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This text is designed for an International readership at Dr Ashutosh Jindal’s  Website       www.healthybaccha.com While we have tried to keep the content  international in application – the prime readership is designed towards India. Hence , some phrases and ideas may be unfamiliar for some regions of the World.For clarifications please feel free to e mail Dr Jindal. Printouts may be taken but the copyright rests with the Site and misuse is prohibited. The Site owns no responsibility for any mishap occurring out of application as such or from misinterpretation of the information. You are advised to meet your local Pediatrician for endorsement of the information before application. UPDATE  # 4 :DIARRHEA: If you go through the matter on the Healthybaccha.com  – there is a fair amount on Diarrhea. However , there are some peculiar practice points I feel like sharing with you. There would perhaps not be a single family where the child would not have suffered Diarrhea. This is a condition that may pass off lightly or may get really nasty, requiring admission to a Hospital for intravenous fluids.          Bacterial v/s Viral Diarrhea: As a general thumb rule , almost all diarrheas are Viral and the commonest is Rotavirus. ‘ Viral ‘ is a word we all hear so often and we also understand it is almost always a self – limiting , time defined illness where it will run its own natural course.The poor Doctor intervenes for two reasons :          You went to him , so he had to dole out some prescription !          He gives some medicines that help make the discomfort less , like control of fever, runny nose etc. Similar is the case with viral diarrheas – they SHALL run their usual course of some 3-5 days and your reaction to the problem would be individual. There are mothers who understand the basic fundamental and are prepared to wait ( in misery , no doubt). Then there are mothers who would call up the Pediatrician at almost every stool passed and, between ourselves – we tend ( please excuse the tongue in cheek expression ) a painful / hysterical / fussy mother! These mothers suffer the risk of over-medication – a case of Pediatrician under duress.  Diarrhea has only one problem that is of medical importance – and that is the body fluid loss ( known as dehydration) . Once dehydration gets significant – hospitalization can not be avoided. But you play the key role in the whole game by ADHERING STRICTLY TO ORAL REHYDRATION SOLUTION ( ORS ). Please keep giving as much ORS or other substitutes ( as below ) as you can – you yourself can prevent hospitalization :          Skikanji = Neembu Paani  ( a solution of some sugar, some salt and some lime ) – the essential components are sugar and salt.          weak tea ( i.e. less milk )          plenty of curds or buttermilk ·         custard powder – sweetened less than usual.You may add banana to it.The cornflour in the custard powder is a good stool binding agent – banana further increases the binding capacity          banana, preferably mashed in curd – or else plain banana          If you child is fussy about not accepting ORS – try one of those lime flavoured aerated cold drinks ( like Limca , Sprite .) , pour the liquid from some height into tumbler so that the fizz escapes - add a dash of salt. Your child will love it , love your Pediatrician too ! Bacterial diarrheas have some specific features:          usually associated with fever          there might be blood mixed with stools          usually very foul smelling Here, there is no chance to be taken and your Pediatrician will happily prescribe an antibiotic.          Some More Practical Tips on Diarrhea :        please use moistened cotton to wipe his backside.Ideally , you may pour some water and then just dab the area with moistened cotton.Wet wipes are commercially available and are nice ( they burn a hole in your pocket though ) The reason behind this is that with passage of several stools , the area around the anus tends to get red. This causes two things. One, it is painful.Second, this sets up a local reflex reaction between the inflammed skin and the intestine leading to small squirts of stools.This develops into a vicious cycle : inflammation – reflex stooling – need to wipe – further inflammation. You may be helped by keeping the anal area as undisturbed as possible and NOT to use a nappy cloth to wipe the anus. There are medicated creams available – your Pediatrician may prescribe one if he feels the need.         Diarrhea commonly is associated with colicky pain in the tummy – you may ask your Pediatrician for some anti-colic medicine if you feel your child is extremely cranky.         Please keep feeding the child solids / semi solids.Try and avoid top milk.Breast milk is okay. The reason is simple.If there is nothing but water in the Intestines, there is nothing but water that he shall expel.Foods help provide a stool binding medium. There shall be more coming from us soon – till then good luck and happy parenting. Dr Jindal and team Healthybaccha.com

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