Things you should know about Diarrhoea
So what is diarrhoea?
Diarrhoea
is defined by the World Health Organization as having three or more loose or
liquid stools per day, or as having more stools than is normal for that person.
SO HOW MANY TYPES OF DIARHOEA ARE THERE?
Secretory
Secretory
diarrhoea means that there is an increase in the active secretion, or there is
an inhibition of absorption. There is little to no structural damage. The most
common cause of this type of diarrhoea is a cholera toxin that stimulates the
secretion of anions, especially chloride ions.
Osmotic
Osmotic
diarrhea occurs when too much water is drawn into the bowels. If a person
drinks solutions with excessive sugar or excessive salt, these can draw water from
the body into the bowel and cause osmotic diarrhea. Osmotic diarrhea can also
be the result of mal digestion.
Exudative
Exudative diarrhea occurs with the
presence of blood and pus in the stool. This occurs with inflammatory bowel
diseases, such as Crohn's disease or ulcerative colitis, and other severe
infections such as E. coli or other forms of food poisoning.
Inflammatory
Inflammatory diarrhea occurs when there
is damage to the mucosal lining or brush border, which leads to a passive loss
of protein-rich fluids and a decreased ability to absorb these lost fluids.
Features of all three of the other types of diarrhea.
Dysentery
If there is blood visible in the
stools, it is also known as dysentery. The blood is trace of an invasion of
bowel tissue. This is also considered one of the most dangerous types of
diarrhoea. Dysentery is a symptom of, among others, Shigella, Entamoeba
histolytica, and Salmonella
So what are the
causes of diarrheoa?
Malabsorption
Malabsorption is the inability to
absorb food fully, mostly from disorders in the small bowel, but also due to
maldigestion from diseases of the pancreas. Some of the causes are…
·
enzyme deficiencies or mucosal abnormality, as in food
allergy and food intolerance pernicious anemia, or impaired bowel function due
to the inability to absorb vitamin B12,
·
loss of pancreatic secretions, which may be due to cystic
fibrosis or pancreatitis,
·
structural defects, like short bowel syndrome (surgically
removed bowel) and radiation fibrosis, such as usually follows cancer treatment
and other drugs, including agents used in chemotherapy.
Sanitation
Poverty often
leads to unhygienic living conditions, as in this communies in the Indian
Himalayas and African nations such as Chad, Niger and Somalia. Such conditions
promote contraction of diarrheal diseases, as a result of poor sanitation and
hygiene.
Open Defecation
is a leading cause of infectious diarrhea leading to death.
Poverty is a good indicator of the rate
of infectious diarrhea in a population. The absence of certain resources
compromises the ability of the poor to defend themselves against infectious
diarrhea. Diarrhoea does not always take place outside one’s home but is also
associated with poor housing, crowding, dirt floors, lack of access to clean
water or to sanitary disposal of fecal waste, cohabitation with domestic
animals that may carry human pathogens, and a lack of refrigerated storage for
food, all of which increase the frequency of diarrhea... Poverty also restricts
the ability to provide age-appropriate, nutritionally balanced diets or to
modify diets when diarrhea develops so as to repair nutrient losses and help
body make up for them. The impact of this disease is gets even worse because of
the lack of adequate, available, and affordable medical care.
Water
One of the most common causes of catching
a death causing infectious diarrhea, is a lack of clean water. Often, improper
fecal disposal leads to contamination of groundwater. This can lead to
widespread infection among a population, especially in the absence of water
filtration or purification. Human feces contains a variety of potentially
harmful human pathogens.
Nutrition
Proper nutrition is important for
prevention of infectious diarrhea. It is especially important to young children
who do not have a fully developed immune system. Zinc deficiency, a condition
often found in children in developing countries can, even in mild cases, have a
significant impact on the development and proper functioning of the human
immune system. Similarly,
vitamin A deficiency can also cause an increase in the severity of stages and
durations diarrhea.
Prevention:-
Sanitation
In institutions, communities, and
households, interventions that promote hand washing with soap lead to
significant reductions in the incidence of diarrhea. The same applies to
preventing open defecation at a world-wide level and providing access to
improved sanitation. This includes use of toilets and implementation of the
entire sanitation chain connected to the toilets (collection, transport, disposal
or reuse of human Feces).
Hand washing
Basic sanitation techniques can have a
profound effect on the transmission of diarrheal disease. The implementation of
hand washing using soap and water, for example, has been experimentally shown
to reduce the incidence of disease by approximately 42–48%. Hand washing in
developing countries, however, is compromised by poverty as acknowledged by the
CDC: "Handwashing is integral to disease prevention in all parts of the
world; however, access to soap and water is limited in a number of less
developed countries. This lack of access is one of many challenges to proper
hygiene in less developed countries." Solutions to this barrier require
the implementation of educational programs that encourage sanitary behaviors.
Water
Given that water contamination is a major
means of transmitting diarrheal disease, efforts to provide clean water supply and
improved sanitation have drastically reduced rate of disease incidence by
40-50% In fact, it has been proposed that we might expect an 88% reduction in
child mortality resulting from diarrheal disease as a result of improved water sanitation
and hygiene. An analysis of numerous studies on improving water supply and
sanitation shows a 22–27% reduction in disease incidence will happen in the
following years, and a 21–30% reduction in mortality rate associated with
diarrheal disease. Chlorine treatment of water, for example, has been shown to
reduce both the risk of diarrheal disease, and of contamination of stored water
with diarrheal pathogens.
Vaccination
Immunization against the pathogens that
cause diarrheal disease is a viable prevention strategy. Similarly, a Cholera vaccine showed a strong
reduction in morbidity and mortality, though the overall impact of vaccination
was minimal as Cholera is not one of the major causative pathogens of diarrheal
disease. Since this time, more effective vaccines have been developed that have
the potential to save many thousands of lives in developing nations, while
reducing the overall cost of treatment, and the costs to society. A rotavirus
vaccine decrease the rates of diarrhea in a population. New vaccines against
rotavirus, Shigella, Enterotoxigenic Escherichia coli (ETEC), and cholera are
under development, as well as other causes of infectious diarrhea. BGS is also
considered one of the best vaccine made for diarrhea presently.
Nutrition
Dietary deficiencies in developing
countries can be combated by promoting better eating practices. Supplementation
with vitamin A and/or zinc. Zinc supplementation proved successful showing a significant
decrease in the incidence of diarrheal disease compared to a control group. The
majority of the literature suggests that vitamin A supplementation is
advantageous in reducing disease incidence.[59] Development of a
supplementation strategy should take into consideration the fact that vitamin A
supplementation was less effective in reducing diarrhea incidence when compared
to vitamin A and zinc supplementation, and that the latter strategy was
estimated to be significantly more cost effective.
Breastfeeding
Breastfeeding practices have been shown
to have a dramatic effect on the incidence of diarrheal disease in poor
populations. Studies across a number of developing nations have shown that
those who receive exclusive breastfeeding during their first 6 months of life
are better protected against infection with diarrheal diseases. Exclusive
breastfeeding is currently recommended during, at least, the first six months
of an infant's life by the WHO.
Others
Probiotics decrease the risk of
diarrhea in those taking antibiotics. An example of a probiotic is curd.
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