For many years, physicians focused on reducing the volume of diarrhea by withholding foods. However, it is now understood that, despite an increase in total quantity of diarrhea, when bland foods and nutritious beverages are consumed, some of the nutrients are absorbed and the patient returns to normal nutritional and health status more rapidly. Maintenance of fluid balance is viewed as the most important home health care measure. Current recommendations for preventing and treating dehydration include beverages enriched with essential salts and electrolytes, especially for children. Most developing countries have distribution programs for oral rehydration solutions (ORS is also referred to as oral rehydration therapy, ORT). Grocery stores and pharmacies carry a variety of flavored rehydration beverages and Popsicles to prevent or combat dehydration. Pediatricians recommend what is referred to as a BRAT diet of bananas, rice, applesauce, and tea. Bananas are a relatively good source of potassium, although not enough potassium is present in normal servings to correct a serious potassium imbalance. Rice has large starch molecules that release glucose gradually. Applesauce contains pectin, which aids in decreasing diarrhea. Tea leaves have been shown to have numerous pharmacological properties including antibacterial, antiviral, anticholesterol, and tumorstatic activity. The first two might be useful in treating diarrhea.
The World Health Organization (WHO) and other international agencies involved in the control and management of diarrheal diseases, dehydration prevention, and rehydration therapy have undertaken many programs and studies to determine the best medical, practical, feasible, and acceptable methods for preventing and treating diarrhea and dehydration. The general conclusions suggest that prevention of dehydration is the best home treatment procedure. However, most studies demonstrate that caregivers have difficulty in mixing the proper amounts of salts, sugars, and water, especially in making the mixture over-concentrated. This in itself can pose a danger for dehydration by pulling water into the intestine through osmosis and increasing diarrheal output. Traditional home preparations of fluids and foods are now encouraged, especially continued breast-feeding when applicable. If feeding, particularly fluids containing nutrients and calories, are continued throughout the diarrheal event, most cases of diarrhea are self-limiting. Traditional healers have also proven to be amenable and effective at promotion of rehydration when trained in preparation and administration of ORS.
Over-the-counter remedies are available for diarrhea. However, the use of antidiarrheals that simply stop the diarrhea can be potentially harmful because of the danger of prolonging retention of an invasive organism in the intestine and providing prolonged opportunity for penetration and erosion of the intestinal lining.
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