Patient's question:
After taking Lìmǎn, it has been 15 days, and I'm still having diarrhea. The stool is green, almost entirely green water. I feel very uncomfortable every day. What should I do? First follow-up question: Today I went to the hospital for a stool test, and the results are as follows: Appearance: Watery; Leukocytes: +. Is this a concern? What medicine should I take?Doctor's answer:
Diarrhea refers to changes in stool characteristics (such as loose stools, watery stools, or stools mixed with pus or blood) and an increase in the frequency of bowel movements. In fact, there are many causes of diarrhea, and poor hygiene in food is one of them, but there are also many other causes. For example, excessive or insufficient milk intake, excessive or too rapid addition of complementary foods, changes in weather, viral infections. Sometimes, diarrhea can also be a symptom accompanying other diseases, such as respiratory infections or Kawasaki disease. Some children may develop diarrhea due to allergies to food (such as milk) or medications. Therefore, there are so many reasons that can lead to diarrhea.Once diarrhea occurs, parents should not give their children antibiotics casually, because some types of diarrhea do not require antibiotics or may even be contraindicated. Instead, it is important to carefully consider the underlying cause of the diarrhea. If the issue is related to feeding, the feeding method should be adjusted; if it is due to an allergic factor, exposure to the allergen should be avoided. If the child has prolonged diarrhea or very large amounts of diarrhea each time, they should seek medical advice from a doctor as soon as possible.
When a child has diarrhea, some mothers become very anxious and naturally take them to the hospital for treatment. The medications prescribed by the doctor are all oral, including oral rehydration salts. Why aren’t the children fasting and receiving fluids? In the past, we often provided fluids to infants with diarrhea, but in 1992, the Chinese Ministry of Health formulated a new plan for mild diarrhea in China, summarized in sixteen characters: "Prevent dehydration, correct dehydration, continue feeding, and use medications reasonably." The key feature of this plan is the use of oral rehydration salts as the primary treatment for dehydration correction and prevention, employing oral rehydration methods to minimize the need for intravenous fluids. Fasting is not recommended, nor are antibiotics overused. Fasting can worsen nutritional deficiencies, which is particularly harmful to infants and young children who are in a critical stage of nutritional development. Fasting also does not reduce the frequency of diarrhea or shorten its duration.
It should be clarified that oral rehydration is only suitable for children who have not yet dehydrated or have mild to moderate dehydration. For severely dehydrated children, intravenous fluids should still be administered. If a mother cannot go to the hospital or if the hospital lacks oral rehydration salts, homemade oral fluids can be prepared at home. The recommended liquid preparation method is:
(1) Rice water + salt: 500 ml of rice water + 1 toothpaste cap of salt (4.5 g);
(2) Sugar and salt water: 500 ml of water + 500 g of sugar + 1 toothpaste cap of salt (4.5 g is sufficient).
Administer 20–40 ml per hour orally.