DIARRHEA

A. Background
The biggest concern related to the poor water access and high contamination
risk is water borne diseases such as diarrhoea. It was found that 88% of the
diarrhoea mortality among children in the world can be attributed to lack of safe
drinking water, good sanitation and hygiene practices. Given the poor availability
of water and sanitation in Indonesia, it comes as no surprise that diarrhoea stills
remains a major health concern in the country. Diarrhoea is the major cause of
31% of post neonatal mortality and of 25% of child mortality in Indonesia.
The scope of diarrhea is systemic disease. The diarrhea including
pathogenic disease type, non-communicable disesase, and foodborne disease.

B. The Organ infected

Diarrhea occurs because more fluid passes through the large intestine
(colon) than that organ can absorb. As a rule, the colon can absorb several times
more fluid than is required on a daily basis. However, when this reserve capacity
is overwhelmed, diarrhea occurs.
The fucntions of large intestine are to absorb water and mineral that cannot
absorb by small intestine. So, if the large intestine (colon) that cannot doing the
fuctions normally, many problem will be occur such as diarrhea. Usually, the
colon will absorb the water from the feses, but the water is not absorb correctly,
so the bowel throught out of the body in liquid form.

C. Definition
Diarrhea is when you have frequent loose watery bowel motions. In most
cases, the symptoms resolve on their own within a couple of days without the
need for medical treatment. Diarrhoea that lasts one or two days and goes away on
its own is known as acute diarrhoea, which is a common condition that affects
people of all ages. Diarrhoea lasting four weeks or more (whether continuous or
intermittent) is known as chronic diarrhoea, and can be a symptom of an
underlying chronic disease or condition.

D. Causes
Acute diarrhoea is usually caused by a bacterial (eg, salmonella), viral (eg,
norovirus or rotavirus), or parasitic (eg, giardia) infection of the bowels.
Diarrhoea caused by any of these infections is referred to as gastroenteritis.
The most common causes of chronic diarrhoea are underlying diseases or
conditions, including:
1. Gluten intolerance (e.g. coeliac disease )
2. Lactose intolerance (dairy intolerance)
3. Irritable bowel syndrome
 4. Chronic bowel infection
5. Inflammatory bowel diseases, such as Crohns disease and ulcerative colitis
6. Bowel cancer
You should see your doctor if you are concerned that you might have any of
these conditions.
Chronic diarrhoea can also occur when taking certain medications, e.g.
some antibiotics and cancer drugs.

E. Signs & Symptoms

The main symptom of diarrhoea is loose, watery bowel motions (stools,
faeces) three or more times a day.
Accompanying signs and symptoms may include:
1. Urgent need to go to the toilet
2. Abdominal pain and cramping
3. Change in colour of your stools
4. Mucous, pus, blood, or fat in your stools
5. Vomiting
6. General body weakness and tiredness

F. Treatment
Because most cases of diarrhoea resolve on their own within a day or two,
self-care to relieve symptoms is usually sufficient for treatment:
1. Avoid caffeine, dairy products, and greasy, high fibre, or sugary foods
2. Placing a hot water bottle or wheat pack on your stomach, or taking
paracetamol (e.g. Panadol), may provide some relief from abdominal cramps
3. Apply zinc and castor oil ointment or a barrier cream to affected areas if you,
or your child, develops a rash (like nappy rash) from the diarrhoea
4. Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as
aspirin, ibuprofen, or diclofenac, for pain relief as these medications can
cause diarrhoea
5. Anti-diarrhoeal medications that slow diarrhoea (e.g. Imodium) should be
avoided as these drugs prevent your body from getting rid of the bacteria or
virus that may have caused the diarrhoea
To avoid dehydration, drink plenty of liquid every day, taking small, frequent
sips. Ideal liquids are clear thin broths or soups, diluted non-caffeinated sports
drinks (e.g. Powerade or Gatorade), and rehydration formulations (e.g. Gastrolyte)
that are available without prescription from a pharmacy.
G. Prevention
1. Always put foods that could spoil in the fridge
2. Ensure that meat is cooked thoroughly
3. Avoid eating raw meats, fish, and shellfish unless you are sure that they have
been freshly prepared and are from a reliable source
4. Never place cooked meet on surfaces or plates that have held raw meat
5. Disinfect bench tops, stove tops, and chopping boards with a diluted bleach
solution.

H. References
1. Topic article: Diarrhoea-causes, treatment, prevention. Taken from
https://www.southerncross.co.nz/group/medical-library/diarrhoea-causes-
treatment-prevention. Access on 5 jan, 2017
2. Journal by: Jong, Eelke de, Ahmad Komarulzaman & Jeroen Smits. 2014.
Clean Water, Sanitation and Diarrhoea in Indonesia: Effects of household
and community factors.