Prolonged diarrhea begins with an acute episode and lasts for more than 14 days. According to estimates by the World Health Organization in developing countries, among children with diarrhea, about 3-20% of acute diarrhea turns into prolonged diarrhea. The consequences of prolonged diarrhea often lead to severe malnutrition and high mortality in children under 5 years old.
Due to bacteria: bacteria that cause acute diarrhea in children are common in prolonged diarrhea episodes, including:
E.coli: There are 5 types but the most common are E. coli causing intestinal disease (EPEC), semi-adhesive E.coli (EAEC) and invasive E. coli (EIEC).
Shigella, Salmonella, Campylobacter jejuni.
Types of parasites: Cryptosporidium, L, giardia.
2. Risk factors for persistent diarrhea
Age: Children under 1 year old have a higher risk of having an episode of acute diarrhea becoming persistent diarrhea in older children.
Nutritional and immune status: The prevalence of prolonged diarrhea in malnourished children is higher than normal children. Research in Brazil showed that the incidence of persistent diarrhea in children with a height of less than 90%, weight less than 75% of the standard is 2 times higher than that of normal children. In patients with severe malnutrition, acquired immunodeficiency syndrome (AIDS) is susceptible to prolonged diarrhea and a high risk of death.
Acute diarrhea is recurring many times, children who often have acute diarrhea episodes are at risk of persistent diarrhea.
Diet, infants who are not breastfed or lactose intolerant, are allergic to animal milk proteins.
Treatment of unreasonable acute diarrhea: Overuse of antibiotics, prolonged use of antibiotics to cause dysbacteriosis or use of defecation drugs to reduce the ability to eliminate bacteria, and to eat and to diet for a long time when having acute diarrhea.
3. Clinical symptoms
Children have loose, lumpy stools, with a sour odor, yellow or green, with foam due to their intolerance to sugar; manifestation of bloody pink mucus feces, which is painful for children with dysentery. Number of diarrhea decreased at increased times. Mild, moderate and severe dehydration may occur depending on the severity.
Children anorexia, weight loss, physical retardation.
Lack of vitamins, especially vitamin A, causes dry eyes and some trace elements such as zinc, iron, copper …
Children often suffer from combined diseases such as inflammation in the middle, pneumonia, urinary tract infections, sepsis …
Diet in diarrhea is prolonged in children
Proper nutrition plays an important role for children with prolonged diarrhea, nourishing and promoting the early recovery of intestinal mucosa, pancreatic function and production of disaccharidase hydrolyzers in microvilli The intestine makes the digestive function absorb nutrients quickly back to normal.
4. Principles of diet formulation
Temporarily reduce the amount of animal milk or lactose in milk, in the diet.
Provide adequate energy, protein, fat, vitamins and trace elements to regenerate and restore damaged intestinal mucosa, improve systemic nutritional status.
Do not allow children to eat foods and drinks that increase diarrhea: Raw foods, foods high in sugar, fat, industrial soft drinks
Use foods available locally: Rice, potatoes, processed in soft, easy-to-digest liquid such as flour, porridge, and soup.
Choose foods rich in protein: Meat, fish, eggs, milk … preferably chicken.
Drink and eat more fresh fruit to provide more vitamins and mineral salts.
Diet for children under 6 months old.
Continue to breastfeed, breastfeed many times, do not force mothers to abstain from excessively.
If you do not have milk: Use lactose-free milk, or fermented milk: Yogurt or soy (soy) milk. Yogurt must be made from milk for babies <6 months old.
Diet for children from 6-12 months
Continue to breastfeed
Diluting animal milk with porridge water reduces the concentration of lactose by 5% or feeds the baby yogurt or soymilk.
Ensure additional food: Flour, porridge cooked with meat, fish, eggs, green vegetables and grease. When processing ensures reduced viscosity, easy digestion, balance protein, fat, sugar to avoid increasing osmotic pressure.
Eat several meals a day: At least 6 meals.
Diet for children from 1 year old
Breast-feeding or eating diluted animal milk as above.
Food processing in the form of porridge, soup from rice, potatoes, vegetables, meat, beans.
Ensure 50% of energy from sam foods and 50% from milk or dairy products, ensure 110Kcal / kg / 24 hours of energy.
When the diarrhea is 1 week, then gradually switch to a normal diet with age.