Diarrhoea and dehydration
Patient education
- Replace lost water and salts
- Keep feeding children
- Watch urine and alertness
What it is
Loose or watery stool, usually from an infection. In a child the danger is almost never the diarrhoea itself - it is losing more fluid than they take in.
When to seek urgent care
There is blood in the stool; the person cannot keep any fluid down; a child is sunken-eyed, floppy, unusually sleepy or has not passed urine for many hours; the diarrhoea has lasted more than three days; or the person is under six months old.
How it shows
Frequent loose stool, sometimes with vomiting, stomach cramps or fever. Signs of fluid loss are a dry mouth, no tears when crying, passing little or no urine, and being sleepy or floppy.
What to do
Replace the fluid. Oral rehydration salts, mixed exactly as the sachet says, given in small sips continuously rather than in large amounts. Keep feeding a child and keep breastfeeding a baby. Zinc alongside ORS shortens the illness in children and a pharmacist will advise on it.
Oral rehydration salts and zinc do not need a prescription and are inexpensive. Antibiotics are usually the wrong answer and anti-diarrhoeal tablets should not be given to children.
Replacing what the body loses
Frequent loose stools and vomiting remove water and salts. Babies, older adults and people who are already unwell can dehydrate quickly. Thirst, dry mouth, dark urine, fewer wet nappies and unusual tiredness are useful warning signs.
Use packaged oral rehydration solution (ORS), mixed with exactly the amount of safe water on its label. Offer small, frequent sips if nauseated. Continue breastfeeding and usual-strength formula; do not dilute feeds. Eat as tolerated. Very sugary drinks can worsen diarrhoea.
Medicines and stopping the spread
Many episodes settle without antibiotics. A clinician should assess blood in the stool, persistent illness or dehydration. Do not give a child diarrhoea-stopping medicine without clinical advice; it may be unsafe.
Wash hands with soap after toileting or changing nappies and before meals. Clean contaminated surfaces and avoid preparing food for others while ill. Seek reassessment when drinking is not keeping up with losses, rather than waiting for diarrhoea to stop.
Sources
- Diarrhoea and vomiting · Public sector health information · OGL v3.0
Contains public sector information licensed under the Open Government Licence v3.0.