored.
Another drug that is more commonly used is abscisicadotril. This is a drug that directly reduces the overproduction of water and electrolytes in the intestinal tract.
Decadron is an enkephalinase inhibitor. The endogenous enkephalin in the human digestive tract can reduce the secretion of water and electrolytes, and it will be destroyed by the enkephalinase enzyme, resulting in the weakening of the effect, and the diarrhea will continue. The effect of enzyme inhibition can be maintained for about 8 hours.
It does not inhibit the peristalsis of the intestine and the secretion of intestinal bases, so it does not inhibit the process of excretion of pathogens and toxins from the intestine, but only interrupts the secretion of intestinal water from the source. In contrast to montelukast, abscisicadotril mainly targets secretory diarrhea, probably because of its “second-hand” effect, that is, it has to inhibit the enzymatic effect and then achieve the effect of reducing secretion, so the overall scope of targeting is small, and the effect is not as direct as montelukast, and the relative effect is not as good as montelukast.