Diarrhea

Understanding
Diarrhea is a condition in which the stool is dilute or watery with a frequency more often than usual. Generally, the cause of diarrhea is food or drink is dirty and contaminated with microorganisms.

Many people suffer from diarrhea once or twice a year. Usually diarrhea lasts 2-3 days and can be treated with over-the-counter medications. But in special cases, diarrhea can last for weeks.

Diarrhea is still a major health problem in developing countries, including Indonesia. This is due to the morbidity rate (comparison between sick and healthy people in a population) and mortality is high. Diarrhea is ranked thirteen causes of death in general in Indonesia with a proportion of 3.5 percent. As for the category of infectious diseases, diarrhea ranked third.

The most age group experienced diarrhea was toddlers, which was 16.7 percent. The prevalence of diarrhea was slightly higher in boys (14.8 percent) than girls (12.5 percent). The results also show that the highest prevalence of diarrhea occurs in children who live in homes without access to clean water is 18.4 percent.
(Data taken from research result of RI Department of Health in 2007)

Diagnosis
Generally, diarrhea can last up to a week and can heal without any treatment. However, if the condition you are experiencing is severe enough, immediately consult a doctor.

To find out if the patient has diarrhea and the cause, the doctor first gathers information about the symptoms experienced. The doctor will ask for the texture of the stool, the frequency of defecation, the daily habits of the patient. In addition you should also inform your doctor if there are other symptoms that accompany (high fever), unusual food consumption, psychological factors, and certain medications that may be undertaken. This can include the analysis of fecal samples, blood tests, and rectal examination .

There are several checks that can be done to diagnose diarrhea, among others: 

• Analysis of feces 

The doctor will ask you to submit the fecal sample for analysis. It aims to identify possible infections. This analysis is done if you have experienced diarrhea for more than two weeks, there is blood or pus in the stool, or there are other symptoms that accompany. In addition, this examination also needs to be done if you have diarrhea after hospitalization or due to a weak immune system (people with HIV).

• Blood test

Your doctor will ask you to take a blood test if diarrhea is suspected as a symptom of another illness. For example, blood test results show inflammation. This is one symptom of inflammatory bowel disease.

• Rectal examination

If the patient is over 50 years old or has diarrhea that is difficult to recover, the doctor will perform a digital rectal examination. How to check is to insert a finger into the rectum to check for abnormal conditions. This examination aims to diagnose diseases associated with the rectum and intestines.

• Additional checks
  

The doctor may also suggest the following checks to help conclude the diagnosis: 

• Sigmoidoscopy, inserts a sigmoidoscope device (thin and flexible tube with camera at the end) into the rectum up to the intestine
• Colonoscopy, the procedure is similar to sigmoidoscopy but tubes are used larger (colonoscope) to check overall intestinal conditions 

SymptomsIn each patient, diarrhea symptoms vary. Some people secrete very dilute stools, while others secrete feces that are less dilute. However, there are some symptoms that are often associated with diarrhea. These symptoms include stomach cramps, nausea and vomiting, headaches, and loss of appetite.
Generally in adults, diarrhea will recover within 2-4 days. In children, the longer recovery time is 5-7 days. If the diarrhea lasts more than a week or the condition gets worse, check your doctor immediately. Beware also signs of dehydration during the recovery period.
Diarrhea and Dehydration
Fluid secretion through excessive feces plus loss of appetite can affect dehydration. This condition should be addressed as it can be fatal. Dehydration itself is easier to occur in children. This is because the resistance of children to dehydration is lower than adults.Symptoms of dehydration in children include: 

• Rarely urinate
• His mouth is dry or cry without tears
• Feces are bloody, red or black
• Seemed drowsy and unresponsive
• Looks sunken on the eyes or stomach
• If the pinched skin does not return (turgor decreases)

While signs of dehydration in adults include:

• Fatigue and lack of energy
• Missing appetite
• Nausea
• Dizzy
• The tongue feels dry
• The eyes look sunken
• Muscle cramp
• Heart beat 

