DIARRHEA

A. DEFINITION OF ILL
Diarrhea is an increase in the frequency of bowel movements or a decrease in the form of
stool (greater looseness of stool). Although changes in frequency of bowel movements and
looseness of stools can vary independently of each other, changes often occur in both.

B. SYMPTOMS

C. CAUSES
1. Viral Gastroenteritis
Viral gastroenteritis is the most common cause of acute diarrhea worldwide. Symptoms
of viral gastroenteritis typically last only 48-72 hours. Unlike bacterial enterocolitis, patients
with viral gastroenteritis usually do not have blood or pus in their stools and have little if any
fever.
Viral gastroenteritis can occur in a sporadic form (in a single individual) or in an
epidemic form (among groups or individuals). Sporadic diarrhea probably is caused by several
different viruses and is believed to be spread by person-to-person contact. The most common
cause of epidemic diarrhea (for example, on cruise ships is infection with family of viruses
known as caliciviruses. This viruses are transmitted by food that is contaminated by sick food-
handlers or by person-to-person contact.

2. Food Poisoning
Food poisoning is a brief illness that is caused by toxins produced by bacteria. The toxins
cause abdominal pain (cramps) and vomiting and also cause the small intestine to secrete large
amounts of water that leads to diarrhea. The symptoms of food poisoning usually last less than
24 hours. With some bacteria, the toxins are produced in the food before it is eaten, while with
other bacteria, the toxins are produced in the intestine after the food is eaten.
Symptoms usually appear within several hours when food poisoning is caused by toxins
that are formed in the food before it is eaten. It takes longer for symptoms to develop when the
toxins are formed in the intestine. Therefore, in the latter case, symptoms usually appear after 7-
15 hours.

3. Traveler’s Diarrhea
Most of the E. coli bacteria are normal inhabitants of the small intestine and colon and
are non-pathogenic, meaning they do not cause disease in the intestines. Nevertheless, these non-
pathogenic e. coli can cause diseases if they spreadoutside the intestines, for example, into the
urinary tract (where they cause bladder or kidney infections) or into the blood stream.
Certain strains of E. coli, however, are pathogenic 9meaning they can cause disease in the
small intestine and colon). These pathogenic strains of E. coli cause diarrhea

4. Bacterial Enterocolitis

Disease-causing bacteria usually invade the small intestines and colon and cause enterocolitis
(inflammation of the small intestine and colon). Bacterial enterocolitis is characterized by signs
of inflammation (blood or pus in the stool, fever) and abdominal pain and diarrhea.
Campylobacter jejuni is the most common bacterium that causes acute enterocolitis in the U.S.
Other bacteria that cause enterocolitis include Shigella, Salmonella, and EPEC. These bacteria
usually are acquired by drinking contaminated water or eating contaminated foods such as
vegetables, poultry, and dairy products.

Enterocolitis caused by the bacterium Clostridium difficile is unusual because it often is caused
by antibiotic treatment. Clostridium difficile is also the most common nosocomial infection
(infection acquired while in the hospital) to cause diarrhea. Unfortunately, infection also is
increasing among individuals who have neither taken antibiotics or been in the hospital.

E. coli O157:H7 is a strain of E. coli that produces a toxin that causes hemorrhagic enterocolitis
(enterocolitis with bleeding). There was a famous outbreak of hemorrhagic enterocolitis in the
U.S. traced to contaminated ground beef in hamburgers (hence it is also called hamburger
colitis). Approximately 5% of patients infected with E. coli O157:H7, particularly children, can
develop hemolytic uremic syndrome (HUS), a syndrome that can lead to kidney failure . Some
evidence suggests that prolonged use of anti-diarrhea agents or use of antibiotics may increase
the chance of developing HUS.

Parasites

Parasitic infections are not common causes of diarrhea in the U. S. Infection with Giardia
lamblia occurs among individuals who hike in the mountains or travel abroad and is transmitted
by contaminated drinking water. Infection with Giardia usually is not associated with
inflammation; there is no blood or pus in the stool and little fever. Infection with amoeba
(amoebic dysentery) usually occurs during travel abroad to undeveloped countries and is
associated with signs of inflammation--blood or pus in the stool and fever.

Cryptosporidium is a diarrhea-producing parasite that is spread by contaminated water because it

can survive chlorination. Cyclospora is a diarrhea-producing parasite that has been associated
with contaminated raspberries from Guatemala.

Drugs

Drug-induced diarrhea is very common because many drugs cause diarrhea. The clue to drug-
induced diarrhea is that the diarrhea begins soon after treatment with the drug is begun. The
medications that most frequently cause diarrhea are antacids and nutritional supplements that
contain magnesium. Other classes of medication that cause diarrhea include:

• nonsteroidal anti-inflammatory drugs (NSAIDs),

• chemotherapy medications,

• antibiotics,

• medications to control irregular heartbeats (antiarrhythmics), and

• medications for high blood pressure.

