What is Diarrhea?

According to WHO definition, diarrhea is defecating with the flabby till watery consistency more than 3x within 24 hours. But this definition is not applicable for new babies. They can defecate till 10 times a day and it is fine. There is also an exception for them that exclusively breastfed. It is called a diarrhea if its frequency more than 6x within 24 hours.

Classification of Diarrhea

Based on the length of occurrence, diarrhea is differentiated to 2 kinds:

1. Acute diarrhea that is diarrhea which has sudden onset and persists for several hours until 14 days (in babies and children), or 21 days (for adults). The main cause is infection. Other causes are toxin, drug, chemotherapy, and any other condition.

2. Chronic diarrhea, lasts more than 3 week ( in adult) or more than 2 week (in babies and children). Its cause varies. It can be caused by infection, for example from acute diarrhea which is not treated well, digestion trouble (malabsorption), and lactose intolerance.

The Cause and Mechanism of Diarrhea

Diarrhea is not an incoming disease by itself. Usually there is a trigger before it happens. Exposure to unpurified water may result in infection. Ingestion of improperly stored or prepared food may cause food poisoning.

In general, the following are some etiology of diarrhea, they are:

1. Infection by bacterium, virus or parasite.

2. Other infection by bacterium or virus accompanying other disease like: measles, ear infection, pharynx infection, malaria, etc.

3. Allergy to certain drug or food.

4. Artificial sweetener.

Based on metaanalyses throughout the world, every child experiences diarrhea at least once every year. From every five children come with diarrhea complaint, one of them is caused by rotavirus. And one out of sixty who is taken care in hospital is also caused by rotavirus.

The germs causing diarrhea bother the process of food absorption in small intestine. Then, the food is not digested and immediately moved into large intestine.

If there is food which is not digested and is not permeated stays in large intestine, the intestine will draw the water from intestine wall. Besides, in this situation the transit process in the colon becomes so brief so the water is not absorbed by large intestine. This is why the consistency of the stool is flabbier or even watery.

In fact large intestine do not only release the water redundantly but also electrolytes. This losing of water and electrolytes will later causes dehydration. Dehydration may endanger the life of diarrhea patient.

Besides because of rotavirus, diarrhea also can be happened as the effect of malnutrition, allergic reaction, lactose intolerance, and etc. Many babies have lactose intolerance because their bodies have no or only a few of the functioning lactase enzyme. This enzyme digests the lactose, the main simple sugar in cow milk.

It is different with the babies which is breastfed. The babies will not experience lactose intolerance because breast milk has its own lactase. Besides, breast milk hygiene is well guaranteed because it can be directly given, no need of glasses or bottles.

Diarrhea can be a side effect of medicine, for example antibiotic. Besides, artificial sweetener (like sorbitol ad mannitol) in chewing gum and free sugar product may also generate diarrhea.

Parents play important role in determining cause of child diarrhea. Baby which is breastfed exclusively generally seldom has diarrhea because there is no contamination from outside. But, formulated milk and baby food may be contaminated by bacteria and viruses.

Diarrhea Symptoms

Symptom of diarrhea is watery feces with the frequency 4 x or more in one day, sometimes accompanied with vomiting, fatigue, fever, anorexia, bloody and mucous stool.

Feel queasy and vomit can precede the diarrhea caused by viral infection. The typical symptom of viral diarrhea is watery and foamy stool, no blood or mucus, and acid smells. If the stool is bloody, it may be caused by bacterium or parasite. Other symptoms can be experienced are stomachache and stomach spastic, fever, pain in bone or muscle, and headache.

Diarrhea may lead to loss of water and electrolytes (for example sodium and potassium). Baby becomes irritable. Mild dehydration is signed by dry lips and skin. If a baby cries it is still having tears. Urination become seldom. If the dehydration is severe, the baby cries without tears, or even cannot cry anymore. Severe dehydration may cause arrhythmia (trouble of heart rhythm), and lead to shock and death.