Treatment of persistent diarrhoea at district level

ORS solution is effective for most children with persistent diarrhoea. In a few, however, glucose absorption is impaired and ORS solution is not effective. When given ORS, their stool volume increases markedly, thirst increases, signs of dehydration develop or worsen, and the stool contains a large amount of unabsorbed glucose. Thesechildren require IV rehydration until ORS solution can be taken without causing the diarrhoea to worsen. Routine treatment of persistent diarrhoea with antibiotics is not effective and should not be given. Some children, however, have non-intestinal or intestinal infections that require specific antibiotic therapy. Examine every child with persistent diarrhoea for nonintestinal infections such as pneumonia, sepsis,urinary tract infection,oral thrush,and otitis media and also for intestinal infections.

Children treated in hospital require special diets until their diarrhoea lessens and they are gaining weight. The goal is to give a daily intake of at least 110 kcalories/kg.
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