Diarrhoea or Montezuma's Revenge
Diarrhoea is a common complaint that accompanies a number of different illnesses. It is usually harmless and vanishes by itself within a few days but in some cases it can be dangerous, especially for young children. It is often not easy to decide whether the symptoms and the situation enable patients to treat themselves, or whether a doctor needs to be consulted. It is a matter of asking the right questions.
Diarrhoea often occurs while travelling in distant and exotic lands, and its name is taken from the Aztec emperor Montezuma who was cheated by Europeans in the sixteenth century. Frequently it results from gastroenteritis caused by viral infections, parasites or bacterial toxins. In sanitary living conditions where there is ample food and a supply of clean water, an otherwise healthy patient usually recovers from a viral infection in a short space of time. In the undernourished or infirm, however, diarrhoea can lead to severe dehydration and can become life-threatening without treatment.
Diseases with diarrhoea remain today one of the major causes of mortality among under-fives, accounting for 1.8 million child deaths worldwide. In spite of the progress in the management of such diseases and the undeniable success of oral rehydration therapy, all attempts at improving this figure significantly have failed.
A Herald of More Serious Illness?
Diarrhoea can be a symptom of a more serious disease, such as cholera or botulism. It can also be an indicator of chronic syndromes such as Crohn's Disease, Colitis ulcerosa or severe mushroom poisoning. Although appendicitis patients do not as a rule have violent diarrhoea, it is also a common symptom of a ruptured appendix.
Conventional treatment of diarrhoea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes and glucose to provide essential salts and nutrients. For many people, further treatment is unnecessary.
The following types of diarrhoea require medical supervision: diarrhoea in infants; moderate or severe diarrhoea in young children; diarrhoea associated with blood; diarrhoea lasting more than three to four days; diarrhoea that is associated with more general illness such as non-cramping abdominal pain, fever, weight loss; diarrhoea in institutions such as hospitals, child care centres, or geriatric and convalescent homes; diarrhoea alternating with constipation can be a warning sign of severe illness; Patients with acute gastroenteritis might need help if the diarrhoea is acute, lasts several days and is accompanied by nausea and/or vomiting.
Jane Funke/Hannelore Gießen
Diesen Artikel finden Sie in DAS PTA MAGAZIN 06/2009 auf Seite 44 f. oder als PDF-Download im Kasten oben rechts.
