1.What is pediatric diarrhea? Pediatric diarrhea is a group of diseases caused by multiple pathogens and factors, mainly diarrhea. It is mainly characterized by an increase in the number of stools and a change in their nature, and can be accompanied by symptoms such as fever, vomiting, abdominal pain and different degrees of disturbances in water, electrolyte and acid-base balance. The etiology can be caused by viruses (mainly human rotavirus and other enteroviruses), bacteria (pathogenic E. coli, virulent E. coli, hemorrhagic E. coli, invasive E. coli, as well as Salmonella typhimurium, Campylobacter jejuni, Yersinia pestis, Staphylococcus aureus, etc.), parasites, fungi, etc. Infections outside the intestinal tract, intestinal flora disorders due to antibiotic abuse, allergies, improper feeding and climatic factors can also cause the disease. It is a common disease in infants and children under 2 years of age. Changes in stool characteristics and an increase in the number of stools compared to usual are collectively referred to as diarrheal disease before the cause is identified. Diarrheal disease is a group of diseases with multiple causes and factors, and is one of the diseases with the highest incidence in childhood, and is a worldwide public health problem. In China, diarrheal disease is also a common disease in children, according to relevant information, the annual incidence of diarrheal disease in children under 5 years of age in China is 201%, with an average annual incidence of 3.5 times per child per year, and its mortality rate is 0.51%. Therefore, the prevention and treatment of pediatric diarrhea disease is very important. 2, what are the symptoms of pediatric diarrhea? Diarrhea is one of the common illnesses in babies, which not only brings many negative effects to the baby’s body, but also causes malnutrition and stunted growth. There are various causes that trigger diarrhea in children, and diarrhea is frequent in special seasons. How to take good care of your baby’s tummy is a must for mothers. (1) The number of stools suddenly increases, and the bowel pattern is broken; (2) The stools are thin, watery, and even jet-like in severe cases; (3) The stools have a strange, unpleasant smell; (4) They may be accompanied by symptoms such as fever, vomiting, and poor spirit; (5) Severe diarrhea can cause thirst and sunken eyes due to dehydration. 3, the causes of pediatric diarrhea? Reason 1: normal physiological phenomenon First of all, it should be clear that the number of bowel movements of babies is more than that of other people, does not mean that it is “diarrhea”. Baby’s gastrointestinal function is not fully developed, breast milk and formula feeding methods, will lead to differences in the number of bowel movements. Judgment: If the stool is thin and yellow, the baby is in good spirits and eating normally, and the baby is gaining weight normally, there is nothing wrong. If there is mucus and water in the stool, it may be diarrhea. Response: In general, you do not need to go to the hospital, just feed reasonably at home and keep an eye on it. Cause 2: Food problems If your baby drinks very thick milk, has sugar, low temperature, or adds supplements too early, it may cause accumulation of food and eventually lead to diarrhea. Judgment: frothy stools, sour and rotten smell, or food particles; sometimes the baby will show vomiting symptoms. Response: Do not add complementary foods too early, pay attention to the concentration and temperature of the milk your baby drinks. Cause 3: Allergy to milk powder Some milk powder is not suitable for babies to drink, and some babies are allergic to the protein in it. Judgment: sticky stools with blood, diarrhea for more than 2 weeks; may be accompanied by asthma and skin allergy. Response: Seek immediate medical attention and follow medical advice on feeding. Cause 4: Cold Diarrhea is a concomitant symptom of a cold, and when the cold gets better, the diarrhea will improve. Judgment: there is a runny nose and other cold symptoms. Response: Treat the cold and to prevent dehydration from diarrhea, hydrate promptly. Cause 5: Infection Some viruses or bacteria can cause diarrhea in children and can be somewhat contagious. Judgment: If the stool is yellow in volume, dilute water egg-shaped, without pus and blood, it may be caused by a viral infection; if there is pus and blood, and the baby has fever and vomiting symptoms, it may be caused by bacteria. Response: Seek medical attention immediately. 