Creating Waves of Awareness
By Dr Guillermo Zamora (Universidad Autónoma de Guadalajara)
Homeopath (Homeopatía de Guadalajara, A.C.)
We talk about Diarrheal diseases (DD), where there is decrease in the consistency of the stools, usually with increased frequency of them.
Currently, the DD is classified into three types:
1. Acute. Characterized by three or more stools in 24 hours, decreased in consistency, with less of two weeks
2. Persistent. The development spans two weeks or more.
3. Disentery. Stools with mucus and blood, which can have acute or persistent changes caused by germs enteroinvasors.
In children it is important to note that the number of stools varies according to age and diet.
The Breast-fed infants have frequent liquid or soft stools. This should not regard as diarrhea. .
In Mexico, the DD is a public health problem, ranks among the top as cause of morbidity and mortality in children under 5 years.
Approximately 75% of diarrhea in children under 5 years are caused by viruses (many by Rotavirus), the rest by other microorganisms. It is also important to mention that many diarrheas in children are due to overuse of antibiotics. Although we could discuss other causes of diarrhea like disaccharide intolerance, toxicity, and many diseases, is not the purpose of this document.
However, it is important to know that the main complications of diarrhea are dehydration and malnutrition, so I will mention plans A, B and C of hydration used in Mexico and many parts of the world. For this, the most important thing is to recognize whether the hydration condition is well hydrated, dehydrated, or if our little patient are in hypovolemic shock(due loss of liquids). To sort, it is convenient to classify the patient through the signs:
1 .- Patient well hydrated: In this case the patient has no thirst, is alert, his eyes are normal and cries with tears, her mouth and tongue are moist and breathe normally. On examination, we find good conditions. Plan A oral hydration.
2 .- Dehydrated Patient: The patient has increased thirst, drinks eagerly, his eyes are sunken and crying without tears, her mouth and tongue are dry with thick saliva, breathing rapidly and deeply. On examination we find that the elasticity of skin is impaired, ie, the fold is rolled slowly (> 2 seconds), pulse is rapid, and capillary refill is 2 to 5 seconds (delayed). The fontanelle (joins in skull bones) in infants is flooded. Plan B oral hydration.
3 .- Patients in hypovolemic shock: The patient can not drink, is unconscious, hypotonic with weak or absent pulse and capillary refill greater than 5 seconds hypotension. Plan C oral hydration.
Plans oral hydration
It applies in patients with diarrhea but hydrated, to prevent dehydration and malnutrition. Includes training for responsible to the care of patients with diarrhea to continue his treatment at home, according to the following rules (the ABC's diarrhea):
A. Food (Alimentación normal): continue breastfeeding and normal feed more frequently than usual.
B. Drinks (Bebidas abundantes): abundant, common use in the home. The drug "Vida Suero Oral" (VSO) (Oral electrolits life), as long as diarrhea *. Avoid soft drinks and juices industrialized.
C. Consultation timely: if no improvement within 72 hours or sooner if she/he is getting: excessive thirst, do not eat or drink, liquid stools and numerous (more than 3 per day), frequent vomiting (more than 3 per day), bloody stools, fever high and persistent.
* In doses 1 / 2 cup (75 ml) after each stool in under a year and 1 cup (150 ml) over one year or accept everything after each stool while diarrhea persists, slowly and teaspoons to avoid vomit.
Medicate with VSO: 100 ml / kg in 4 hours, divided into doses every 30 minutes, with glass or cup and spoon given by the mother. Hourly Rate (abdominal diameter and hydration)) and adjust the dose of VSO
The patient with hypovolemic shock is preferably treated at hospital by a combined method of fluid, intravenous and oral. Using Hartmann's solution or Ringer's lactate will be administered at doses of 50 ml / kg the first hour, 25 ml / kg the second hour, 25 ml / kg the third hour. Intravenous.
Plan B and C need to be watched carefully by the doctor or homeopath as you may require other techniques such as feeding tube placement, assessment of the abdomen (not to exceed more than 2-4 cm in abdominal girth before the start of the Plan B oral hydration), and changes in dosage.
Once we considered the importance of restoring liquids in our patients with diarrhea, then I would like to mention some of the remedies often used in acute diarrhea based on stool characteristics and circumstances surrounding the diarrhea.
- "As thorny minced or chopped: Argentum nitricum.
- Red-Pieces: Argentum nitricum..
-Foam, puddle frogs: Magnesia carb.
–Scybalos (escibalos): Opium.
-Scarce: Nux vomica, Podophyllum peltatum.
-Abundant: Podophyllum peltatum, Gambogia, Bismutum, Phosphorus.
-Green: Chamomilla, Calcarea phos, Argentum (on pamper), Podophyllum pelt., Magnesia carb, Borax .
-Bleached: China, Digital purp.
-White: Phosphoric acid.
