First Aid for Diarrhoea – a common problem after Pakistan Floods

Monday, September 13, 2010

As the worst ever floods of human history have ravaged Pakistan, Diarrhoea is emerging the most common problem of the flood victims. Out of every 10 patients, 4 presented to me with Diarrhoea, 4 with viral conjunctivitis, 1 with a skin infection & 1 with other problems in the recent field camps. So,

What is Diarrhoea?
It is the increased water content & frequency of stools, as a result of which body becomes deprived of water & electrolytes.

How it is caused?
The most common cause of Diarrhoea, esp., in the flood victims is Gastroenteritis ( infection of the gut ) which occurs after taking in contaminated food & water. The reasons for contaminated diet are,
  1. Mixing of drinking water with sewerage.
  2. Lack of washing of hands before eating.
  3. Utensils washed with dirty water.
  4. Lack of proper cooking of food.
  5. Pests, like flies not prevented from sitting on the food.
  6. Food & water left in the open.
What are the accompanying symptoms?
Fever, abdominal pain & vomiting are the usual accompanying symptoms.

How to assess the patient?
Looking at the tongue gives one a rough estimate about the water content of the body.

If the tongue is wet, then home management is enough.

If the tongue appears to be dry plus there is severe weakness, then patient should be immediately taken to hospital for intravenous fluids.

What is the home management?
The diarrhoea caused by gastroenteritis is usually self limiting & improves by itself in 2-3 days. As a result, home management involves correcting the underlying water & electrolyte deficiency of the body.

Oral re-hydration salt ( ORS ) is commonly used for this purpose. It contains glucose, sodium, potassium & chloride. It is prepared by mixing a single sachet of ORS in 1 liter of boiled water. Once solution is prepared, it should be consumed within 24 hrs. Taking 1-2 sachets of ORS mostly does the job. This should be accompanied by light diet in the next few days.

I still remember one my Professors of Medicine calling ORS, to be one of the greatest inventions, in health industry.

How it is prevented?
Basic hygiene is the most effective solution to the problem. This involves washing hands before ingesting, drinking boiled water, avoiding salads, peeling own fruit and consuming freshly prepared & properly cooked food.