4, several common infectious diarrhea clinical manifestation characteristics (1) rotavirus enteritis: prevalent in autumn and winter, is epidemic or small epidemic, the virus through the fecal-oral route as well as respiratory transmission. Mostly seen in infants and children aged 6 to 24 months. The incubation period is 1 to 3 days, often with fever and upper respiratory tract infection symptoms. The onset of the disease is rapid, with vomiting at the beginning of the disease, followed by diarrhea, with watery or egg-like stools, with a small amount of mucus, without fishy odor, several times a day to more than 10 times a day. It is often accompanied by dehydration and acidosis. The disease is self-limiting, the course of 3-8 days, a few longer, stool microscopy occasionally see a small number of white blood cells. A large amount of virus is excreted from the stool within 1 to 3 days of the disease, up to 6 days. Serum antibodies generally rise after 3 weeks, the virus is more difficult to isolate, immunoelectron microscopy, ELISA or nucleic acid electrophoresis are helpful for diagnosis. (2) Norwalk virus enteritis: mostly seen in older children and adults, clinical presentation is similar to rotavirus enteritis. (3) Escherichia coli enteritis: often occurs from May to August, the disease varies in severity. Pathogenic E. coli enteritis stools are egg-flake soup-like, fishy, with more mucus, occasionally see blood or mucus peptone stool, often accompanied by vomiting, mostly without fever and systemic symptoms. The main manifestations are water and electrolyte disorders. The duration of the disease is 1 to 2 weeks. Toxin-producing Escherichia coli enteritis, the onset of more acute, the main symptoms are vomiting, diarrhea, watery stools, no white blood cells, often obvious water, electrolyte and acid-base balance disorders, the course of 5 to 10 days. Invasive E. coli enteritis, rapid onset, high fever, frequent diarrhea, mucopeptic stools with pus and blood, often accompanied by nausea, abdominal pain, shortness of breath and other symptoms, sometimes serious toxic symptoms, and even shock. Clinical symptoms and bacterial dysentery are difficult to distinguish, and stool culture is needed to identify. Haemorrhagic Escherichia coli enteritis, the number of stools increases, starting with yellow watery stool, then turning into bloody stool, with a special odor, stool microscopy with a large number of red blood cells, often without white blood cells. It is accompanied by abdominal pain. May be accompanied by hemolytic-uremic syndrome and thrombocytopenic purpura. (4) Campylobacter jejuni enteritis: can develop throughout the year, mostly in summer. It can be disseminated or outbreak epidemic. The incidence is highest in infants and children aged 6 months to 2 years, and livestock and poultry are the main sources of infection, which are spread by the fecal-oral route, animal → human or human → human. The incubation period is 2 to 11 days. The onset of the disease is rapid and the symptoms are similar to those of bacterial dysentery. Fever, vomiting, abdominal pain, diarrhea, mucus or pus-blood stools, and foul odor. Infection by virulent strains can cause watery stools, stool microscopy with a large number of white blood cells and a variable number of red blood cells, can be complicated by severe small intestinal colitis, sepsis, pneumonia, meningitis, endocarditis, pericarditis, etc. (5) Yersinia pestis small intestinal colitis: It occurs mostly in winter and spring, and is more common in infants and children. Incubation period of about 10 days. No obvious prodromal symptoms. The clinical symptoms are age-related, and diarrhea is the main symptom in children under 5 years of age. In children under 5 years of age, diarrhea is the main symptom, and stools are watery, mucus-like, purulent or bloody, with a large number of leukocytes on microscopic examination. The disease can be complicated by mesenteric lymphadenitis, erythema nodosum, reactive arthritis, sepsis, myocarditis, acute hepatitis, liver abscess, conjunctivitis, meningitis, urethritis or acute nephritis. The duration of the disease is 1 to 3 weeks. (6) Salmonella typhimurium enteritis: year-round incidence, with the highest incidence from April to September. Most are infants and children under 2 years of age and are prone to epidemics in pediatric wards. It is transmitted through the mouth. The main clinical manifestations are fever, nausea, vomiting, abdominal pain, abdominal distension, “jet” diarrhea, the number of stools can be more than 30 times, yellow or dark green stools, watery stools, mucus stools or pus and blood stools. Stool microscopic examination can be seen a large number of white blood cells and different numbers of red blood cells, serious cases may appear dehydration, acidosis and systemic toxicity symptoms, and even shock, can also cause sepsis, cerebrospinal meningitis. The general course of the disease is 2 to 4 weeks. The carrier rate is high, and some children are excreted for more than 2 months after the disease. (7) Staphylococcus aureus enteritis: rarely primary, mostly secondary to the application of a large number of broad-spectrum antibiotics or secondary to chronic disease basis. The onset of acute, toxic symptoms. The manifestations are fever, vomiting, frequent diarrhea. Different degrees of dehydration, electrolyte disorders, serious cases of shock. At the beginning of the disease, the stool is yellowish green, and after 3-4 days, it mostly changes to fishy-smelling, seawater-like stool with a lot of mucus. Stool microscopy has a large number of pus cells and gram-positive bacteria. Stool culture with