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Bachcho me acute diarrhea me kya de treatment

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acute diarrhea children

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WHO children diarrhoea oral rehydration zinc treatment guideline

Bachchon me acute diarrhea ka main treatment dehydration ko rokna hai:
  1. ORS
    • WHO-ORS packet ko packet par likhe hue sahi paani ki quantity me hi gholein.
    • Har loose stool ke baad:
      • <2 saal: 50-100 mL, yani ¼-½ cup
      • 2-10 saal: 100-200 mL, yani ½-1 cup
      • Bada bachcha: jitna pee sake
    • Ulti ho to 5-10 min rukkar, 1-1 chammach har 1-2 min dein. Breastfeeding band na karein.
  2. Zinc
    • 6 mahine se chhota: 10 mg roz
    • 6 mahine ya zyada: 20 mg roz
    • Aam taur par 10-14 din diya jata hai. Zinc diarrhea ki duration aur severity kam karta hai. WHO guidance
  3. Khana jari rakhein
    • Maa ka doodh zyada baar dein.
    • Halka normal ghar ka khana: khichdi, chawal-dal, dahi, banana, aloo, roti etc.
    • Sirf paani, juice, cold drinks, packaged sugary drinks ya soda na dein, in se loose motions badh sakte hain.
  4. Kya na dein
    • Loperamide / Imodium, diphenoxylate jaise loose-motion rokne wale medicines bachchon ko na dein.
    • Antibiotic routine watery diarrhea me nahi hoti. Doctor tab dete hain jab dysentery, cholera, ya specific bacterial infection ka shak ho. Pediatric emergency text ke mutabik antimotility drugs young children me harmful ho sakti hain.
Turant doctor / emergency le jayein agar:
  • Bachcha bahut sust, behosh-sa, ya pani na pee pa raha ho
  • Baar-baar ulti aur ORS na ruk raha ho
  • Peshab bahut kam, aankhen dhansi hui, muh sookha, aansu na aana
  • Stool me khoon, tez bukhar, severe pet dard
  • 6 mahine se chhota baby
  • Diarrhea 3 din se zyada rahe ya dehydration lage
Mild-moderate dehydration me ORS ghar par bahut effective hota hai, lekin severe dehydration, shock, marked lethargy ya fluids na pee pane par IV fluids ki zarurat ho sakti hai. WHO/UNICEF bhi ORS, zinc aur continued feeding ko standard treatment mante hain.

Acute diarrhea me antibiotic kab deni chahiye?

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acute infectious diarrhea children antibiotics guideline

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WHO IMCI child diarrhoea antibiotic bloody diarrhea cholera guideline

Bachchon ke acute diarrhea me routine antibiotic nahi deni chahiye. Zyada tar cases viral hote hain aur ORS + zinc + feeding se theek hote hain.
Antibiotic doctor ki salah se dene ki situations:
  1. Stool me khoon/mucus ho, saath me bukhar ya pet me mरोड़ ho
    • Isse dysentery, khas kar Shigella, ka shak hota hai. Isme evaluation aur appropriate antibiotic lag sakti hai. WHO IMCI me bloody diarrhea ke liye Shigella-effective antibiotic recommend hai. WHO IMCI guidance
  2. Suspected cholera
    • Bahut zyada “rice-water” watery stool, severe dehydration, ya cholera outbreak/travel exposure. ORS/IV fluid sabse pehle hota hai; antibiotic selected cases me illness aur stool loss kam karne ke liye di jati hai.
  3. Typhoid ya systemic bacterial infection ka shak
    • High/persistent fever, toxic/sick-looking child, blood culture ya clinical assessment ke basis par.
  4. Severe/prolonged traveler’s diarrhea
    • High-risk area se travel ke baad severe ya persistent diarrhea me doctor antibiotic consider kar sakte hain.
  5. Specific diagnosed infection
    • Stool test ya clinical picture se amoebiasis, giardiasis, C. difficile, etc. confirm/suspect ho to organism-specific dawa di jati hai. Har persistent diarrhea me antibiotic nahi hoti.
  6. High-risk child
    • Severe malnutrition, immunodeficiency, very young infant, ya serious underlying illness me pediatrician ka assessment jaldi hona chahiye.
Important caution:
Khooni diarrhea me bhi ghar se antibiotic shuru na karein. Kuch E. coli infections, especially STEC, me antibiotic se HUS naam ki kidney/blood complication ka risk badh sakta hai. Isliye stool culture/testing aur local resistance pattern ke hisab se pediatrician treatment choose kare.
Antibiotic usually nahi chahiye: simple watery diarrhea, halka fever, vomiting ke saath viral gastroenteritis, aur 1-3 din ka uncomplicated loose motion. WHO ke mutabik antimicrobials ko bloody diarrhea aur severe cholera jaise selected cases tak hi simit rakhna chahiye. WHO diarrhea manual
Agar bachcha sust ho, pee na raha ho, urine kam ho, baar-baar vomit ho, severe dehydration ho, ya stool me khoon ho, same day doctor ko dikhayein.

Lopramide de sakte h kya

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loperamide acute diarrhea children

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FDA loperamide children acute diarrhea contraindicated age 2 official label

Bachchon me acute diarrhea ke liye loperamide (Lopramide/Imodium) routine me nahi dena chahiye, khas kar bina pediatrician ki salah ke.
  • 2 saal se chhote bachche: bilkul nahi. Isse saans ki problem, behoshi, paralytic ileus, aur heart-related toxicity ho sakti hai.
  • Kisi bhi age me na dein agar stool me khoon/mucus, high fever, pet phoolna, severe pet dard, suspected bacterial dysentery, ya antibiotic ke baad diarrhea ho.
  • Ye infection ko bahar nikalne se rok sakta hai aur bacterial diarrhea ko worse/prolong kar sakta hai.
Kuch labels me 2 saal se bade bachchon ke liye indication diya hua hai, lekin pediatric acute gastroenteritis me standard management ORS + zinc + continued feeding hai, loperamide nahi. FDA/DailyMed warning
Bachcha sust ho, pani na pee raha ho, urine kam ho, baar-baar vomiting ho, ya khoon wala stool ho to aaj hi doctor ko dikhayein.
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