What is the treatment for diarrhea in children?

Nowadays, most families have only one child, so many parents spoil their children. When a child becomes ill, many parents wish they could get sick for their children, especially when the child has diarrhea. Acute diarrhea has a great impact on children. If not treated in time, it may cause dehydration and death in severe cases. So what are the treatments for children's diarrhea?

The principles of treatment for diarrhea are to prevent dehydration, correct dehydration, continue diet, and use medication appropriately.

Treatment of acute diarrhea

(1) Prevention and treatment of dehydration: The prevention and correction of dehydration plays an extremely important role in the treatment of diarrhea. The oral rehydration salt (ORS) recommended by the World Health Organization (WHO) has the advantages of being effective, simple, inexpensive and safe. It has become the main way of rehydration and is an important progress in the treatment of diarrhea. Oral rehydration therapy is based on the Na-glucose coupled transport mechanism of the small intestine. There is a common carrier of Na-glucose on the brush border of the microvilli epithelial cells of the small intestine. Only when Na and glucose are combined at the same time can they be transported. Even in acute diarrhea, this transport function is still quite complete. Animal experimental results show that the Na and glucose ratio in ORS solution is appropriate, which is conducive to the absorption of Na and water. ORS contains potassium and bicarbonate, which can replenish potassium loss during diarrhea and correct acidosis.

①Prevent dehydration: Diarrhea causes a large amount of water and electrolyte loss in the body. Therefore, when the child starts to have diarrhea, he should be given enough oral fluids and continue to be fed, especially breast-fed infants and young children, to prevent dehydration. The following methods can be used:

A.ORS: This liquid is a 2/3 solution. When used to prevent dehydration, add an equal amount or half amount of water to dilute it to reduce the tension of electrolytes. After each diarrhea, children under 2 years old should take 50-100 ml; children 2-10 years old should take 100-200 ml; children over 10 years old should be given as much as they can drink, or 40-60 ml/kg can be used, and the child should be taken when diarrhea starts.

B. Rice soup plus salt solution: 500ml rice soup + 1.75g ​​fine salt or 25g fried rice noodles + 1.75g ​​fine salt + 500ml water, cook for 2-3min, dosage is 20-40ml/kg, finish in 4h, and can be taken orally at any time thereafter, give as much as the patient can drink.

C. Sugar and salt water solution: 500ml boiled water + 10g sucrose + 1.75g ​​fine salt. Usage and dosage are the same as rice soup and salt solution.

② Correct dehydration: Dehydration caused by diarrhea in children can mostly be corrected through oral rehydration therapy, while severe dehydration requires intravenous rehydration.

A. Oral rehydration: Suitable for patients with mild to moderate dehydration. Patients with severe abdominal distension, shock, heart and kidney failure and other serious complications as well as newborns are not suitable for oral rehydration. It is divided into two stages, namely, the dehydration correction stage and the maintenance treatment stage.

a. Dehydration correction stage: Use ORS to correct dehydration; replenish the accumulated loss. For mild dehydration, give 50ml/kg; for moderate dehydration, give 50-80ml/kg. Take orally in small amounts and multiple times to avoid vomiting that affects the efficacy. The required amount of liquid should be taken within 4-6 hours.

b. Maintenance treatment stage: After dehydration is corrected, ORS is diluted with an equal amount of water to replenish the continued loss. It is replenished as it is lost. It can also be calculated at 10ml/kg each time. Low-salt liquids such as boiled water, breast milk or milk should be used for physiological needs. Infants and young children have a relatively large body surface area and a high metabolic rate, so attention should be paid to replenishing physiological needs.

B. Intravenous rehydration: Intravenous rehydration is suitable for children with severe dehydration and neonatal diarrhea.

Fluid replacement on day 1: includes cumulative losses, ongoing losses and physiological needs.

a. Cumulative loss: calculated according to the degree of dehydration, 50 ml/kg for mild dehydration, 50-100 ml/kg for moderate dehydration, and 100-120 ml/kg for severe dehydration.

The ratio of electrolytes and non-electrolytes in the solution (i.e. the type of solution) is determined according to the nature of dehydration. Isotonic dehydration uses 1/2 to 2/3 sodium-containing solution, hypotonic dehydration uses 2/3 isotonic sodium-containing solution, and hypertonic dehydration uses 1/3 sodium-containing solution.

The infusion drip rate should be slightly faster, generally completed within 8 to 12 hours, about 8 to 10 ml/kg per hour.

For patients with severe dehydration and peripheral circulatory disorders, 20 ml/kg of 2:1 isotonic solution should be injected intravenously or dripped rapidly within 30 to 60 minutes to rapidly increase blood volume and improve circulation and kidney function. After dissolution, the above-mentioned different solutions can be selected according to the nature of dehydration to continue intravenous drip, but the dissolution volume needs to be deducted. For moderate dehydration without obvious peripheral circulatory disorders, dissolution expansion is not required.

b. Continuous loss and physiological needs: Oral administration is recommended for those who can take it orally. For those who cannot take it orally, who vomit frequently, and who have abdominal distension, intravenous rehydration is recommended. The physiological need is 60-80 ml/kg per day, which should be replenished with 1/5 of sodium-containing solution. The continued loss is based on the principle of "replenish as much as lost", and should be replenished with 1/2-1/3 of sodium-containing solution. The two should be combined and completed within the remaining 12-16 hours, generally about 5 ml/kg per hour.

Fluid replacement on the second day: replenish the continued loss and physiological needs. For those who can take orally, the principle is the same as preventing dehydration. For those who need intravenous fluid replacement, both the physiological needs and the continued loss (calculation method is the same as described above) are replenished evenly over 24 hours.

The above is about the Western medicine treatment methods for children with acute diarrhea. In fact, there are other methods to treat diarrhea, such as traditional Chinese medicine treatment or physical therapy. However, it should be noted that whether it is traditional Chinese medicine treatment or physical therapy, the symptoms of diarrhea are relatively mild. If the symptoms are more serious, timely hospitalization is very necessary.