32.3.1  Diarrhoea

Diarrhoea is the passage of loose faeces (liquid stool) three or more times a day, or more than is normal for the individual. If the diarrhoea continues for less than 14 days, it is referred to as acute diarrhoea; if it lasts for more than 14 days it is said to be chronic or persistent diarrhoea. Diarrhoea is also distinguished into acute watery diarrhoea (sometimes abbreviated to AWD), which typically occurs in cases of cholera, and bloody diarrhoea (also known as dysentery), which typically occurs in cases of shigellosis and amoebiasis.

Diarrhoea results in dehydration – the rapid loss of body fluids and important salts required for proper control of body functions, particularly in the brain, nerves and muscles. Children are highly susceptible to dehydration if they have diarrhoea, even after only one day; they can quickly die if the fluid loss is continuous and cannot be replaced by drinking fluids. A sign of some degree of dehydration in a child with diarrhoea is if it seems restless and irritable (easily upset), and drinks eagerly if offered fluids. If the dehydration is severe, the child may be too lethargic to drink, the eyes often appear sunken, and if you pinch the skin on the child’s abdomen it may take two seconds or more for the pinched skin to go back to the normal position.