In September 2005, Children’s Hospital 1 in Ho Chi Minh City received 6,168 cases of children with digestive disorders and acute diarrhea, which increased to 7,350 in October. At Children’s Hospital 2, the corresponding figures for the two months were 2,886 and 3,660 cases, respectively.
Majority Due to Viruses
Dr. Hoàng Lê Phúc – head of the Gastroenterology Department at Children’s Hospital 1 – stated that the World Health Organization (WHO) classifies diarrhea based on the characteristics of the stool into two types: bloody diarrhea, usually caused by bacterial agents, and non-bloody diarrhea, which can be caused by bacteria, bacterial toxins, or viruses. In Vietnam, the proportion of diarrhea cases caused by bacteria is significant, but it is likely still less than those caused by viruses.
Dr. Nguyễn Thị Phương Huệ – deputy head of the Outpatient Department at Children’s Hospital 2 – mentioned that children with viral diarrhea often experience high fever, fatigue, starting with vomiting, and then develop watery, odorless diarrhea. Typically, the illness resolves within 3-5 days, but in some cases, it can last up to seven days. The treatment for children with viral diarrhea mainly includes antipyretics, rehydration, and good nutrition.
Viral diarrhea usually occurs more frequently in infants, but recently the hospital has seen cases in children aged 7-10 as well. Children with viral diarrhea often do not show signs of weakness or lethargy; they still play and eat even when experiencing diarrhea multiple times.
In contrast, children with bacterial diarrhea typically exhibit signs of lethargy, fatigue, sunken eyes, dry skin, dry lips, reduced urination, and dark yellow urine — clear signs of dehydration that caregivers can easily recognize. Unlike bacterial diarrhea, which is usually transmitted through oral-fecal routes, viral diarrhea can spread rapidly through respiratory routes. Preventive measures are also quite challenging, especially for children attending daycare or preschool.
What to Avoid
According to Dr. Hoàng Lê Phúc, many mothers with children suffering from diarrhea make several common mistakes, such as making their child fast from food and drinks or allowing them to drink fluids too quickly when they should be fed slowly. If fed too quickly, children may vomit or exacerbate the diarrhea.
Some mothers mistakenly believe that medication is more important than hydration, not realizing that water is more crucial than medicine. When a child has diarrhea, failure to rehydrate can quickly lead to severe dehydration and even death.
When giving fluids, it is essential to choose appropriately. Oresol is a medication used to treat dehydration. To prevent dehydration, children can drink various types of fluids, except for sugary drinks. Oresol should only be given after loose stools. Some mothers have mistakenly given their children Oresol as if it were plain water daily when the child was not dehydrated, leading to excess salt and potential toxicity in children, causing symptoms such as convulsions and coma.
Dr. Phương Huệ advises against giving children antidiarrheal medications. This is not beneficial for children as it can disrupt intestinal contractions, exacerbating the effects of viral toxins on the intestines, leading to bloating and increased fatigue.
Rehydration is Key
In terms of treatment, the primary focus should be on ensuring that children drink more fluids than usual to prevent dehydration due to diarrhea and to replenish lost fluids. Children should be given fluids slowly, one spoonful or sip at a time (if they are older). If a child vomits, take a break for about 10 minutes before continuing to give fluids but at a slower pace.
If the child is still breastfeeding, breast milk serves as both food and the best type of “water.” Encourage breastfeeding as much as possible and allow longer feeding sessions. For older children, they should be given additional types of fluids such as broth, boiled vegetable water, porridge water, soy milk, yogurt, fresh juice (without or with very little added sugar), fresh coconut water, and boiled water.
Avoid sugary drinks and overly sweet fruit juices as they can worsen the child’s condition. Encourage children to eat and drink more than usual to gain strength and recover quickly. Increase the number of meals while reducing the quantity of food per meal. Supplementing with zinc tablets may also be beneficial.
LÊ THANH HÀ
