Every year in summer, diarrhoea hits our country. Scorching heat and rush of diarrhoeal patients in different hospital, specially in ICDDR,B is a common scenario. In ICDDR,B alone, more then 500 patients per day are coming for treatment with diarrhoea.

Diarrhoea means passage of liquid watery stool more then 3 times a day.

There are various organisms causing diarrhoea, namely - Rota virus, E. coli, Salmonella, Shigella, Entamoeba histolytica, Campylobacter jejuni, Cholera etc.

During winter season viral diarrhoea are common, but during summer, bacterial diarrhoea predominates. During this hot summer, acute bloody diarrhoea / dysentery are very common.

Dysentery is an acute inflammation of the large intestine, characterised by diarrhoea with blood and mucous in the stool. In children it is accompanied by abdominal cramp, fever, occasional dehydration and convulsion. Patients may become toxic and moribund. Most common causes of dysentery in our country is shigella, Entamoeba histolytica, salmonella, entero invasive E. coli.

Shigella infects human being only and spread is facilitated by low infecting dose. Only 10 organism may produce disease.

Spread of the disease occurs by contaminated food, fluid / drinks, flies. Unwashed or improperly washed hands after defecation are the main source of infection.

Symptoms are passage of small, frequent, mucoid bloody stool with abdominal cramp and tenesmus (condition where the patient feels he needs to pass faeces or sometimes urine, but is unable to do so and experiences pain). Fever, dehydration, weakness reactive arthritis, iritis may also occur.

Management depends on severity but as soon as diarrhoea starts, Oral Rehydration Saline (ORS) to be started. For children less then 2 years, 10- 20 tea spoonful of ORS should be given after each stool. For patients aged 2 years -10 years, 20- 40 tea spoonful of ORS to be given after each stool. Older children aged more then 10 years needs ORS as per as they want.

Normal feeding of the children to be continued along with ORS. Antimicrobial drugs are to be given 3-5 days according to doctor's advice.

For prevention:
1. wash hands with soap and running water after each defecation and before and after each meal.

2. please do not take any open food.

3. Do not take sugar cane juice or any other sharbat on the street.

4. Try to avoid salad and sweets in social invitations.

5. Safe disposal of the excreta is a must.

6. Ensure safe drinking water.

Maintain better personal hygiene of your children and keep them away from all diarrheal diseases.

The writer is an Associate Professor of Department of Pediatrics of Community Based Medical College, Mymensingh. E mail- [email protected]