rehydration

Cholera is a bacterial infection that causes diarrhea. The cholera bacterium is usually found in water or food that has been contaminated by feces (poop). Cholera is rare in the US. You may get it if you travel to parts of the world with poor water and sewage treatment. Outbreaks can also happen after disasters. The disease is not likely to spread directly from person to person.

Cholera infections are often mild. Some people don't have any symptoms. If you do get symptoms, they usually start 2 to 3 days after infection. The most common symptom is watery diarrhea.

In some cases, the infection can be severe, causing lots of watery diarrhea, vomiting, and leg cramps. Because you quickly lose body fluids, you are at risk for dehydration and shock. Without treatment, you could die within hours. If you think that you might have cholera, you should get medical care right away.

Doctors diagnose cholera with a stool sample or rectal swab. Treatment is the replacement of the fluid and salts that you lost through the diarrhea. This is usually with a rehydration solution that you drink. People with severe cases may need an I.V. to replace the fluids. Some of them may also need antibiotics. Most people who get fluid replacement right away will recover.

There are vaccines to prevent cholera. One of them is available for adults in the U.S. Very few Americans need it, because most people do not visit areas that have an active cholera outbreak.

There are also simple steps you can take to help to prevent cholera infection:

• Use only bottled or purified water for drinking, washing dishes, making ice cubes, and brushing your teeth
• If you do use tap water, boil it or use iodine tablets
• Wash your hands often with soap and clean water
• Make sure that the cooked food you eat is fully cooked and served hot
• Avoid unwashed or unpeeled raw fruits and vegetables

Centers for Disease Control and Prevention

Dehydration is a condition caused by the loss of too much fluid from the body. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly.

You can become dehydrated because of:

• Diarrhea
• Vomiting
• Sweating too much
• Urinating too much, which can happen because of certain medicines and illnesses
• Fever
• Not drinking enough water or other fluids

Certain people are more likely to develop dehydration:

• Older adults. Some people lose their sense of thirst as they age, so they don't drink enough fluids.
• Infants and young children, who are more likely to have diarrhea or vomiting
• People with chronic illnesses that cause them to urinate or sweat more often, such as diabetes, cystic fibrosis, or kidney problems
• People who take medicines that cause them to urinate or sweat more
• People who exercise or work outdoors during hot weather

In adults, the symptoms of dehydration include:

• Feeling very thirsty
• Dry mouth
• Urinating and sweating less than usual
• Dark-colored urine
• Dry skin
• Feeling tired
• Dizziness

In infants and young children, the symptoms of dehydration include:

• Dry mouth and tongue
• Crying without tears
• No wet diapers for 3 hours or more
• A high fever
• Being unusually sleepy or drowsy
• Irritability
• Eyes that look sunken

Dehydration can be mild, or it can be severe enough to be life-threatening. Get medical help right away if the symptoms also include:

• Confusion
• Fainting
• Lack of urination
• Rapid heartbeat
• Rapid breathing
• Shock

To find out if you dehydration, your health care provider will:

• Do a physical exam
• Check your vital signs
• Ask about your symptoms

Your provider may also order tests, such as:

• Blood tests to check your electrolyte levels, especially potassium and sodium. Electrolytes are minerals in your body that have an electric charge. They have many important jobs, including helping to keep a balance of fluids in your body.
• Blood tests to check your kidney function.
• Urine tests to check for dehydration and its cause.

The treatment for dehydration is to replace the fluids and electrolytes that you have lost. For mild cases, you may just need to drink lots of water. If you lost electrolytes, sports drinks may help. There are also oral rehydration solutions for children. You can buy those without a prescription.

Severe cases may be treated with intravenous (IV) fluids with salt in a hospital.

The key to preventing dehydration is making sure that you get enough fluids:

• Drink enough water every day. Each person's needs can be different, so ask your health care provider how much you should be drinking each day.
• Avoid drinks that have sugar and caffeine.
• Drink extra fluids when the weather is hot, especially if you are exercising or working outside. If you are losing a lot of minerals in sweat, sports drinks can help you. But some sports drinks have lots of sugar, so be careful not to drink too much of them.
• Get extra fluids when you are sick. If you are having trouble keeping liquids down, you can try taking small sips of water or sucking on ice chips.

Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.

Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go.

The most common causes of diarrhea include:

• Bacteria from contaminated food or water
• Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children.
• Parasites, which are tiny organisms found in contaminated food or water
• Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
• Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
• Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease
• Problems with how the colon functions, such as irritable bowel syndrome

Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly.

Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary.

People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year.

People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water.

Other possible symptoms of diarrhea include:

• Cramps or pain in the abdomen
• An urgent need to use the bathroom
• Loss of bowel control

If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.

Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.

Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have:

• Signs of dehydration
• Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours.
• Severe pain in your abdomen or rectum (for adults)
• A fever of 102 degrees or higher
• Stools containing blood or pus
• Stools that are black and tarry

If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants.

To find the cause of diarrhea, your health care provider may:

• Do a physical exam
• Ask about any medicines you are taking
• Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
• Ask you to stop eating certain foods to see whether your diarrhea goes away

If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease.

Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.

Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.

Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.

Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses.

You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries:

• Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth
• If you do use tap water, boil it or use iodine tablets
• Make sure that the cooked food you eat is fully cooked and served hot
• Avoid unwashed or unpeeled raw fruits and vegetables

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Rotavirus is a virus that causes gastroenteritis. Symptoms include severe diarrhea, vomiting, fever, and dehydration. Almost all children in the U.S. are likely to be infected with rotavirus before their 5th birthday.

Infections happen most often in the winter and spring. It is very easy for children with the virus to spread it to other children and sometimes to adults. Once a child gets the virus, it takes about two days to become sick. Vomiting and diarrhea may last from three to eight days.

There is no medicine to treat it. To prevent dehydration, have your child drink plenty of liquids. Your health care provider may recommend oral rehydration drinks. Some children need to go to the hospital for IV fluids. Two vaccines against rotavirus infections are available.

Centers for Disease Control and Prevention