TreatmentSymptoms of diarrhea will generally disappear by itself without any treatment assistance. Usually the diarrhea lasts up to 7 days. In certain cases, diarrhea may last longer depending on the cause. You can do the following to relieve the condition that is being experienced:
Expand fluid intake
When you have diarrhea, you should consume more fluids. Especially if accompanied by vomiting. This is needed to avoid and handle dehydration. Drink a little but often. Better to enter the liquid slightly than not at all. If enough fluid intake, the urine will be light yellow or almost clear. Avoid giving fruit juice or soft drinks because it will make diarrhea worse.
Eat
At the time of diarrhea, experts recommend that you do not eat solid foods first. At least until you are able to eat normally. Eat smaller portions than usual. Also avoid fatty and spicy foods.
Do not give solid foods to children if they are dehydrated. Wait until they consume enough fluids. New foods can be given after they no longer show signs of dehydration. If the child is not dehydrated, give the food as usual.
Oralital fluid
For people with diarrhea who are susceptible to dehydration, doctors will recommend the use of ORS. Those of you who are weak-minded, aged over 60 years, and have a history of serious health are strongly advised to consume ORS.
Oralite is sold freely in pharmacies. You just mix it with water. The function of ORS is to replace the salt, glucose, and other essential minerals that may be lost when experiencing fluid shortage.
For patients with children, the doctor will suggest oralit if visible signs of dehydration. Oralite can be given every time a child defecates. The amount depends on the child's weight.
Use of drugs
Antidiarrheal drugs can reduce the symptoms of diarrhea and shorten its duration. However, actual medication is not necessary because the immune system will fight it naturally. The most commonly used antidiarrheal drug is loperamide because it can reduce bowel movement so that the liquid will be absorbed more. This can help overcome diarrhea.
Do not take antidiarrheal medication if diarrhea is accompanied by other symptoms such as high fever and there is blood or pus in the feces. You should immediately consult a doctor.
Use of antibiotics for diarrhea
Usually the doctor will advise the use of antibiotics if the cause of diarrhea has been confirmed bacteria or if diarrhea occurs very badly. It is not recommended to use antibiotics if the cause of diarrhea is not known for sure. This is because antibiotics will not work if the cause of infection is a virus. And if used for mild disease will reduce the effects of antibiotics against more serious conditions.
Pain relief medicine
The painkiller can not cope with diarrhea. However, administration of paracetamol or ibuprofen may help relieve symptoms that accompany diarrhea such as fever and headache. Make sure you provide the appropriate medicines and follow the instructions for use.Treatment of the main conditions
If you have previously been diagnosed with certain diseases that can cause diarrhea, you should treat the disease first. This will alleviate the condition of the diarrhea. If the main condition is not handled appropriately, then the diarrhea as a symptom will continue. 

CauseDiarrhea generally occurs when fluid from food can not be absorbed intestine well. Or there is too much fluid secreted into the intestine. Normally, the large intestine absorbs the fluid from the food we consume and leaves the stools (half feces) dense. If the liquid from the food is not absorbed well, then the result of the stool will be dilute or even liquid. This condition is influenced by many factors so that diarrhea can be short or long.
Short-lived diarrhea
Usually this diarrhea is a symptom of intestinal infection, caused by:

• Viruses, such as rotavirus
• Bacteria, such as campylobacter
• Parasites, such as intestinal giardia
  

Other causes include psychological factors (feel anxious), consume alcohol, food allergies, appendicitis, or side effects of drugs.
Long-term diarrheaCan be caused by:

• Colon syndrome
• Celiac disease, a disease that causes the body to reject gluten protein
• Crohn's disease, inflammation of the lining of the digestive system
• Chronic pancreatitis
• Bowel cancer
• Side effects of abdominal removal (gastrectomy) 

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Atopic Dermatitis (Allergy to Skin)

UnderstandingAtopic dermatitis is one type of dermatitis (eczema) that occurs due to inflammation of the skin. This condition can be accompanied by skin that is red, dry, and cracked. Inflammation usually lasts long, even for years.
Atopic dermatitis often appears in areas of skin that have creases. As in the forehead of the face, the area around the eyes and ears, the side of the neck, the inside of the elbow, the back of the knee, and the area around the groin.
Sometimes atopic dermatitis can also be followed by other allergic diseases. Atopic dermatitis is more common in infants and children. However, this condition can also occur in adults. 
ComplicationsAtopic dermatitis may cause complications. Complications that occur include:

• Chronic itching causes scaly skin. A skin condition called neurodermatitis begins with a patch of itchy skin.
• Skin infections. Scratching on the skin repeatedly can cause open sores. This increases the risk of infection from bacteria and viruses, including the herpes simplex virus.
• Eye problems. Symptoms of eye complications include itching around the eyelids, eyelid inflammation (blepharitis), and inflammation in the conjunctiva (conjunctivitis).
• Irritant dermatitis. This primarily affects people whose jobs demand that their hands are often wet and exposed to harsh soaps, detergents, and disinfectants.
• Sleep problems. The itchy cycle can cause you to wake up repeatedly. Ultimately this will degrade your sleep quality.
• Behavior issues. Studies show an association between atopic dermatitis and attention-deficit disorder or hyperactivity disorder, especially if the child also loses sleep.

