We’d be hard pressed to find an Indian person who doesn’t love the monsoon. We’d be equally hard pressed to find one who doesn’t worry about contracting the water-borne diseases that the monsoon brings! For most of us, the annual monsoon probably brings with it at least one episode of an upset tummy. For an unlucky few, it brings diarrhoea and dehydration.
Most of us don’t have to worry too much about an episode of diarrhoea; after all, the body is resilient and as long as we hydrate well, diarrhoea leaves us with no long term effects. However, for vulnerable populations like the elderly, people with certain chronic diseases and immune deficiencies, and for very young children, diarrhoeal dehydration can have real consequences.
Each year, in India, more than 1 Lakh children under the age of 5 die from diarrhoeal dehydration. This is an alarming statistic, especially since battling dehydration effectively is a matter of having the right information. Hint: it’s not just about drinking enough water.
Network18 and Electral present the Hydration for Health campaign which aims to build a body of knowledge around everyday hydration, hydration myths and common missteps, and what to do when dehydration strikes.
In the panel discussion, Network18’s Mughda Kalra talked to Dr. Virendra Mittal, Consulting Pediatrician, Pediatrics & Neonatolog, Jaipur; Dr. Surendra Singh Bisht, MD (Pediatrics), DNB (Pediatrics), Fellow Neonatology, AIIMS, Delhi and Dr. Amit Adhikary – MBBS, MD (Pediatrics), CCIP PGPN (Boston University), Child Specialist and consultant neonatologist, Kolkata.In this panel, the discussion centred on diarrhoeal dehydration, its causes, preventions and interventions.
Understanding the causes
Dr Bisht observed that for any infection to take hold, three conditions must be present: an agent (diarrhoea can be bacterial or viral), a host (susceptible populations) and an environment (conducive to infections). In India, where we have high population density and poor access to clean drinking water, diarrhoeal infections can and do occur frequently.
Dr Adhikary pointed out that diarrhoeal dehydration on the other hand, is a preventable outcome of diarrhoea and only occurs when the child or adult is expelling more fluids and salt than they are consuming.
Understanding who it affects
According to Dr Bisht, diarrhoea is a major cause of mortality in children under the age of 5. Elderly are also susceptible, especially those under chemotherapeutic agents, or suffering from malnutrition, or chronic gastrointestinal diseases or liver disorders. Pregnant women are another at-risk group, especially considering that dehydration can also lead to intrauterine deaths.
Dr Adhikary added that people suffering from any sort of malnutrition, or those with immunodeficiency disorders like AIDS, as well as cancer patients are at higher risk of dehydration, particularly from diarrhoea.
Recognising Dehydration and Taking Corrective Action
All three doctors pointed out the common symptoms of dehydration: fatigue or lethargy, thirst, little or no urine, sunken eyes, palpitations. If unheeded, dehydration then progresses to loss of consciousness, and severe complications like organ failure, and ultimately death.
However, as Dr Bisht mentioned, not all diarrhoea cases need a doctor. As long as caregivers are able to get more fluids into the patient’s body than he/she is purging, there is little cause for concern. However, should the patient begin vomiting, and is unable to keep down the fluids the parent is trying to administer, it is best to bring them to a hospital, so doctors can administer intravenous fluids.
Dr Mittal recommends a 4 stage treatment plan for children based on the severity of dehydration:
Plan A: When the patient is having loose motions but the dehydration is mild, manage at home with fluids and salts and high hydration foods.
Plan B: When you begin to notice signs of dehydration, make the patient drink an ORS solution and observe their symptoms closely.
Plan C: If the dehydration continues to get worse, administer 70ml of ORS per kg of weight every 4 hours. This manages dehydration, while the patient’s body fights the infection.
Plan D: If even then dehydration worsens, it is time to go to the hospital for IV fluids.
According to all three doctors, the first line of defence must be the administration of WHO ORS. Dr Adhikary pointed out that the biggest mistake he sees people make is not starting ORS early enough, while Dr Mittal highlighted common mistakes caregivers make while calculating the ORS dose.
You can watch the full panel discussion here. For more details on diarrhoeal dehydration, and to learn how to recognise and prevent dehydration in yourself and your loved ones, visit https://www.news18.com/electralhydrationforhealth/
This is a Partnered Post.
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