DIARE

Dewi Rahmawati
• Outline
a. Definisi Diare
b. Gejala-gejala Diare
c. Terapi (Farmakologi & Non Farmakologi
Definisi
Diarrhoea is defined as an increased
frequency of bowel evacuation, with the
passage of abnormally
soft or watery faeces

The basis of treatment is electrolyte

and fluid replacement;
in addition, antidiarrhoeals are
useful in adults and older
children
Jenis Diare
• Diare Non Spesifik : diakibatkan karena cemas/stress selflimiting
• Diare Spesifik : Infeksi Virus, bakteri, atau penyakit IBD, IBS
• Diare akut : kurang dari 14 hari
• Diare kronis : lebih dari 3 minggu
Symptoms
• Acute diarrhea
a. Rapid onset
b. Produces watery stools that are passed frequently
c. Abdominal cramps, flatulence and weakness or malaise
d. Nausea and vomiting

Perlu ditanyakan pada bayi Severe

mengenai muntah dan demam dehydration
yg di alami
• The presence of blood or mucus in the stools
• Diarrhoea with severe vomiting or with a high fever would

referral or require medical advice

• Chronic diaarrhoea  more than 3 weeks duration

Bowel conditions antara lain;

Crohn’s disease,IBS or ulcerative
colitis and requires medical advice
• Irritable bowel syndrome This non-serious, but troublesome,condition is one of
the more common causes of recurrent bowel dysfunction in adolescents and
young adults.
• The patient usually describes the frequent passage of small volumes of stool
rather than true diarrhoea.
Penyebab
• Infeksi
• Obat-obatan
•
When to refer
• Diarrhoea of greater than
• 1 day’s duration in children younger than 1 year
• 2 days’ duration in children under 3 years and elderly patients
• 3 days’ duration in older children and adults
Management Terapi
• Oral rehydration therapy
• Tx utk cegah dehidrasi terutama pd anak dan lansia
• standard treatment for acute diarrhoea in babies and young children.
• Oral rehydration sachets may be used with antidiarrhoeals in older children and
adults
• Oral rehydration therapy contain sodium as chloride and bicarbonate, glucose
and potassium.
• The absorption of sodium is facilitated in the presence of glucose.
• Patients should be reminded that only water should be used to make the solution
(never fruit or fizzy drinks) and that boiled and cooled water should be used for
children younger than 1 year.
• The solution can be kept for 24 h if stored in a refrigerator. Fizzy, sugary drinks
should never be
Loperamide
• effective antidiarrhoeal treatment for use in older children and adults.
• When recommending loperamide the pharmacist should remind patients to drink
plenty of extra fluids.
• Oral rehydration sachets may be recommended.
• Loperamide may not be recommended for use in children under 12 years.
Kaolin
• used as a traditional remedy for diarrhoea for many years
• Its use was justified on the theoretical grounds that it would absorb water in the GI
tract and would absorb toxins and bacteria onto its surface, thus removing them
from the gut.
• The use of kaolin-based preparations has largely been superseded by oral
rehydration therapy, although patients continue to ask for various products
containing kaolin.
Morphine
• The theoretical basis for its inclusion is that morphine, together with other narcotic
drugs such as codeine, is known to slow the action of the GI tract; indeed,
constipation is a well recognize side-effect of such drugs.
• Kaolin and morphine mixture remains a popular choice for some patients, despite
the lack of evidence of its effectiveness
• Opioid analgesic : ESO konstipasi

Jangka waktu Pengobatan : 1 hari pada naka-anak, 2 hari pselain anak

• Px Diare disrankan minum selain susu
• Boleh dianjurkan menghindari makanan padat selama 24 jam. ASI/PASI tetap
harus diberikan pd bayi terutama yang undernourishutamakan kesehatan.
• PASI dihentikan, jika diduga karena enzim sal cerna tdk bekerja dgn baik terutama
pd fase akut diare atau karena tidak cocok dgn PASI (susu sapi)lactose
intolerance
Studi Kasus
• Seorang ibu datang ke apotek meminta obat untuk anaknya yang berumur 14 bln,
anaknya mengalami diare sejak tadi kemarin malam dan semakin parah sampai
sore hari ini, BAB konsitensinya lunak, frekuensi BAB 5 x sehari dalam sehari,
lemas dan lesu serta demam. Beberapa sebelumnya ibunya menganti susu
formulanya dengan merek yang lain. Bagaimana tanggapan anda sebagai
farmasis/apoteker dan pengobatan apa yang tepat dan dapat diberikan kepada
pasien ini?
Studi kasus 2
• Seorang pemuda datang ke apotek ingin membeli obat untuk diare yang dialami
sejak tadi malam, frekuensi BAB yang dialami sudah 5 x konsistensinya semipadat
(lunak) dan tidak berlendirnya. Badan terasa letih, lesu dan lemas serta nafsu
makan sedikit menurun daripada biasanya. Bagaimana tanggapan anda sebagai
farmasis/apoteker dan pengobatan apa yang tepat dan dapat diberikan kepada
pasien ini?