Diagnosis
The process of diagnosis in atopic dermatitis can be done by the doctor through the collection of information. The doctor will ask you several things, such as medical history and scratching habits (pruritus).

Symptoms
The most easily recognizable symptoms and signs of atopic dermatitis are severe itching. The itching sensation will usually worsen at night. Sometimes to interfere with sleep quality of the sufferer.

When the itch is worsening, you may find it hard to resist the urge to scratch. The thing is, scratching can make your condition worse. The skin may bleed from scratching, itching, and secondary infection occurs.

• In addition to the itchiness, there are other signs that you can recognize, such as:
• Skin that is reddish or tanned.
• The appearance of small bumps filled with fluid.
• In the long term, the skin will thicken, cracked, scaly, and rough.

Although more often appear in areas of skin that have a fold, actual atopic dermatitis may appear throughout the skin surface 

Treatment
Treatment of atopic dermatitis focuses on precipitating factors, including food allergens. Usually the doctor will give allergy that has the effect of drowsiness to relieve itching at night. However, if there are symptoms of airway, your meal requires allergy that does not provide sleepy effect.

Antibiotics will be given if there are other diseases that accompany atopic dermatitits. To prevent skin dryness, keep hydration and use emollients. Avoid also the use of alkaline soaps. If your skin allergy is severe enough, you may need a local corticosteroid by injection. 

Prevention
You can do several things to prevent atopic dermatitis from recurring. One of the main ones is to avoid triggering factors. If allergic trigger is dust, avoid dust. If the originator is milk, avoid all foods and drinks containing milk. Doing the following things can also help you:

• Periodically clean the bedding. Change the sheets and pillowcase at least 2 weeks.
• Use a blanket when you sleep, especially if you can not stand the cold.
• Clean the house regularly. 

Cause
Here are the causes of atopic dermatitis:

• Foods, such as: milk, fish, eggs, oranges, nuts, wheat.
• Non-food allergens, such as: dust, detergent, soap, perfume.
• Stress.
• Emotional disturbance.
• Extreme temperatures, such as: cold weather with low humidity and dry air.

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Depression

UnderstandingDepression is a mood disorder that causes feelings of sadness and loss of interest constantly. Depression usually affects a person in thinking and behaving, and can trigger a variety of physical and emotional problems.
A person who is depressed may experience problems with daily activities. In fact, they often feel that life is no longer useful. However, a person who is depressed does not mean a weak figure. Because depression is a disease that can be cured.
If left unchecked, depression can lead to dangerous complications. For example anxiety disorders, panic disorder or social phobia. People who suffer from depression tend to be socially isolated so that the desire to commit suicide. In addition, they are also vulnerable to harm his own body. For example cutting a particular limb.
Depression can get worse if left untreated. Untreated depression can lead to emotional problems, behaviors, and health problems that can affect every aspect of your life, even leading to death.

Diagnosis
In addition to consultation to the doctor, to diagnose depression is also required psychological evaluation by psychiatrists. You will be asked to answer and fill out some of the questions included in the depression guide.

The doctor will also perform a physical exam if necessary. Depression can also be caused by certain side effects of the disease.

Therefore, doctors can also perform laboratory tests such as full blood tests or thyroid tests to determine your thyroid function
The key words of depression are a moody mood and lose interest in activities you've previously liked. To establish a diagnosis of depression, a psychiatrist needs to watch for signs, at least for two weeks.

