Where There Is No Doctor 2011 157
Special treatment in different cases of diarrhea:
While most cases of diarrhea are best treated by giving plenty of liquids and
food, and no medicine, sometimes special treatment is needed.
In considering treatment, keep in mind that some cases of diarrhea, especially
in small children, are caused by infections outside the gut. Always check
for infections of the ears, the throat, and the urinary system. If found, these
infections should be treated. Also look for signs of measles.
If the child has mild diarrhea together with signs of a cold, the diarrhea is
probably caused by a virus, or ‘intestinal flu’, and no special treatment is called for.
Give lots of liquids and all the food the child will accept.
In certain difficult cases of diarrhea, analysis of the stools or other tests may be
needed to know how to treat it correctly. But usually you can learn enough from
asking specific questions, seeing the stools, and looking for certain signs Here are
some guidelines for treatment according to signs.
1. Sudden, mild diarrhea. No fever. (Upset stomach? ‘Intestinal flu’?)
♦ Drink lots of liquids. Usually no special treatment is needed. It is usually
best not to use ‘diarrhea plug’ medicines such as kaolin with pectin
(Kaopectate, p. 383) or diphenoxylate (Lomotil). They are never necessary
and do not help either to correct dehydration or get rid of infection so why
waste money buying them? Never give them to persons who are very ill, or
to small children.
2. Diarrhea with vomiting. (Many causes)
♦ If a person with diarrhea is also vomiting, the danger
of dehydration is greater, especially in small children.
It is very important to give the Rehydration Drink
(p. 152), tea, soup, or whatever liquids he will take.
Keep giving the Drink, even if the person vomits it
out again. Some will stay inside. Give sips every 5 to
10 minutes.
♦ If you cannot control the vomiting or if the
dehydration gets worse, seek medical help fast.
3. Diarrhea with mucus and blood. Often chronic. No fever. There may be
diarrhea some days and constipation other days. (Possibly amebic dysentery.
For more details, see page 144.)
♦ Use metronidazole (p. 368). Take the medicine according to the
recommended dose. If the diarrhea continues after treatment, seek
medical advice.