ACUTE CHILDHOOD DIARRHEA: A REVIEW OF RECENT ADVANCES IN THE STANDARD MANAGEMENT
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Seema Alam, Rajeev Khanna, Uzma Firdaus
Pediatric Gastroenterology Section, Department of Pediatrics, JNMC, AMU, Aligarh.
Corresponding Author: Dr Seema Alam, Reader, Department of Pediatrics, JN Medical College, AMU, Aligarh, UP. Email: email@example.com
No investigations are routinely required in in acute diarrhea. Majority of the cases need no investigations. In a small proportion the following may require investigations.
Standard Management of Acute Childhood Diarrhea :
WHO-ORS, feeding and zinc supplementation remain the standard management of all acute childhood diarrhea. The treatment protocols (Fig 1 & 2) have been developed at our centre as per the hydration and nutrition status of the child. Depending upon the hydration status the children are put under Plans A, B or C. If the child has severe malnutrition (Weight for age <60% and Weight for height <70 %) then intravenous systemic antibiotics are started at admission and the fluid replacement is done slowly under close monitoring to avoid fluid overload Protocol based standardized management of severely malnourished patients with diarrhea decreases the mortality by 47% 5 . For those with moderate malnutrition and children below 4 months 6 close watch should be kept for sepsis. It has been seen that in neonatal diarrhea metabolic acidosis may be the commonest cause for lethargy or refusal to feeds 7
FIG 1: Treatment Protocol for management of acute childhood diarrhea.
* Antibiotics as per recommendations for those with bloody diarrhea and cholera *
FIG 2: Treatment Protocol for management of acute childhood diarrhea in severely malnourished children
*Antibiotics as per recommendations for those with bloody diarrhea and cholera.
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