SymptomsDepression symptoms occur for at least two weeks. Some sufferers can suffer from severe depression that disrupts their daily activities. For example in work, at school, social activities, or in interacting with others. Some other sufferers may also feel unhappy without knowing the reason.
The Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) is a widely used guide in diagnosing mental disorders. According to the guidelines, depression can be suffered by a person if he or she has at least five of the following symptoms:

• Feeling moody / depressed most of the day, especially in the morning
• Fatigue or loss of energy almost every day
• Feelings of no use or guilt almost daily
• Disturbance of concentration, uncertainty
• Have trouble sleeping or even sleeping excessively
• Reduced interest and interest in all activities
• The thought of death or suicidal desire that arises repeatedly
• Feeling uneasy or being sluggish
• Significant weight loss or weight gain 

TreatmentUntil now there is no medicine that really cure and eliminate depression. Depression sufferers are recommended to regularly take depression medication and perform psychological counseling. This method proves to be effective for most people with depression.
If you are suffering from major depression, you may need to be admitted to the hospital or follow an outpatient therapy program until symptoms improve. Here are the types of drugs used as depression or anti-depressants:

• Selective serotonin reuptake inhibitors (SSRIs): fluoxetine, paroxetine, sertraline.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): duloxetine, venlafaxine, desvenlafaxine.
• Norepinephrine-dopamine reuptake inhibitors (NDRIs): bupropion
• Atypical antidepressants: trazodone, mirtazapine.
• Tricyclic antidepressants: imipramine, nortriptyline, amitriptyline, doxepin, trimipramine, desipramine.

Monoamine oxidase inhibitors (MAOIs): tranylcypromine, phenelzine, isocarboxazid.
In addition to taking drugs, people with depression can also follow psychotherapy. Psychotherapy is a general term for dealing with depression by talking about your condition and the problems associated with your doctor or counselor. Psychotherapy is also known as speech therapy or psychological therapy. 

Prevention
There is no definite way to prevent depression. However, you can do the following things that may be useful:

• Perform stress control measures, to increase your resilience and confidence.
• Get closer to family and friends, especially during tough times, to help you through it.
• Immediately seek treatment when the earliest signs of depression appear, to help prevent depression gain weight.
  

Consider getting long-term maintenance therapy to prevent symptoms of depression reappearing.
Tip Relieve Depression 

Depression does include a disease that has not yet been found to cure, but you who have already suffered from depression can take various actions to relieve symptoms of depression, such as the following:

• Do not stop taking depression medications before telling your doctor. Stopping treatment suddenly or forgetting to take multiple doses of medication can cause symptoms resembling withdrawal symptoms and may worsen depressive symptoms.
• If you are pregnant or breastfeeding, some antidepressants may be at risk for a fetus or breastfeeding child. Talk to your doctor when you are pregnant or breastfeeding.
• Live life simply. Maybe you should allow yourself to do less work or activity if you feel tired or weak.
• Write a diary to improve your mood.
• Read books or internet sites that can help you get better.
• Do not confine yourself or break away from social activities.
• Find some ways to relax and cope with stress.
• Do not make important decisions when feeling disappointed or moody because maybe you are not thinking clearly. 

CauseUntil now, not yet known exactly what causes depression. However, the disease can be affected by various factors, such as:

• Biological changes. People with depression experience physical changes in their brains. The changes in question can not be clearly defined.
• The instability of chemical reactions in the brain. In a study found if the chemicals contained in the brain may play a role in the occurrence of depression. Changes in brain chemicals will lead to changes in the stability of the mood in a person.
• Hormonal changes. Changes in hormonal balance in the body can lead to depression. Hormonal changes can occur during pregnancy, for several weeks or months after childbirth, due to thyroid problems, menopause, or other conditions.
• Family descent. Depression is more common in people who in their sedarah family also have this condition. Researchers are still trying to find genes that may be involved in causing depression.

In addition to the above factors, some of these factors also potentially increase the risk of developing a person's depression.

• Having low self-esteem and being too dependent on others, often self-blame, and pessimistic.
• Experiencing a traumatic or stressful event. For example sexual harassment or physical torture, death or loss of a loved one, difficult relationships with someone, or financial problems.
• Experiencing childhood trauma or depression that begins as teenagers or children.
• Have different sexual identity such as lesbian, gay, bisexual, or transgender in situations that do not support.
• Have other mental disorders, such as anxiety disorders, eating disorders, or post-traumatic stress.
• Dependence on alcohol or illegal drugs.
• Chronic illness or serious illness, including cancer, stroke, chronic pain, or heart disease.
• Are in certain medications, such as taking some medication hypertension or sleeping pills. Some experts find the relationship of depression with the consumption of certain chemical drugs. Better talk with your doctor before stopping any treatment. 

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