Interview with Dr. Komlavi Gonçalves, General Practitioner, on diarrhea in children

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Extract from the article: Diarrhea is a common problem in children. However, this does not mean it should be trivialized. It causes severe dehydration, which can be very dangerous. Thousands of children under the age of 5 are hospitalized each year in Togo for cases of diarr

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« Diarrhea in children can be dangerous. We must take it seriously. If we don't act quickly, it can be disastrous for the child. »

 Diarrhea is a common problem in children. However, this does not mean it should be trivialized. It causes severe dehydration, which can be very dangerous.  Thousands of children under the age of 5 are hospitalized each year in Togo for cases of diarrhea, and some die. What are the causes? How should you respond when your child has it? Dr. Komlavi Gonçalves, a general practitioner, provides some clarification.

Health Education: What is diarrhea?

Dr. Komlavi Gonçalves: We talk about diarrhea when stools are more liquid and more frequent than usual. Normally, our stools should have a certain consistency, so when they become very liquid, we talk about diarrhea. But a single liquid stool is not enough to be considered diarrhea; there must be a certain frequency. An infant or child may normally have two liquid stools a day. However, if they have more than three loose or liquid stools a day, this is considered acute diarrhea. This is a bad sign.

What are the symptoms of diarrhea in children?

In most cases, the symptoms are caused by a virus (mainly rotavirus in children under 5 years of age). Diarrhea is often accompanied by fever, bloating, vomiting, and abdominal cramps. It can also manifest as foul-smelling, mucus-streaked, and very watery stools, as well as weight loss.

What causes diarrhea?

The causes of diarrhea in children can be related to poor diet or food allergies. Too many sugary foods, candy, chocolate, cookies. A child who is allergic to milk and consumes this food may experience diarrhea. It can also be caused by food poisoning: poorly prepared baby bottles, for example, or consumption of unsafe water.

Diarrhea in children can be the result of an ENT infection (ear infection, tonsillitis, rhinitis) or a respiratory infection (bronchitis, pneumonia). Most of the time, diarrhea is caused by an intestinal infection of viral, bacterial, or parasitic origin.

What are the complications of diarrhea in children?

When a child has diarrhea, they lose water and minerals. If this is not compensated for, it will cause an imbalance in the body, leading to a serious complication called dehydration. Children have more than 90% water in their bodies. A dehydrated child may develop a fever.  This loss of water and minerals can very quickly have a significant impact. Signs include shock, impaired consciousness, paleness and dark circles under the eyes, rapid breathing, and blood in the stool. If this condition is not corrected quickly, the child may fall into a coma or die.

Is diarrhea contagious?

Diarrhea is highly contagious, whether it is viral, bacterial, or parasitic. Contagion is linked to food. Basic hygiene rules are therefore essential to prevent contamination and poisoning. Hand washing is essential when preparing meals, before eating or feeding your child, as they are very fragile and have diarrhea. Particular attention should be paid to cleaning surfaces that the child touches.

When should you see a doctor?

Diarrhea can sometimes be beneficial because it clears out the system. The child feels lighter. However, if the child has watery or very loose stools more frequently than normal for more than two or three days, accompanied by fever and fatigue for more than 24 hours, you should seek medical advice. You should also take them to the hospital if they refuse to drink and have been vomiting everything they swallow for more than 24 hours, if they are bloated with a swollen, hard, and painful stomach, and if there is blood in their stools.

How should diarrhea in children be treated?

Normally, rapid rehydration with fluids and a return to normal eating should help to overcome acute diarrhea. If the child is unable to drink directly, intravenous fluids are administered to replace what they have lost through diarrhea. However, if this is not enough, the doctor may prescribe appropriate medication. In all cases, these medications must be administered in addition to oral rehydration.

How should diarrhea in children be treated?

Normally, rapid rehydration with solutions and a return to normal eating should be enough to overcome acute diarrhea. If the child is unable to drink directly, IV fluids are administered to replace everything lost through diarrhea. However, if this is not enough, the doctor may prescribe appropriate medication. In all cases, these medications must be administered in addition to oral rehydration.

What should you do when a child has diarrhea?

A child with diarrhea should be given drinking water to compensate for fluid loss, and in practice, rice water should be given. Also give them an oral rehydration solution (ORS), regardless of their age. This powder, which is mixed with water, is specially designed to prevent dehydration. It is available at pharmacies.

Can diarrhea be prevented?

Yes. First, you need to pay attention to your child's diet. Any changes to their diet should be made gradually, not suddenly. This is especially important when weaning your child, so that they can adapt to and tolerate the new food you are offering them. From an infectious disease perspective, you need to be careful about everything you give your child to eat, and make sure you store or cover food properly. You should also be careful when buying food from roadside vendors, as hygiene standards are not always high. There is a high risk because these foods can promote infections. There are also vaccines that can prevent viral diarrhea in infants and children. In addition to food hygiene, personal hygiene is also important. The child's environment must be clean, and the child must be washed thoroughly, along with their clothes and everything they use. Children tend to put everything they find in their mouths. Watch for changes in your child's behavior, and if you see that they are developing diarrhea, react quickly before complications arise.

Your advice to parents

Diarrhea can be dangerous. If not treated quickly, it can be disastrous for the child. Diarrhea is serious and must be taken seriously. Parents must pay attention to their child's diet, the composition of their food, and its cleanliness. A child with diarrhea must have a good diet. With an appropriate diet, your child's bowel movements should return to normal within a few days. Keep an eye on your child until the diarrhea has completely stopped. If they develop a fever, the signs of diarrhea do not improve, their behavior changes, or they show signs of dehydration, consult your doctor again.

 Interview by Abel OZIH