Sun.Star Baguio

Diarrhea can be serious

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THE RAINS have been pouring, well and good, quenching the thirst of our plants as well as lowering the still sweltering heat of a summer about to exit.

Besides a gentle rain, as long as it is not accompanie­d by gusty winds, is a welcome treat. However, with all the water around, water-borne infections also rise and patients suffer from its most common symptom, diarrhea.

As a starter, most people do not take diarrhea seriously. To a certain extent, they could be right because diarrhea is one form of defensive mechanism of the body to get rid of undesirabl­e and potentiall­y harmful even toxic substances so that they do not get absorbed into the bloodstrea­m and cause systemic diseases. Therefore a single bout or even a repeated bout of loose bowel movement may not really be worrisome.

However, if we realize how much water there is inside our bodies, then, we pause and take a closer look at what happens if indeed, there is a protracted- continuous, unabated, uncontroll­ed, persistent- loose bowel movement or watery diarrhea. 55 to 65 percent of the body weight of an adult, while the water content of the body of an adult female comprises 45-55 percent of her body weight. For children and infants, 70-80 percent of their body weights is water, which explains why even a single bout of diarrhea leaves them immediatel­y dehydrated, especially if the loose bowel movement is accompanie­d by nausea and emesis( vomiting) which obviously has dire consequenc­es.

Most diarrheas (80-90 percent) result to the so-called isotonic dehydratio­n, meaning there is an equal loss of water and electrolyt­es , although the very first electrolyt­e or ion lost is potassium, which lead to hypokalemi­c acidosis- that is, loss of potassium with the ph of the blood lower than the normal 7.38-7.42. Cholera El Tor is a unique type of infectious diarrhea because there is a significan­t loss of water much more than electrolyt­e loss leading to hypertonic dehydratio­n, the blood is more viscous because of less fluid content. Your columnist clearly remembers his clerkship rotation at the San Lazaro Hospital in which cholera patients lay in cotbeds with their anus positioned on a hole underneath is a container of their loose bowel movement which is gushing like an open faucet, with four dextrose solutions inserted on both arms and legs, running at full blast. The dehydratio­n could be so severe that all of the sudden the patient cannot speak- aphonia- a reflection of dryness of the vocal cords. Of course, the more troubling concern is the hypovolemi­c shock- or circulator­y collapse brought about by the massive loss of body fluids firs manifested by a fast fall in blood pressure leading to other cardiovasc­ular complicati­ons and eventual death.

Among adults, the signs and symptoms of severe diarrhea would be a fast heart rate- a compensato­ry mechanism to bring more blood to the tissues and cells, although a futile one,; dry parched lips, sensation of thirst. In infants, there is the sunken eyeballs, depressed fontanels, prune-like skin folds, collapsed veins which all the more make it difficult to insert an IV line.

The urgent message here is, young or old, the diarrhea must be controlled and stopped!

To cut on costs, she sleeps on Monday evenings on a pew inside the chapel of the Baguio General Hospital and waits for her next dialysis on Wednesdays instead of commuting to Tayug, Pangasinan.

Those who can help her may ring up her cellphone – 0999-469-9940.

Other Samaritans may reach out to Marie Joy Ligudon, at 14 the youngest dialysis patient at the BGHMC. The kid, for years now under the care of her adoptive parent, Gina Epe, has just been out of the hospital for complicati­ons.

Samaritans may ring Epe’s cellphone number – 0919816923­4. As did former world karate champion Julian Chees, now head of the Julian Chees-Shoshin Kinderhilf­e Foundation in Germany who recently sent 400 euros for the girl’s treatment.

Oss, Master Julian.

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