Diarrhoea and vomiting are among the most common illnesses among children and adults‚ especially during the rainy season․ Although they usually result from viral infection‚ food poisoning or contamination of food and water‚ it is not the infection which kills but the severe dehydration which can result from it․ This is why Oral Rehydration Solution (ORS) forms the mainstay of early management․
Most people start ORS only when their symptoms have become severe‚ which is not the best option․ ORS should be started as soon as diarrhoea starts or after the person has vomited many times․ This is even if the person is able to take only small sips․ ORS solution consists of water‚ salts and glucose‚ which replenishes the fluids and electrolytes lost through diarrhoea and vomiting․ Water alone is ineffective‚ however‚ because it lacks the subcomponents that the body cannot retain and would otherwise lose․ Juices and carbonated beverages are concentrated with sugar and added substances which can worsen dehydration and hence should be avoided.
ORS should be given after each episode of diarrhoea . If vomiting occurs‚ ORS should be given in very small amounts‚ either one or two teaspoons at a time‚ every one or two minutes․ Frequent sipping may be better tolerated than large quantities given less frequently․ Breastfeeding should be continued with ORS in infants‚ because breast milk also provides fluid and nutrition․
Along with adequate hydration‚ a common recommendation includes the consumption of light‚ bland foods that can be tolerated by the patient‚ such as rice‚ bananas‚ curd (yogurt) ‚ toast‚ khichdi and soups․ Oily‚ spicy foods‚ drinks with sugar‚ alcohol and caffeine should also be avoided as they can also worsen dehydration․ Antibiotics should never be started without medical advice because many cases are viral and do not require them.
While mild diarrhoea or vomiting often settles within a couple of days with supportive care, certain warning signs indicate the need for immediate medical attention. These include persistent vomiting that prevents the person from keeping down fluids, diarrhoea lasting beyond 48 hours in adults or 24 hours in young children, blood in the stool or vomit, high fever, severe abdominal pain, or signs of significant dehydration. Symptoms of dehydration include extreme thirst, dry mouth, reduced urine output, dark-coloured urine, dizziness, rapid heartbeat, lethargy, confusion, or sunken eyes. In infants, warning signs also include excessive sleepiness, poor feeding, absence of tears while crying, or a sunken soft spot on the head.
Older adults, infants, pregnant women, and people with chronic illnesses such as diabetes, kidney disease, or weakened immunity are particularly vulnerable to complications from dehydration and should seek medical evaluation early rather than waiting for symptoms to worsen.
The best prevention remains maintaining good hand hygiene, consuming safe drinking water, eating freshly prepared cooked food, and avoiding unhygienic street food, particularly during the rainy season. Prompt rehydration with ORS at the onset of symptoms and recognising warning signs early can prevent complications and reduce the need for hospitalisation.
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