1. Paediatric Management of
Diarrhea
Hina Hussain

2. Diarrhea
A symptom of underlined Pathological conditions
e.g., Malnutrition, Short Bowel syndrome,
Gastroentritis, Diabetis Mellitus, Lactose
intolerance, Antibiotic therapy
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3. Definition
The passage of more than three watery stools
a day is diarrhea
• Frequency
• Consistency
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4. TYPES OF DIARRHEA
• Acute Diarrhea
• Chronic diarrhea
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5. COMMON CAUSES OF
DIARRHEA- BACTERIA
– Vibrio cholera
– Shigella
– Escherichia coli
– Salmonella
– Campylobacter jejuni
– Yersinia enterocolitica
– Staphylococcus
– Vibrio parahemolyticus
– Clostridium difficile

6. COMMON CAUSES OF
DIARRHEA- VIRUS
• Rotavirus
• Adenoviruses
• Caliciviruses
• Astroviruses
• Norwalk agents and Norwalk-like viruses

7. How body gets effected
Diarrhea results in excessive water and electrolytes
lose in the body called dehydration.
Signs of dehydration
• Increased thirst
• Irritability
• Sunken eyes
• Decresed skin turger
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8. Standard Treatment Guidelines
(STG’s)
• These are the guidelines set by certain
organization to standardize the treatment of
the patients and to maximize the cure rate.
e.g., WHO, WGO, CDC etc.
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9. WHO STG’s on Diarrhea
WHO have STG’s on the basis of grade of
Dehydration:
• No dehydration: Treatment Plan ‘A’
• Mild: Treatment Plan ‘B’
• Severe: Treatment Plan ‘C’
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10. Grading/ Assesment
Dehydration
No dehydration Mild Severe
Appearance Irritable, thirsty Irritable, Lethargic
very thirsty or Coma
Eyes Normal depressed markedly
depressed
Skin Normal Slow Very slow
retraction retraction
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11. Objective of these STG’ s
• Rehydration– replace the loss of fluid and
electrolytes
• Antibiotics– according to the type of pathogens
• Start food as soon as possible
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12. Treatment Plan ‘A’
Home based treatment
• ORS, other fluids
How much to give, what kind of fluids are given
• Increase feed
• Oral Zinc
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13. Treatment Plan ‘B’
Oral rehydration therapy
• ORS + Zinc supplementation
• Amount of ORS given for first 4 hours
According to the weight and age of the child
• If abdominal distension
• Reassesment and selection of Plan
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14. Treatment Plan ‘C’
• IV RL at the 100ml/kg
• Reassesment of the patient
• Selection of treatment plan accordingly
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15. BUT
A good saying prevention is better than cure
• Safe drinking water and food
“Boil it, cook it, peel it, or forget it. "
• Hand washing
• Proper sanitation
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