DIARRHEA

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Last Updated : 12/25/2010
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Dr Sanjay Prabhu
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How do you assess a child with diarrhoea?
History
: stool frequency, quantity and type of stool
: blood in the stool
: fever
: decreased passage of urine
: vomiting - pronounced in rotaviral diarrhoea
: abdominal distension
: altered sensorium
: feeding history

Examination :
Conditionwell, alertrestless, irritablelethargic, drowsy, floppy
Eyesnormalsunkenvery sunken and dry
Tearspresentabsentabsent
Tonguemoistdryvery dry
Thirstdrinks normallythirsty, drinks eagerlyunable to drink
Skin pinchnormaldelayedvery delayed
Statusno dehydrationsome dehydrationsevere dehydration


What investigations are helpful?
Stool routine is not of much value as more than 10 leukocytes per HPF are also seen in rotaviral diarrhoea. There is no role of stool pH and reducing substances in acute diarrhoea as the lactose intolerance in this condition is self-limiting. Trophozoites of giardia and E Histolytica may be sometimes demonstrated rarely. Stool culture usually grows E coli which may be a commensal.Serum electrolytes may be needed in very dehydrated patients.



Contributor Information and Disclosures Dr Sanjay Prabhu
Consultant Pediatrician, Bhaktivedanta Hospital, Borivali, Mumbai, India


First Created : 2/21/2001
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