staphylococcal growth, coagulase positive. (8) Pseudomembranous enterocolitis: mostly seen after long-term use of antibiotics, due to the long-term use of antibiotics lead to intestinal flora disorders, so that Clostridium difficile proliferate, resulting in the production of necrotoxin. The main symptom is diarrhea, the stool is yellow thin watery or mucus stool, a few with blood, with pseudomembrane discharge (intestinal tube), accompanied by fever, abdominal distension, abdominal pain. Abdominal pain often precedes or coincides with diarrhea. It is often accompanied by significant hypoproteinemia, water and electrolyte disorders, and generalized weakness in the form of chronic wasting. In mild cases, diarrhea usually stops 5 to 8 days after discontinuation of the drug, but in severe cases, dehydration and shock may occur until death. If the child’s diarrhea occurs after the cessation of drugs, or diarrhea appears after the continued use of antibiotics, the course of the disease is often prolonged. (9) Candida albicans enteritis: mostly occurs in frail, malnourished children, long-term abuse of broad-spectrum antibiotics or adrenocorticosteroids. The oral cavity is often accompanied by thrush. Increased number of stools, dilute yellow or greenish, foamy, with mucus sometimes visible bean curd-like pieces (colonies), stool in the microscopic fungal spores and pseudomycorrhizae, fecal fungal culture to help identify. 5, common misconceptions about pediatric diarrhea care Don’t eat if you have diarrhea Many people believe that since they have diarrhea, they should not eat anymore, until their stomachs are empty, they will no longer have diarrhea. In fact, such a view is completely wrong. Because even if diarrhea, the intestines are still able to absorb nutrients, and diarrhea itself can also cause dehydration, malnutrition and other consequences, more need to properly supplement nutrition. Drinking (sugar and salt) water to prevent dehydration The “traditional method” of drinking sugar and salt water is actually not useful and may lead to more serious diarrhea. The correct method is to take oral rehydration salts, etc. Chicken soup can replenish lost nutrients Chicken soup can indeed replenish nutrients, but it is not suitable for babies with diarrhea. This is because drinking chicken soup at this time may cause your baby to get hypernatremia. Don’t eat oil after diarrhea Only if your baby has acute intestinal infections, you should not eat oil, and not more than 3 days. If you don’t eat oil after diarrhea, it will affect the absorption of nutrients in the baby’s body and may make the diarrhea symptoms more serious. 6, the diet of pediatric diarrhea, to symptomatic care wounded food type diarrhea sour stools, loss of appetite, abdominal pain and bloating, indigestion, crying and irritability. Countermeasures: (for babies over one year old) chop apples, boil them in water, add a little rock sugar or salt, cook them and make apple puree; or boil them directly in water and drink boiled apple water. Wind-cold diarrhea Dilute stools, pale and slightly smelly, with foam, may be accompanied by abdominal pain, fever symptoms. Countermeasure: Boil ginger and tea leaves in a ratio of 10:3 in water, you can add the right amount of brown sugar and drink the soup after support. Warm diarrhea Mucus in the stool, like egg flower shape, thick tongue coating, with fever symptoms. Countermeasure: Put red dates in a pot and fry them slightly. After frying, boil them with water together with Chen Pi for about 15 minutes, make and drink the soup. Spleen deficiency diarrhea Dilute stools, prolonged diarrhea without improvement, loss of appetite, yellow face. Countermeasure: Wash and cut fresh carrots into pieces, add water and boil them together, the soup and carrots can be eaten at this time. 7.How to prevent? Promote breastfeeding Breast milk is the best food for babies, which is more suitable for their digestive ability than formula milk and can avoid digestive disorders to the greatest extent. Pay attention to the hygiene of food utensils Contaminated food utensils can easily cause pediatric diarrhea. Especially for artificially fed babies, attention should be paid to the hygiene and cleanliness of food and eating utensils, and bottles and teats should be disinfected every day. The baby’s gut is relatively soft and tender, so adding complementary foods should be done carefully. First of all, it should not be added too early, and secondly, every time you let your baby try a new food, there should be a process of adaptation, and it is not advisable to add a variety of complementary foods at the same time. The quality of the diet Non-exclusively breastfed babies especially need to pay attention to the diet mix, should not try too early rice paste, porridge and other complementary foods to avoid indigestion. Enhance the baby’s physical strength The baby’s resistance is enhanced, which can effectively prevent various infectious diseases. Parents can take their children out more often to get in touch with nature and enhance hygiene education.