Diarrhea
Diarrhea
What does diarrhea mean?
Diarrhea is when stools are loose and watery and the frequency of stools is more than 3 in a day. Your child may pass stools more than this. Diarrhea is a very common problem in children. It usually lasted for a few days 1 to 2 days and resolves on its own. If diarrhea does not subside within 2 days then there may be more problems in your child.
Diarrhea Maybe
Acute Diarrhea (Short Term) - your child will have sudden onset loose bowel movements with very high frequency. It usually lasted for a few days and subsides on its own. It is due to infection by bacteria and viruses.
Chronic Diarrhea (Long Term) – Diarrhea lasts for a few weeks. it may be of sudden onset diarrhea with high frequency but does not subsides as in acute diarrhea and continues more usually more than 14 days (Persistent Diarrhea) or gradual onset but lasted for more than 14 days (chronic diarrhea). Chronic diarrhea may be due to intestinal diseases like celiac disease, food protein allergy (cow milk protein allergy), ulcerative colitis, Crohn’s disease, irritable bowel syndrome.
What are the causes of diarrhea in children?
Children may be having diarrhea because of many things, including:
- Bacterial infection
- Viral infection
- Parasitic infection
- Celiac disease
- Digestion problems (food intolerance)
- Immune problem - food allergy like cow milk protein allergy (CMPA)
- Intestinal disease – inflammatory bowel disease
- Functional bowel problems like irritable bowel syndrome
- Immune deficiency
Severe diarrhea means your child may be having a serious disease. Consult your doctor if diarrhea symptoms don’t go away. Also take help from your doctor if your child stops activities, feeding because of diarrhea.
What are the symptoms of diarrhea?
Symptoms can be different in different children. This includes:
- Frequent urge for motions
- Cramping
- Belly pain
- Stomach upset or nausea
- Vomiting
- Fever
- Bloating of stomach
- Blood in the stools
- Loss of body fluids (dehydration)
- Decreased urine output
- Lethargy and decreased activities
- Refusal of food/ feeding (poor oral intake)
- Irritability
- Poor weight and height gain (not thriving well)
The symptoms of diarrhea may look like other health problems. Severe diarrhea and chronic diarrhea may be a sign of serious disease. Make sure that your child sees the doctor (pediatric gastroenterologist) for diagnosis.
How is diarrhea diagnosed?
Your doctor will ask you for a detailed history (child symptoms and other health related, feeding related history). Then he/she will do a physical examination. After evaluation, your doctor may sometimes ask for a few tests to check blood and urine to detect the cause of diarrhea.
These tests include:
- Stool tests – to detect infection like abnormal bacteria or parasites in your child’s intestine. A small stool sample is collected in a stool container and sent to the lab.
- Stool evaluation of blood or fat
- Blood tests to rule out certain diseases such as celiac disease, immune deficiency
- Endoscopy – This test helps your doctor to see your child's food pipe (stomach and intestine and colon) from inside to detect diseases like celiac disease, inflammatory bowel disease, and CMPA). It also helps to detect what is causing diarrhea, stomach pain, constipation, abnormal growth, bleeding in your child. Not all children with diarrhea need an endoscopy. Only a few of them need evaluation by endoscopy. Depending on your child's conditions upper GI endoscopy (to see the esophagus, stomach, and duodenum) or colonoscopy (to see the large intestine), or sigmoidoscopy (to see the rectum and sigmoid colon) will be suggested.
How to treat diarrhea in children?
Treatment of diarrhea in your child will depend on age, the severity of illness, child symptoms, and general health.
In acute diarrhea, dehydration is a major concern in children. Most of the child treatment includes replacement of fluid deficit either orally with ORS (oral rehydration salt) or intravenous fluid therapy (IVF). Antibiotics are only prescribed in bacterial infections are the cause of diarrhea.
Do the following:
- You have to give lots of fluids (ORS) to your child to drink. It prevents dehydration by replacing lost fluid.
- Feeding should be continued.
- Keep Breastfeeding your baby if the baby is o breastfed
- Avoid juice or soda or soft drink. They may aggravate diarrhea.
- Avoid plain water for your baby
- Not give too much plain water to children of any age. It can be dangerous.
What are the complications of diarrhea?
- Dehydration – greatest complication of acute diarrhea. This is more common in young children and those with weak immune systems. Dehydration may be mild, moderate, and severe. In the worst cases, it can lead to shock which is life-threatening.
- Poor thriving – in chronic diarrhea
- Malabsorption – in chronic diarrhea
How can we prevent diarrhea?
- Proper handwashing can reduce bacterial and viral spread
- Exclusive breastfeeding (till 4 to 6 months of age)
- Vaccination – Rotavirus vaccine
- Drinking potable water only
- Not eating raw or undercooked meat and fish
- Not eating raw vegetables or fruits unless properly washed.
- Not eating street foods
When should I consult my doctor for diarrhea?
You should consult your doctor if your child is less then 6 months of age or has any one of the following symptoms:
- Pain abdomen
- Blood or mucous in the stools
- Frequent vomiting
- Refusal to feed or does not want to drink liquids (ORS)
- Lethargy or decreased activities
- High fever
- Dry, sticky mouth
- Weight loss
- Urinates less frequently
- Frequent motions and the large volume of diarrhea
- Extreme thirst
- Sunken eyes
- No tears when crying
