DIARRHOEA

Diarrhoea is an intestinal disorder characterized by abnormal fluidity and frequency of fecal evacuations, generally the result of increased motility in the colon. The loss of fluids through diarrhea can cause severe dehydration which is one cause of death in diarrhea sufferers.

Acute Diarrhoea
It is an extremely common presenting complaint. It is usually is due to faeco-oral transmission of micro-organisms.
Causes:
1.Infection-
a.Infective food poisoning- Rotavirus gastroenteritis.
                                              - Shigella
                                              - Cholera
                                              - Salmonella
b.Protozoal                              - Giardiasis
                                              - Amoebic dysentery
c.Toxin mediated                     - Bacillius
                                              - Staphyloccocus
d.Systemic                             - Sepsis
                                              - Malaria
2.Non- Infection-
a.Gastro-intestinal Disorder - Inflammatory Bowel Diseases.
                                              - Acute Diverticulitis
                                              - Pelvic Inflammatory disease.
b.Metabolic upset                     - Ketosis
                                               - Uraemia
c.Drugs and Toxins

Chronic or Relapsing Diarrhoea
It can be present with increased frequency of defecation and loose, watery or pellety stools. Diarrhoea rarely occurs in night and usually aggravated before and after breakfast. The stool is often contains mucus but never blood, and 24-hours stool volume is less than 200g.

	COLONIC	MALABSORPTION	SMALL BOWEL
CLINICAL FEATURES	1. Blood and mucus in stool. 2. Cramping lower abdominal pain.	1. Steatorrhoea. 2. Undigested food in stool. 3.Weight loss and nutritional disturbances.	1. Large amount watery stool. 2. Abdominal bloating. 3. Cramping mid- abdominal pain.

SOME CAUSES

1. Inflammatory

Bowel diseases.

2. Neoplasia.

3. Ischaemia

4. Irritable Bowel

Syndrome

1.Pancreatic-

Chronic

pancreatitis

Cancer of pancreas

Cystic fibrosis

2. Enteropathy-

Coeliac diseases

Tropical sprue

Lymphoma

Lymphangiectasia

1. Lipoma

2. Drug- induced

Investigations:
1.Blood Count- Hb, TLC, DLC, ESR.
2.Stool examination- to detect presence of any infective agent.
3.Ultrasound to detect any pathology.
4.Barium meal
5.Colonoscopy
6.CT-scan and MRCP

Complication:
The most common complication of diarrhoea is dehydration. The level of dehydration needs to be judged to find out the severity of the condition. Levels of dehydration can be judged considering the status of certain features, which are described in the below table.

FEATURES	MILD	MODERATE	SEVERE
Condition	Well alert	Restless, Irritable	Lethargic
Eyes	Normal	Sunken	Very sunken & dry
Mouth & tongue	Moist	Dry	Very dry
Skin pinch	Goes back quickly	Goes back slowly	Goes back very slowly
Thirst	Not thirsty	Thirsty	Drinks poorly/ unable to drink
Lips		Dry	Parched
Urine		Reduction in urine	Marked reduction in urine

Management:
1.Patient should take good amount of fluid in order to prevent dehydration.
2.Dairy products should be avoided.
3.Diet should be simple, heavy food must be avoided.
4.Diet should contains those product that easy to digest.
5.Proper rest must be advised.
6.Homoeopathy- Homoeopathy is highly scientific, logical, quick and an extremely effective method of healing. Homoeopathy proved curative in diarrhoea and gives splendid results. Diarrhoea could be very effectively and quickly treated with homoeopathy without producing any side effects whatsoever. Unlike antibiotics and other such medicines, homeopathic pills neither hamper digestion, nor lower the body's resistance. They neither cause any allergies nor cause any damage even if taken over a long period. One point that must be remembered here is that one diarrhoea remedy will not cure another case of diarrhoea, until and unless the remedy matches the peculiarities of that particular case.

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