Diarrhea is a leading cause of death in Kenya that can be prevented and treated.

What is important?

To know HOW to manage at home and know WHEN you need to see a doctor.

  • Hydrate- Your ability to drink water and other liquids is the MOST IMPORTANT thing in treating diarrhea/vomiting/food poisoning.

  • Make sure you are passing urine. If you are not passing urine multiple times in the day, it is a sign that your not drinking enough water and you might need to either increase your fluid intake or go to hospital for hydration. Your kidneys can get damaged without good hydration.

  • You may need blood tests. If you have persistent diarrhea for several days or blood in your stool or fever you may need a blood test. Some infections like typhoid, malaria and HIV can cause diarrhea as well and can be picked on a blood test. Infection is the leading cause of diarrhea but not the ONLY cause.

  • You may need antibiotics. There are antibiotics that can be used to treat some forms of diarrhea like cholera. However, NOT ALL diarrhea needs antibiotics. Some forms of diarrhea are worsened or caused by antibiotics. Using antibiotics in some forms of diarrhea can even lead to organ failure and death.

  • Who needs admission? If you are not able to tolerate liquids or are NOT making urine you probably need admission. Elderly people, children or ANYONE who cant drink water or liquids is at the highest risk for deterioration and death .

  • Stool test- A stool test is not compulsory. If possible, it can diagnose amoeba, cholera and typhoid and other bacteria. This helps you know what you are treating. Stool tests can fail to identify the cause of diarrhea in some cases.

  • Children are at a VERY high risk of deterioration. If they cannot drink ORS or water or breast milk or any other liquids, or if they are vomiting up everything, have them checked IMMEDIATELY .They get dehydrated VERY QUICKLY. Monitor the number of nappies or diapers they are wetting or how many times they are passing urine. If the child is weak or tired or has sunken eyes or a weak cry they may be severely dehydrated and need URGENT attention.

  • Monitor the amount your child is drinking and compare with what they are losing in diarrhea or vomiting. If at any stage they are losing more than they are drinking its a sign you should go to hospital.If you live far from the hospital start going early.Do not waste time.Many children arrive at hospital when its too late. The further you live from a hospital with a doctor, the earlier you should start planning to go to hospital.

  • Remember bloody diarrhea in children can also be a sign of either dysentry or twisted bowels. Be careful if you notice a child with bloody stool and very severe stomach pain. They might need an x-ray/ scan in hospital and a surgeon if they have a twist in their intestines.

  • The elderly are at a HIGH risk for deterioration. The reason is because they may not be able to verbalize their thirst many times. They can also get confused as a result of being unwell. Make sure to monitor them closely and have them seen if they are not drinking or tolerating liquids.

When you are vomiting or have diarrhea, you loose minerals like potassium and magnesium from the body. Loss of these minerals can cause fatigue and muscle cramps/pain. If you experience this you may need them replaced with oral supplements like ORS or in hospital if you cannot tolerate anything orally. Most balanced diets contain these minerals and if your able to eat then this may also help.

For children, ORS(ORS stands for Oral Rehydration Salt. It is a powder that has multiple minerals that is diluted in water or juice) is better than plain water because it has all the necessary minerals. If you have it and your child can tolerate it, then it is best. If they can not tolerate it ,water will help to hydrate them but they will still need the minerals supplemented. Breast milk is equally as nutritious and if they are still breast feeding and you can use both or either .If your child can eat, then give them a nutritious diet.

There are other alternatives to ORS like ‘madafu’ (non sweetened coconut water ) can be considered if ORS is not available.

Common foods that can cause you trouble;

  • Salads or raw foods or kachumbari- they need to be thoroughly washed with clean water. If you are not sure avoid it.

  • Cooked rice that is not refrigerated-Bacteria like to live on cooked unrefrigerated rice. They survive even if you reheat the rice.

  • Food prepared with dirty water can cause diarrhea

  • Meats that have not been defrosted adequately or are hurriedly defrosted before cooking will make you sick because bacteria remain in the ice inside the meat. The outside looks defrosted but inside has ice.

  • On the other hand, leaving food especially meats outside for long, after defrosting it, allows bacteria to multiply. The above 2 have caused food poisoning at weddings and schools.

  • Fish and sea food that has not been stored properly in ice will make you sick

  • Matumbo or mutura that has not been thoroughly washed. Wash it at home if possible.

  • Fatty foods and greasy foods cause diarrhea and vomiting. If you are unwell its best to take plain soup or foods instead of spicy or greasy foods.

  • Wash your fruits thoroughly in clean water. The peels can cause you to be sick cause of bacteria.

  • Never wash eggs as it will cause bacteria to move from the outer shell into the egg.

  • Don’t eat cracked eggs. Wash hands before and after cracking eggs. The external shell carries bacteria.

  • Cheese, mayonnaise, custard can also be contaminated if not stored in the fridge. These are used in many burgers, salads, sandwiches and dessert so be careful.

  • Poorly stored maize, peanuts and grains that are damp can harbor aflatoxin which causes liver cancer. Damp maize used to produce ugali flour can be lethal.

  • Raw honey can cause paralysis in babies less than a year old because tiny babies are sensitive to bacteria that may contaminate the honey.

  • Boil drinking water before consuming

  • Latrines located near food produce or near boreholes can contaminate underground drinking water

Wash your hands with soap and water before eating and before handling food.

It is the cheapest and easiest way to prevent infection.

Persistent diarrhea (lasting more than 2 weeks) usually needs further tests.

Not all diarrhea is caused by infections. There are very many other causes.

After certain surgeries involving your intestines or the organs in your tummy, you may develop diarrhea and this can be managed with the advice of your doctor and a change in diet.

Lets prevent illness and death where we can.

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