Get out of the “misunderstanding” of diarrheal diseases

  Diarrhea is a common disease in infants and young children, and with the improvement of medical care, the number of deaths caused by it is decreasing. However, as infants and young children are at a critical stage of growth and development, the effects of malnutrition and intellectual development caused by persistent diarrhea should still be taken seriously by parents. There are many misunderstandings in the treatment and care of infant diarrhea, and it is important to get out of these misunderstandings so that the child can recover as soon as possible.  1. Clearly identify the cause of the disease and carry out targeted treatment.  The etiology of diarrhea in infants and young children is complex, except for individual cases belonging to “physiological diarrhea” which do not require treatment, the vast majority are pathological, a few of which are non-infectious diarrhea caused by climate change, dietary changes, abdominal cold, intestinal allergies, etc. The rest are infectious diarrhea. Bacterial enteritis accounts for about 70% of cases in the hot season (March-September) and viral enteritis accounts for 50-80% of cases in the cold season (October-February). Non-infectious diarrhea only requires the regulation of spleen and stomach functions, while infectious diarrhea requires anti-infective treatment and targeted anti-infective treatment, without abusing antibiotics.  2. Strictly control diet and ensure water supply.  The mother should choose a relatively light diet during this period and avoid eating raw and cold food; the child should not eat fish, shrimp, meat, eggs and fruits, but mainly rice flour, thin rice, rotten noodles and diluted milk. For children <4 months old, if the disease lasts less than 2 weeks, breastfeeding should be adhered to; for more than 2 weeks, feeding should be changed to formula for diarrhea. While controlling the type and quantity of diet, attention should be paid to securing the supply of water and salt to prevent the occurrence of dehydration. The recovery period of diarrhea usually takes about 1 week, from one kind to many kinds, from a small amount to a large amount, slowly returning to a normal diet.  3. Understand the treatment characteristics of infectious diarrhea in infants and children and cooperate with doctors.  Infant diarrhea is completely different from adult diarrhea. In adults, because of their well-developed gastrointestinal function, infectious diarrhea is basically cured after the end of anti-infection. The first stage is the anti-infection stage, in which effective antibiotics or antiviral drugs are applied for anti-infection treatment. After laboratory examination, it is determined that the infection has been controlled (at this time, the number of stools and their properties may still not improve, which does not mean that the treatment is ineffective), that is, the anti-infection drugs should be stopped, but this is not the end of treatment. However, this is not the end of the treatment.  4, reasonable combination of drugs to improve the effectiveness of treatment.  Since infants and young children are in the period of growth and development, the digestion, absorption and defense functions of the gastrointestinal tract are not perfect, so diarrhea is easy to occur and not easy to recover. The combination should be applied according to the disease and the course of the disease.  5, the correct choice of medication, to improve drug utilization.  As infants are more difficult to feed, if the drug does not stimulate the gastrointestinal tract, you should try to feed the drug before milk to prevent vomiting after milk feeding, resulting in insufficient drug intake. Frequent vomiting in acute gastroenteritis must be administered intravenously, and oral drugs can only increase the stimulation of the gastrointestinal tract and aggravate the symptoms of vomiting. The choice of the timing of drug administration should also be given attention, such as the application of montelukast, must be fasting and the need to take the drug in suspension; application of intestinal microecological agents must be interval of 2 hours with antibiotics; antidiarrheal drugs must be applied only after the infection has been controlled.  6, long-term diarrhea does not heal, should be reasonable feeding, enhance nutrition.  Long-term diarrhea does not heal is bound to cause malnutrition in children, malnutrition in turn affects the recovery of diarrhea disease, resulting in a vicious circle, therefore, for children with long-term diarrhea, nutrition should be enhanced. As children with diarrhea need to restrict the type of diet, high protein diet such as fish, shrimp, meat and eggs are within the restricted range, and it is recommended to use amino acid nutrition powder as a milk substitute to enhance nutrition.