For diarrhea, drink oral rehydration salts first; do not give anti-diarrhea drugs to a child under 5
Grade AMedium benefitLifespanLow costLittle timeNo willpower
What matters most in diarrhea is replacing water, not stopping the diarrhea. Mix oral rehydration salts with water the way the leaflet says, and drink that. Do not use fruit juice or a soft drink instead. They are too sweet, and that makes a person even shorter of water. Do not give a child under 5 an anti-diarrhea drug such as loperamide. A severe case can block the bowel, and that can kill.
- Benefit
- The diarrhea-treatment manual of the World Health Organization (WHO) states that "anti-diarrhea" drugs and anti-vomiting drugs have no real benefit for acute or prolonged diarrhea in children. They cannot prevent dehydration, and they cannot improve nutrition. The Chinese edition of the manual says, in its own words, that some drugs have dangerous and sometimes fatal side effects, and that these drugs must never be used in children under 5. Drugs such as loperamide, which slow the movement of the bowel, can cause severe paralytic obstruction of the bowel. That can kill, and it can also drag the infection out. The manual also states that drinks with too much sugar, such as soft drinks and fruit drinks sold in shops, pull water from the body into the intestine and cause hypernatremic dehydration (dehydration in which the blood sodium is too high). What the WHO manual recommends is a reduced-osmolarity formula, with a total osmolarity of 245 mOsm/L (milliosmoles per liter). Compared with the older formula, it cut unplanned intravenous fluids by 33%. A Cochrane review pooled 8 trials and found a similar result (OR 0.59, 95% CI 0.45–0.79, about 40% less).
- Notes
- When you buy it, check the osmolarity on the leaflet and choose the reduced-osmolarity formula. The manual states that blood in a child's stool is usually bacterial dysentery. See a doctor for antibiotics. Do not only replace water at home. The benefit is rated moderate, as a judgment: the figures in hand compare the rehydration formulas with each other, not drinking against not drinking.
Sources · 1
- World Health Organization (2005). The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th revision. iris.who.int/handle/10665/43209（中文版《腹泻治疗：医生和高年资卫生工作者使用手册》第 2.6 节，同一页面下载）；Hahn S, Kim S, Garner P (2002). Reduced osmolarity oral rehydration solution for treating dehydration caused by acute diarrhoea in children. Cochrane Database of Systematic Reviews, (1):CD002847. doi.org/10.1002/14651858.CD002847