Diarrhoea is a common ailment characterized by frequent, loose, and watery stools. It can be caused by a variety of factors, including bacterial or viral infections, food poisoning, certain medications, and underlying medical conditions. While diarrhoea can typically be managed with over-the-counter medications or home remedies, in severe cases, intravenous (IV) fluids may be necessary to prevent dehydration and electrolyte imbalances.

Dextrose, a simple sugar, is often used in IV fluids to provide the body with energy and hydration. However, dextrose is contraindicated, or should not be used, in patients with diarrhea for several reasons:

1. Dextrose Can Exacerbate Diarrhoea:

Dextrose is a rapidly absorbed sugar, which means it quickly passes through the digestive tract. This can worsen diarrhoea by stimulating the secretion of water and electrolytes into the intestinal lumen. This increased fluid and electrolyte movement can lead to more frequent and watery stools.

2. Dextrose Can Cause Dehydration:

Diarrhoea already leads to fluid loss through frequent bowel movements. Administering dextrose can further exacerbate dehydration by drawing water from the cells into the intestinal lumen. This can lead to electrolyte imbalances and other complications associated with dehydration.

3. Dextrose Can Promote Bacterial Growth:

Dextrose is a favorable substrate for the growth of bacteria, including those that cause diarrhoea. When dextrose is administered to patients with diarrhoea, it can provide a food source for these bacteria, allowing them to multiply and worsen the diarrhoea.

4. Dextrose Can Interfere with Oral Rehydration Therapy:

Oral rehydration therapy (ORT) is the recommended treatment for mild to moderate diarrhoea. ORT involves drinking a solution containing water, electrolytes, and sugar to replace the fluids and electrolytes lost through diarrhoea. Dextrose, if present in ORT solutions, can interfere with the absorption of electrolytes, making ORT less effective.

5. Dextrose Can Worsen Underlying Medical Conditions:

In patients with underlying medical conditions such as diabetes or heart failure, dextrose administration can worsen their condition. In diabetes, dextrose can lead to hyperglycemia, a condition characterized by high blood sugar levels. In heart failure, dextrose can increase fluid retention, worsening the symptoms of heart failure.

CONCLUSION

Dextrose is contraindicated in diarrhoea due to its potential to worsen the diarrhoea, cause dehydration, promote bacterial growth, interfere with oral rehydration therapy, and worsen underlying medical conditions. Alternative intravenous fluids, such as saline or Ringer's lactate, should be used instead of dextrose in patients with diarrhoea.

FREQUENTLY ASKED QUESTIONS

1. Why is dextrose contraindicated in diarrhoea?

Dextrose can worsen diarrhoea by stimulating the secretion of water and electrolytes into the intestinal lumen, leading to more frequent and watery stools. It can also cause dehydration, promote bacterial growth, interfere with oral rehydration therapy, and worsen underlying medical conditions.

2. What are the alternatives to dextrose in IV fluids for patients with diarrhoea?

Saline or Ringer's lactate are preferred IV fluids for patients with diarrhoea as they do not worsen diarrhoea and help correct dehydration and electrolyte imbalances.

3. Can dextrose be used in ORT solutions for diarrhoea?

No, dextrose should not be used in ORT solutions as it can interfere with the absorption of electrolytes, making ORT less effective.

4. What are the signs of dehydration in diarrhoea?

Signs of dehydration in diarrhoea include dry mouth, decreased urine output, sunken eyes, and fatigue.

5. When should a patient with diarrhoea seek medical attention?

Patients with diarrhoea should seek medical attention if they experience severe diarrhoea, vomiting, fever, abdominal pain, or signs of dehydration.