Diarrhoea is an intestinal disease characterised by loose watery stools more than three (3) times in the same day. Generally it can be categorised based on its duration; acute (a short bout lasting 1-2 days), prolonged (more than 2 days) or chronic (usually due to a chronic ailment). This condition can also be accompanied by cramping, bloating, abdominal pain and nausea. Fever and bloody stools are also rare symptoms which can be associated with diarrhoea.
Though diarrhoea affects all age groups, the most vulnerable age groups are children and older persons who are be affected due to dehydration or the excessive loss of fluid and electrolytes (salts and minerals such as sodium, potassium etc.). In newborns and infants dehydration can occur very quickly; within 24 – 48 hours. On average an adult may get about 4 episodes of diarrhoea in a year while a child can get as much as 15 episodes before age 5. 
The common causes of acute diarrhoea are infections due to bacteria, virus or parasites after consumption of contaminated food or water as in the case of traveller’s diarrhoea. Some other causes of diarrhoea are due to the inability of some persons to tolerate certain foods, for example a person may be unable to digest the some artificial sweeteners or lactose which is the sugar in milk. Chronic diarrhoea is usually caused by irritable bowel syndrome and inflammatory bowel disease. Note that diarrhoea is a symptom also of an HIV infection. Diarrhoea can also be induced by using some medicines such as antibiotics, antacids which contain magnesium, some blood pressure tabs and cancer drugs.
How do you know when someone becomes dehydrated?
Look for these signs in adults– thirst, less frequent urination, dry skin, fatigue, dark colored urine, light-headedness, fatigue.
Look for these signs in children– dry mouth and tongue, no tears when crying, no wet diapers for three (3) hours or more, sunken abdomen, eyes and cheeks, skin that does not flatten when pinched and released, high fever, listlessness or irritability.
When dehydration is severe hospitalisation is required where infusions such as dextrose saline will be administered taking into account the person history of diabetes and hypertension.
Do’s
    Prompt treatment by a doctor is required if:
-diarrhoea is more than three (3) days
-severe pain in the abdomen or rectum
-fever of more than 102 degrees
-stool appears bloody or tar like.
-signs of dehydration as indicated above.
A doctor may prescribe certain antibiotics if the diarrhoea is due to bacteria or other parasites. If it is due to viruses, the doctor may advise that just fluid and electrolyte replacement is the way to go and let the viral infection run its course.
    Use treatable water preferably sealed bottles.
    Foods must be cooked properly.
    Replace lost fluids and electrolytes with water, broths, soups, fruit juices, coconut water, soft fruits, vegetables containing potassium. Over the counter preparations such as oral rehydration salts can also be used to replace fluids and electrolytes.

Don’ts
    Avoid caffeine – Apart from the obvious coffee, energy drinks and beverages such as Pepsi Max contain lots of caffeine.
    Avoid milk products and greasy foods.
    Don’t use high fibre foods such as brown bread, some fruits with skins (e.g. apples) and some vegetables such as lettuce all of which facilitate bowel movements.
    Popular OTC medicines like loperamide or Lomotil should only be used if the diarrhoea is not caused by bacteria or parasite since these organisms will then be trapped in the intestines and can prolong the problem.
Tips to prevent Traveller’s Diarrhoea:

Do not drink tap water or use it to brush your teeth.
Do not drink unpasteurized milk or dairy products.
Do not use ice made from tap water.
Avoid all raw fruits and vegetables, including lettuce and fruit salads, unless they can be peeled and you peel them yourself.
Do not eat raw or rare meat and fish.
Do not eat meat or shellfish that is not hot when served.
Do not eat food from street vendors.

As you improve, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the paediatrician may also recommend a bland diet.
Once the diarrhoea has stopped, the paediatrician will likely encourage children to return to a normal and healthy diet if it can be tolerated.

Points to Remember
•    Diarrhoea is a common problem that usually resolves on its own.
•    Diarrhoea is dangerous if a person becomes dehydrated.
•    Causes include viral, bacterial, parasitic infections, food intolerance, reactions to medicine, intestinal diseases, and functional bowel disorders.
•    Treatment involves replacing lost fluid and electrolytes. Depending on the cause of the problem, a person might also need medication to stop the diarrhoea or treat an infection. Children may need an oral rehydration solution to replace lost fluid and electrolytes.
•    Call the doctor if the person with diarrhoea has severe pain in the abdomen or rectum, a fever of 102 degrees or higher, blood in the stool, signs of dehydration, or diarrhoea for more than 3 days.
For further advice consult the pharmacist at Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg.
Tel #225-5142.