2. Approach to Diarrhea Dr.Honar Pediatric Gastroenterohepatologist

3. Definition
Diarrhea -frequency -consistency -weight

4. Definition Normal pattern of defecation Non pathologic diarrhea
Self limited pathologic diarrhea

5. Classification Acute diarrhea -prolonged episode of acute diarrhea
Non acute diarrhea
-chronic diarrhea
-persistent diarrhea

6. Acute Diarrhea
Less than 2 weeks Cause of diarrhea Self limited

7. Acute Diarrhea
Treatment
-Hydration
mild
moderate
severe

8. Acute Diarrhea Mild dehydration -hydration at home - 50 ml/kg ORS
Moderate dehydration
-hydration with supervision-75ml/kg ORS
Severe dehydration
-admit the patient,IV hydration-100ml/kg

9. ORS Efficacy of ORS -standard or WHO ORS -hypoosmolar ORS
Cooperation of mother
Preparation of ORS
The most efficacy in moderate dehydration

10. Acute Diarrhea -Breast feeding -Feeding -Supplement
-Complication(medical ,surgical)
Electrolyte imbalance
Ileus
Intussusception
HUS
-Antibiotic

11. Persistent Diarrhea More than 2 weeks Acute onset
Persistent(recovery less than 48 hours)
Mechanism of Persistent diarrhea

12. Persistent Diarrhea
One of the most common cause of mortality of diarrhea -prophylaxy -indication of NPO -breast feeding -appropriate feeding -supplements

13. Persistent Diarrhea In formula fed -Lactose free formula
-continue for at least 1 month,tapering
-Second line :extensive pr.hydrolysate
:soy based formula

14. Chronic Diarrhea
-More than 2 weeks -Insidious onset -On and off

15. Chronic Diarrhea Food allergy -usually self limited IBD Celiac CF
Others