Diarrhea in Children

Diarrhea is defined either as watery stool or increased frequency (or both) when compared to a normal amount. It is a common problem that may last a few days and disappear on its own.

Diarrhea may be:

• Acute (short-term, usually lasting several days), which is usually related to bacterial or viral infections.
• Chronic (long-term, lasting longer than four weeks), which may have a variety of causes, such as irritable bowel syndrome, or may be due to chronic diseases such as ulcerative colitis, Crohn's disease, or celiac disease. Giardia may also cause chronic diarrhea.

Diarrhea in children may be caused by a number of conditions, including the following:

• Bacterial infection
• Viral infection
• Food intolerances or allergies
• Parasites
• Reaction to medications
• A gastrointestinal (GI) disease, such as inflammatory bowel disease
• A functional bowel disorder, such as irritable bowel syndrome
• A result of surgery on the stomach or gallbladder

Many people suffer "traveler's diarrhea" caused by a bacterial infection or a parasite, or even food poisoning.

Severe diarrhea may indicate a serious disease, and it is important to consult your child's healthcare provider if the symptoms persist or affect daily activities. Identifying the cause of the problem may be difficult.

The following are the most common symptoms of diarrhea. However, each child may experience symptoms differently. Severe diarrhea may indicate a serious disease, making it important to consult your child's healthcare provider if any or all of the following symptoms persist:

• Cramping
• Abdominal pain
• Bloating
• Nausea
• Urgent need to use the restroom
• Fever
• Bloody stools
• Dehydration
• Incontinence

The symptoms of diarrhea may resemble other conditions or medical problems. Always consult your child's healthcare provider for a diagnosis.

You should call your healthcare provider if your child is less than 6 months of age or presents any of the following symptoms:

• Abdominal pain
• Blood in the stool
• Frequent vomiting
• Loss of appetite for liquids
• High fever
• Dry, sticky mouth
• Weight loss
• Urinates less frequently (wets fewer than 6 diapers per day)
• Frequent diarrhea
• Extreme thirst
• No tears when crying
• Depressed fontanelle (soft spot) on infant's head

In addition to a complete medical history, physical examination, and laboratory tests for blood and urine, the child's healthcare provider may request:

• Stool culture to check for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your healthcare provider's office. In two or three days, the test will show whether abnormal bacteria are present.
• Blood tests to rule out certain diseases.
• Imaging tests to rule out structural abnormalities.
• Tests to identify food intolerance or allergies.
• Sigmoidoscopy, a diagnostic procedure that allows the healthcare provider to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.

Specific treatment for diarrhea will be determined by your child's healthcare provider based on:

• Your child's age, overall health, and medical history
• Extent of the condition
• Your child's tolerance for specific medications, procedures, or therapies
• The expectations for the course of the condition
• Your opinion or preference

Treatment usually involves replacing lost fluids. Antibiotics may be prescribed when bacterial infections are the cause.

To replace the body fluids that are lost with diarrhea, children should drink fluids liberally. If they are dehydrated, a glucose-electrolyte solution (for example, Pedialyte or Infalyte) should be given to help the body absorb fluid more easily. These fluids have the right balance of water, sugar, and salts, and some are available as popsicles. Avoid juice or soda because these drinks may make diarrhea worse. Too much plain water at any age can be dangerous. Do not give plain water to infants. If you are bottle-feeding or breastfeeding your child, continue to do so.