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  • Acute Diarrheal Disease
  • Diagnosis of Acute Diarrheal Disease

Diagnosis of Acute Diarrheal Disease

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Prompt & adequate
Replacement of water & electrolytes is very important. It may be given orally or Intravenously.

Clinical Management
Early treatment, in most cases by oral rehydration therapy, can reduce the case fatality of cholera to less than 1%. If treatment is delayed or inadequate, death from dehydration and circulatory collapse may follow rapidly.

A. Oral Rehydration Therapy
For mild cases Oral Rehydration Salt is recommended
  • Recommended ORS solution – WHO formula
  • Compostion of ORS (net weight = 27.9gm).
ORS is available in powder form, in following composition which is recommended by WHO. The powder is to be dissolved in one litre of water & given orally as per schedule given in table:
Sr no Ingredient Weight (gm)
1 Sodium Chloride IP 3.5
2 Potassium Chloride IP 1.5
3 Sodium citrate IP 2.9
4 Glucose anhydrous IP 20.0

ORS packets are available at all subcentres, PHCs and other hospitals. Depot holders are established at villages & Padas in Tribal area.

The age–wise requirement of ORS is as follows
The ORS schedule is of 4 hours
Age Dose
0–6 months 250 ml(1/4 litre)
6 months to 1 year 500 ml(1/2 litre)
1 year to 2 year 750 ml(3/4 litre)
2 years to 5 years 1 litre
5 years to 15 years 1 to 2 litres
Above 15 years 2 to 4 litres

If the patient is thirsty and wants to drink more, allow to drink.

After rehydration has been achieved, continue giving ORS solution for replacement of ongoing losses. Plain water and home available fluids can be taken.

Signs of dehydration are to be checked until they subsides.

Introduction of ORS has reduced cost of treatment & is very effective way to reduce morbidity & mortality due to dehydration. Development of Oral rehydration therapy is a major breakthrough in the fight against cholera and other diarrhoeal diseases.

B. Intravenous Therapy
For sever cases of cholera I.V. infusion of fluid & electrolyte is required.
Age wise requirement of I.V. Infusion.

Age Group Quantity required Frequency (Timing)
Infants 30 ml/kg body weight
70 ml/kg body weight
1st hour
Next five hours
Older Children/Adults 30 ml /kg body weight
70 ml/kg body weight
1st 30 min
next 2 & half hours

Recommended Fluid Therapy
  • Preferred: Ringer lactate solution.
  • Suitable: Normal Saline (does not correct base acodosis and potassium losses).
  • Unsuitable: Plain glucose (dextrose) solution.
Antibiotic Therapy
Antibiotics are to be given as soon as vomiting has stopped – which is usually 3–4 hours of oral rehydration.
The drug of choice for treatment is

Antibiotic Children Adults Preferred to
Doxycycline (once) – 300 mg Adult
Tetracycline (4 times a day for 3 days) 12.5 mg/kg 500 mg Adult
Trimethroprim (TMP)Sulfamethoxazole (SMX) twice a day for 3 days TMP 5 mg/kg SMX 25 mg/kg TMP 160 mg SMX 800 mg Children
Furazoludine 4 times a day for 3 days 1.25 mg/kg 100 mg Pregnant woman

Injectable antibiotics have no special advantageous.

No other medications, antispasmotics antidiarrhoeal cardiolotrics are required. If diarrhoea persists after 48 hours of treatment resistance to antibiotics should be suspected & antibiotics are to be prescribed accordingly.

Maintenance therapy
After the initial fluid and electrolyte deficit has been corrected. Oral fluid should be used for maintenance therapy. In adults and older children, thirst is an adequate guide for fluid needs. The Oral fluid intake should equal the rate of continuing stool loss.

Incubation Period
Incubation period varies from a few hours to 5 days, usually 2–3 days
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Acute Diarrheal Disease

  • Oral Rehydration Therapy
  • Diagnosis of Acute Diarrheal Disease
  • Mode of Transmission for Acute Diarrheal Disease
  • Who is Commonly Affected by Acute Diarrheal Disease?
  • Causes of Acute Diarrheal Disease

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