-Yellow: Phosphoric acid, Podophyllum, Aloe, Kali Bi, Croton tiglium, Gambogia, Gratiola.
-Dark: Muriatic acid.
-Black: Stramonnium, Pyrogenemium, Opium, Arsenic album.
-Coffee: Graphites, Psorinum Pyrogenemium, Rumex (cough).
–Watery: Phosphorus, Phosphoric acid, Silica, Antimonium tart, Natrum sulph, Graphites, Psorinum, Pyrog, Argentum, Podophyllum, Croton tiglium, Nat mur, Magnesia carb, Nux moschata, Arsenicum album, Oleander, Bismutum, camphora, Rumex, Rheum, Gambogia, Gratiola.
-Pasty: Podophyllum, Gambogia, Magnesia carb, Mercurius vivus.
-Shredded: Ammonium mur Magnesia mur.
-Almost formed: Gambogia
• Additional elements
-Undigested (with traces of undigested food): China officinalis, Graphites, Ferrum metallicum, croton Tiglium, Oleander.
-"With Parasites: China officinalis, Stannum, Cina.
-"With particles as sago or dysentery: Phosphorus.
-"With abundant blood: Ferrum phosphoricum, Aloe Socotrina, Kali Bi, Arsenicum album.
-"With mucus: Graphites, Argentum (Green), Podophyllum, Aloe and Kali Bi (gelatinous).
-"With epithelial fragments: Argentum nittricum.
-Bloody: Arsenicum album, Mercurius solubilis.
-Fetid: Chamomilla (rotted like eggs), Baptista tinctoria, Psorinum, Pyrog, Arsenicum album, Podophyllum.
-Fermented: Bryonia alba.
–Epitelial Corpses: Bismutum, Kreosote.
-Acid: Rheum, Magnesia carb, Calc.
Now, we are going to focus on the circumstances or forms of diarrhea:
-Extended: China officinalis.
-Worse after eating fruit: China officinalis.
-> After-midnight: Sulfur (or in the afternoon)
-Worse due movement: Bryonia alba.
-Worse in the evening: Sulfur, Calc.
-With vomiting, diarrhea: Arsenicum album, veratrum album.
-Trembling due to diarrhea: Lachesis, Gelsemium.
-Frequent and ineffective desire for stool : Nux vomica, Lycopodium, Lachesis.
-¡¡Run it reaches you!!: Aloe Socotrina.
-Diarrhea in a single stream for expulsion: Gambogia.
-Diarrhea in one fell swoop, in one long effort: Gambogia.
-Diarrhea with Cough: Rumex crispus.
- "Diarrhea in children by drinking cold water: Gratiola.
-Dairrea by overeating(much food): Antimonium crudum.
-Diarrhea-summer heat: Antimonium crud, Bryonia, Silicea terra.
->During the day: Petroleum, Borax.
-Sudden desire to depose: Gambogia.
-Diarrhea apprehension Argentum, Gelsemium.
-Constipation and diarrhea, alternating: Podophyllum, Antimonium crud (older persons), Nux Vomica.
-Eject diarrheal stool involuntarily when emit flatus or urine: Aloe Socotrina., Muriatic acid.
-Evacuation leaves blow as gun: Croton tiglium.
-Worse at night while he / she eats or drinks: Ferrum metallicum, China officinalis, Croton tiglium.
–Diarrhea when gas-emitting: Aloe, Pyrog, Oleander.
-Involuntarily defecate: Hyoscyamus niger, Opium.
-Diarrhea teething: Chamomilla, Kreosotum (with pain), Calcarea carb, Rheum.
-With large amounts of gases: China officinalis, Calcarea phos, Argentum.
1. Diario Oficial de la Federación. Norma Oficial Mexicana NOM-031-SSA2- 1999, para la Atención a la Salud del Niño. 9 de febrero de 2001. 1ª. sec.:13-58.
2. Dirección General de Estadística e Informática/Instituto Nacional de Estadística, Geografía e Informática (INEGI). Estadísticas e salud, mortalidad. México, D.F.:Secretaría de Salud, 1999. Disponible en: http://www.ssa.gob.mx/
3. Consejo Nacional de Vacunación. Enfermedades Diarreicas. Programa de Atención a la Salud del Niño. Manual de procedimientos técnicos. México, D.F.:Secretaría de Salud,1998:1-78.
4. Mota-Hernández F. Deshidratación por diarrea. Bol Med Hosp Infant Mex 1998;55(9):530-538.
5. Leyva LS, Mota HF. Manual de consulta educativa en diarreas. México, D.F.: Ediciones Médicas del Hospital Infantil de México, 199
6.-Essentials of medical microbiology de Vol. Benjamín.Kadner.Parsons 3era edicion., 1989, Editorial Interamericana S.A. de C.V.
7.-Keynotes flow chart, designed by Dr. Guillermo Zamora