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Diarrhea

Diarrhea is defined either as watery stool or increased frequency of stool (or both) when compared to a normal amount. It is a common problem that may last a few days and disappear on its own. There are two types of diarrhea: acute and chronic.

Acute diarrhea (short-term, usually lasting one to several days) is usually related to bacterial or viral infections.

Chronic diarrhea (long-term, lasting longer than four weeks) can have a variety of causes including:

What causes diarrhea?

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

Many people suffer “traveler’s diarrhea” caused by a bacterial infection, a parasite or food poisoning. Severe diarrhea may indicate a serious disease, and it is important to consult with your child’s health care provider if the symptoms persist or affect daily activities. Identifying the cause of the problem may be difficult.

What are the symptoms of diarrhea?

The following are the most common symptoms of diarrhea. However, each child may experience symptoms differently. Severe (or chronic) diarrhea may indicate a serious disease, making it important to speak with your child’s doctor if any or all of the following symptoms persist or worsen over one to two weeks, and are affecting your child’s ability to participate in daily activities.  It is important to contact your child’s doctor if there is blood in your child’s stool on more than one occasion.

  • Cramping
  • Abdominal pain
  • Bloating
  • Nausea
  • Urgent need to use the restroom
  • Fever
  • Dehydration
  • Incontinence
  • Bloody stools (contact the child’s doctor as soon as possible).

The symptoms of diarrhea may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis. The pediatric gastroenterologists at CHOC Children’s specialize in working with children and their families to get to the root cause of chronic or severe diarhhea.

What are the warning signs of severe diarrhea?

It is important to contact your child’s pediarician or gastroenterologist if your child is less than six months of age or presents any of the following symptoms:

  • Severe 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 six diapers per day)
  • Frequent diarrhea
  • Extreme thirst
  • No tears when crying
  • Depressed fontanelle (soft spot) on infant’s head.

How is diarrhea diagnosed?

In addition to a complete medical history, physical examination and laboratory tests for blood and urine, your child’s doctor 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 doctor’s office. In two or three days, the test will show whether abnormal bacteria are present. Learn more about stool tests.
  • Blood tests to rule out certain diseases. Learn more about blood tests at CHOC.
  • Imaging tests to rule out structural abnormalities. Learn more about imaging at CHOC.
  • Tests to identify food intolerance or allergies. Learn more about food allergy patch testing at CHOC.
  • Colonoscopy, a diagnostic procedure that allows the health care 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 flexible, lighted tube, called a colonoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier. Learn more about colonoscopy.

What is the treatment for diarrhea?

At CHOC Children’s, our pediatric gastroenterologists work with patients, their families and referring physicians to determine the cause of a child’s acute and chronic diarrhea. Specific treatment for diarrhea will be determined by your child’s health care provider based on:

  • The child’s age, overall health and medical history
  • Extent of the diarrhea, expectations for the course of the diarrhea and underlying cause of the diarhhea
  • The child’s tolerance for specific medications, procedures or therapies
  • The family’s opinion or preference.

Antibiotics may be prescribed when bacterial infections are the cause, but for some bacterial infections, and most viral infections, antibiotics are not recommended due to the body’s ability to fight off most of these infections on its own.

If your child has ongoing, chronic diarrhea, CHOC gastroenterologists will work with the patient, his or her family and other medical specialists as needed to diagnose and develop a treatment plan for the underlying cause of the diarrhea.

Immediate treatment usually involves replacing lost fluids by increasing the amount of liquids the child drinks. If a child is dehydrated, a glucose-electrolyte solution (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. It is important to avoid milk (and milk products), juice or soda because these drinks may make diarrhea worse. Too much plain water at any age can be dangerous and plain water should not be given to infants. Mothers who are nursing should continue breastfeeding their baby as breastfed babies usually have less diarrhea. Formula-fed babies should continue with formula.

Children who are eating solid foods should eat low-residue, low-fiber foods. They should avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn and dried beans.

Viruses, Bacteria and Parasites That Can Cause Diarrhea

Viruses, bacteria and parasites that invade the digestive tract usually cause diarrhea. Symptoms can be mild to severe and can be particularly dangerous for children with weakened immune systems. Learn about viruses, bacteria and parasites in the digestive system and what children and parents can do to minimize the risk of infection.

Long Live Childhood

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