D. EFFECTS

• One of the major side effects of diarrhea is dehydration. With the frequent passing of
watery stools, the body loses excessive fluids and minerals that lead to dehydration. The
functions of human body systems can also be affected, as too much loss of body fluid
takes place due to over-excretion. So, in case you are suffering from diarrhea, drink lots
of water or clear liquids to replenish the body fluids.
• Some other commonly noticed side effects of diarrhea are thirst and dry mouth. Moderate
or severe abdominal pain or tenderness can also be commonly seen in case of diarrhea.
• Severe diarrhea can lead to heart complications in some cases. To prevent further
problems, it is better to consult physician.
• Diarrhea can also result in nausea and vomiting in some cases.
• If not treated immediately, diarrhea can lead to severe complications like affected brain
function in infants and young children. Infants are more prone to become severely
dehydrated and thus, suffer from such problems.
• Diarrhea itself is a common side effect of certain drugs and medicines. in such a case, the
effectiveness of the drugs and medicines gets lessened, once the diarrhea sets in.
• A person can faint upon standing, due to orthostatic hypotension. This occurs due to
reduction in the volume of blood, which causes a drop in blood pressure upon standing.
• The body loses electrolytes along with water, in cases of prolonged diarrhea. This can
lead to deficiency of minerals, especially sodium and potassium.
• A person suffering from diarrhea can notice abnormalities of chloride and bicarbonate
also.
• One can observe irritation of the anus due to frequent passage of watery stools, when
diarrhea sets in.
• Prolonged and severe diarrhea can lead to kidney failure, diminished urine output, shock
and acidosis (too much of acid in the blood).
• Diarrhea can lead to coma as well, when it is not promptly treated and becomes too
severe.
• In case of pregnant women, acute diarrhea can adversely affect the health of the fetus.

E. PREVENTION
General Diarrhea Prevention

1. Wash hands often: always after using the restroom and before you eat.

2. Immediately refrigerate foods. Do not leave food out at room temperature.

3. Do not eat cooked foods that have sat out and no longer hot.

4. Dairy products should be pasteurized.

Travelers Diarrhea Prevention

If traveling to underdeveloped areas, then avoid tap water and choose foods
carefully.

1. Drink bottled water or canned drinks, or hot drinks made from boiled water.

2. Avoid: ice, diary products, undercooked meat, fish and shellfish, salads, and
uncooked vegetables and fruit that cannot be peeled.

3. Avoid swimming in contaminated pools, lakes, and rivers.

4. Brush teeth with bottled water.

F. CURE
1. Medical Cure

Absorbents. Absorbents are compounds that absorb water. Absorbents that are taken orally bind
water in the small intestine and colon and make diarrheal stools less watery. They also may bind
toxic chemicals produced by bacteria that cause the small intestine to secrete fluid; however, the
importance of toxin binding in reducing diarrhea is unclear.

The two main absorbents are attapulgite and polycarbophil, and they are both available without
prescriptions.

Bismuth compounds. Many bismuth-containing preparations are available around

the world. Bismuth subsalicylate (Pepto-Bismol) is available in the United States. It
contains two potentially active ingredients, bismuth and salicylate (aspirin). It is not
clear how effective bismuth compounds are, except in traveler's diarrhea and the
treatment of H. pylori infection of the stomach where they have been shown to be
effective. It also is not clear how bismuth subsalicylate might work. It is thought to
have some antibiotic-like properties that affect bacteria that cause diarrhea. The
salicylate is anti-inflammatory and could reduce secretion of water by reducing
inflammation. Bismuth also might directly reduce the secretion of water by the
intestine.

2. Herbal cure

The most common herbal remedies for diarrhea are described below. They can be used as teas
unless otherwise noted. Make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10
minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.

Astringent herbs:

• Astringent herbs, such as blackberry leaf (Rubus fruticosus) or raspberry leaf (Rubus
idaeus), help "dry up" the mucous membranes in the intestine. Make a tea with 1 heaping
tsp. per cup. Drink a ½ cup per hour.
• Carob powder (Ceratonia siliqua), which is rich in fiber, may be taken at the rate of 1.5 g
per 2.2 pounds or 1 kg of body weight. Dissolve powder into a hydrating solution such as
Pedialyte.
• Extract of bilberry (Vaccinum myrtillus) also has astringent properties (4 g, spread over
several doses). Do not take bilberry if you take anticoagulants (blood thinners).
• Agrimony (Agrimonia eupatorium) is a traditional remedy for diarrhea. Usual dosage is 3
g (about 1/2 tsp.) per day. Agrimony can have a blood thinning effect and can lower
blood pressure; speak with your physician if you are dealing with these health issues.

Inflammation reducers:

• Quercetin (250 - 500 mg 2 - 4 times per day), a plant based flavonoid, may help to reduce
inflammation.
• Chamomile (Matricaria recutita) is usually taken as a tea. Dissolve 3 - 4 g powder (about
3 tsp.) in 1 cup hot water, strain and cool. Drink 3 times per day.
• Marshmallow root (Althea officinalis) can be taken as cold-water tea. Soak 2 tbs. root in
1 quart of water overnight. Strain. Drink throughout the day.
• Slippery elm powder (Ulmus fulva) or marshmallow root powder (Althaea officinalis) can
be soothing to the intestines. Use 1 oz. powder to 1 quart of water. Make a paste with the
powder and a small amount of water. Gradually add in the rest of the water and then
simmer down to 1 pint. Take 1 tsp. every 30 - 60 minutes.
Since I’ve known you babe
You brought a light for me
The taste of your sincerely
Build me a world to believe

But still there’s a doubt

In you for lovin’ me
Know deep down inside
You see what’s in me

Reff :
Be my lady, be the one
And good things will come to our heart
You’re my lady, you’re my one
Give me chance to show you love

Kau boleh menyentuh jarinya

Kau boleh mencium bibirnya

Hatiku tlah mati rasa

Meskipun kau lebih dan lebih
Lanjutkanlah
Kini ku tak mau tau
Ambil dia
Aku siap sakit hati

Kau bebas sebebas maumu

Anggaplah aku tak melihat
Hatiku tlah mati rasa
Meskipun kau lebih dan lebih
Lanjutkanlah
Kini ku tak mau tau
Ambil dia
Aku siap sakit hati

Aku siap sakit hati

Kini ku tak mau tau
Ambil dia
Aku siap sakit hati
Lanjutkanlah
Kini ku tak mau tau
Ambil dia
Aku siap sakit hati