1. DIARRHEA
MODULE FOR TEACHERS

2. OBJECTIVES Define diarrhea
Present major causes and symptoms associated with diarrhea
Provide guidance as to when to seek medical attention for diarrhea
Students should know:
When diarrhea requires medical attention
When to recognize and manage dehydration

3. Diarrhea is “an abnormal increase in the frequency and liquidity
DEFINITION
Diarrhea is “an abnormal increase in the frequency and liquidity
of one’s stools”

4. SCOPE OF THE PROBLEM
Incidence of diarrhea varies significantly in different countries
In the Philippines, as of January 2006 per FHSIS Annual Report - diarrhea is the No. 1 cause of morbidity (illness) in the Philippines

5. CAUSES OF DIARRHEA INFECTIOUS NON-INFECTIOUS Viral Bacterial Parasitic
Certain medications
Stress
Changes in diet
Other medical conditions
Medical conditions
Diabetes
Lactose intolerance
Inflammatory bowel disease
Hyperthyroidism
Gallbladder disease
Hepatitis
Malabsorption syndrome

6. COMMON SIGNS & SYMPTOMS OF DIARRHEA
Nausea and vomiting
Loss of appetite
Bloating and gas
Abdominal cramps and pain
Fever

7. COMMON SIGNS & SYMPTOMS OF DIARRHEA
General weakness or feeling faint
Malaise and headache
Blood in stool
Mucus in stool

8. When MUST a person with diarrhea consult a doctor?
If there is blood or mucus in the stool
If the patient has fever
If the patient has diarrhea lasting > 24 hours
If the patient has persistent vomiting
If the patient has signs of dehydration (dehydration is the most common complication of diarrhea)

9. What are the signs of dehydration?
Dryness of the mouth
Thirst
Reduced amount of urine
Weakness and lightheadedness

10. TREATMENT
All diarrheas are “treatable”. Dehydration can be avoided with adequate fluid replacement.

11. Give Oral Rehydration Therapy (ORT). It is important to start early
TREATMENT
Give Oral Rehydration Therapy (ORT). It is important to start early
and continue giving
ORT throughout the
diarrheal illness

12. How to prepare ORT Ingredients: 1 liter of treated or clean water
2 tablespoons of sugar
½ teaspoon of salt
Dissolve sugar and salt in water. Advise the patient to drink 1 cup after each loose bowel movement

13. TREATMENT Give small, frequent and soft feedings as tolerated.
Avoid milk, milk products, alcohol, caffeine and oily foods.
If diarrhea persists for more than 24 hours or is severe at the onset, consult a physician.

14. PREVENTION OF FOOD AND WATER-BORNE DISEASES
MODULE FOR TEACHERS

15. BACKGROUND AND OBJECTIVES
Primary strategy in preventing diarrhea is the avoidance of food and water contaminated with bacteria from stools.
Students should understand the following:
All untreated water and food that was not properly prepared are probably contaminated and could be dangerous to your health.
Be aware of water and food-borne diseases and how transmission occurs.
Know the proper methods of food and water preparation.

16. BASIC PREVENTIVE MEASURES
Always wash your hands before handling food (preparation or consumption).
Keep your hands away from your mouth.
Always wash your hands after using the bathroom!
Dispose of waste properly.

17. WATER PREPARATION
Tap water may be contaminated unless it is known to be safe: i.e., potential bacteria are removed or inactivated.
Bottled water may be the best advice.

18. WATER PREPARATION
Two preferred methods of water disinfection – effective against all pathogens
Boil for at least 3 minutes.
Filter using a 1-2 micron pore-size filter FOLLOWED by treatment with iodine or chlorine
Chlorine bleach 2 drops/liter, let stand for 15 minutes
Iodine 2% 5 drops/liter, let stand for 15 minutes
Iodine tablets ½ tablet/liter, let stand for 15 minutes

19. FOOD PREPARATION Fresh fruits and vegetables
All fruits and vegetables that can be peeled are safe once washed and peeled.
Any fruit or vegetable that is not or cannot be peeled should be washed and soaked.
Soak items in a solution of strictly one tbsp. (15 ml) household bleach per gallon for 15 minutes and then rinse in treated water.

20. FOOD PREPARATION Meat preparation
All meats should be cooked thoroughly.
Adequate cooking will prevent parasitic and bacterial infections.

21. FOOD PREPARATION Milk products Other tips:
Bring all fresh (unpasteurized) milk to boil before consuming.
Other tips:
Canned foods are generally safe if consumed before the expiration date.
Freezing does not disinfect food.
Food should be eaten immediately after cooking and should be protected from flies and other sources of recontamination.

22. REFERENCES
“Diarrhea” module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services
“Food and Water Preparation” module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services
Protocare Corporation 1997

23. Philippine Society of Gastroenterology
The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation of this module
Philippine Society of Gastroenterology
Ma Lourdes O. Daez, MD