Мила Марги, не иска да давам акъли или съвети, а САМО да се опитам да те насоча. Три месеца с разтройство е много, рота вируса е тежък, но минава за седмица, най- много 10 дни. Това, което му даваш е доста и би трябвало да е подействало до сега. Както го описваш ми прилича на непоносимост към храна или съставка на храна или мляко. Особено е типично при непоносимост към захрата в млякото Lactose Intolerance, но има и други. Това, което ме безпокои е, че той губи ценни вещества необходими за развиващич се организъм. Моляте миличка потърси още едно мнение. Забравих да те попитам, те изследваха ли му акото и как се установи Рота вирус?
How long does it take to show signs of rotavirus after being exposed?
The incubation period for rotavirus diarrhea is 1-3 days. Symptoms of infection vary and depend on whether it is the first infection or a repeat infection.
What are the symptoms of rotavirus?
In young children, rotavirus disease commonly begins with fever and vomiting, followed by diarrhea. Vomiting and diarrhea may last from three to seven days; the diarrhea may be watery. Children may lose interest in eating and drinking and become dehydrated from loss of fluids.
Етко, ето причинителите на хронична диария при деца:
Differential Diagnosis
1. Malabsorption secondary to pancreatic insufficiency or intestinal mucosal injury
Children are frequently irritable and have loss of appetite
Stools are foul smelling and greasy
Poor weight gain and abdominal distention.
The child is often weak and displays decreased activity.
Anemia, hypoproteinemia, vitamin deficiencies.
2. Allergies to Food
Vomiting, diarrhea, and blood in stool
+ family history of atopy
Failure to gain and grow
History of eczema, reactive airway disease, urticaria, and allergic rhinitis
Loss of protein in the gut may lead to hypoproteinemia and edema
3. Lactose Intolerance
Genetic lactase deficiency is rare in young children and will manifest later on in life
Secondary lactase deficiency following gastroenteritis is usually transient and is improved within 2 weeks
4. Giardia Infection
Foul smelling watery stools
Gassy and abdominal distention
Can develop into chronic condition and diagnosed by inspecting stool or duodenal fluid for cysts.
Usually waterborne but can be from person to person transmission
5. Cryptosporidium
Watery, foul smelling stools that may contain mucus.
Crampy abdominal pain
+ oocysts in stool specimen
Waterborne or animal or person to person transmission.
Though not necessarily apposite to the above case, medications, in particular, antibiotics, are common causes of diarrhea in children of any age.
6.Pathogenesis
Increased colonic transit time and decreased inhibition of post-prandial transit time
This is easiest to understand when considering its extreme form which takes place in short bowel syndrome, also known as short-gut, where at least 2/3 of the intestines have been surgically excised (secondary to NEC, tumor, ischemia, etc.)
Decreased fat in diet because of diarrhea that is needed to decrease transit time
Fluid load is increased because of fear of dehydration and this aggravates the condition
Increase sugar in diet that acts as an osmotic diuretic and causes more water in the gut.
Treatment
Increase fat in the diet
Decrease fluid in the diet
Avoid fructose and sorbitol- decrease fruit juices
Increase dietary fiber
Normal diet for age
Reassurance- this is difficult because parents have been to many physicians and are convinced that their child has a serious illness. It is important after making your recommendations to follow-up soon to reassure again and watch weight and height gains.
There is no role for medications.
The parents should be told that there is no serious sequelea and this is not a precursor to inflammatory bowel disease, chronic diarrhea as adults.
Most children are better by 4 years of age, and are better by the time they become potty trained.
The APA has recently (Dec 2010) investigated the use of probiotics and prebiotics in the treatment of gastrointestinal ailments in children. They preliminary, good data shows that taking probiotics can limit the duration of infectious diarrhea in children by up to 40 hours, and reduce the occurrences of diarrhea in children exposed to enteric viral infection (rota) and started on antibiotics. In healthy children, the use of probiotics and prebiotics have been found to be completely safe thus making their use worth a try.
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Дашам ти тези неща, защото причината може да е толкоз елементарна и да не се нуждае от никакво лекарсво, а просто изключване от менюто някоя храна.
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