Diarrhea In Children

Overview, Causes, & Risk Factors

Diarrhea is a condition in which loose, watery stools are passed with greaterfrequency than normal.

What is going on in the body?

Diarrhea occurs when the colon or large intestine becomes irritated. This canbe caused by many things, including infection, chemical toxins, inflammation,stress, or anxiety. Thecolon responds to this irritation in the following ways:

  • The amount of water and mucous in the stool is increased.
  • The amount of water the colon reabsorbs from the stool is decreased.
  • The intestine empties the stools from thebody with increased frequency.
  • What are the causes and risks of the condition?

    Most of the time, diarrhea in children is caused by the viruses that causegastroenteritis. Diarrhea is often associated with vomiting.There are other causes of diarrhea, such as:

  • bacteria that invade the intestinal tract
  • gastrointestinal disorders, such as irritable bowelsyndrome
  • inherited birth defects, such as cystic fibrosis
  • the introduction of a new food
  • toxins from contaminated food
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Diarrhea in children can cause the following symptoms:

  • abdominal distressand cramping, which may disrupt sleep
  • frequent, watery stools, and in more serious situations,pus or blood
  • irritability
  • loss of appetite
  • sluggishness and less activity than usual
  • vomiting
  • When severe, diarrhea can cause dehydration. Signs of dehydration include the following:

  • absence of tears when crying
  • decreased urination
  • dry mouth
  • sluggishness and lethargy
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diarrhea is diagnosed by the frequency and looseness of the stools. The causeof the diarrhea is diagnosed by considering other symptoms. These may includethe presence of blood or mucus in the stool, the duration of the diarrhea,weightloss, or other signs of illness.

    A healthcare provider will take a history of the child’s symptoms. He or shewill then do a physical exam. The provider will look for signs of dehydration.

    Labs tests, such as blood tests and tests on the stool, may be performed.Special X-rays may be taken, as well. Occasionally, an instrument known as acolonoscope is used to view the interior of the intestine. This canhelp determine the cause of the diarrhea.

    Prevention & Expectations

    What can be done to prevent the condition?

    Diarrhea is very contagious if it is caused by an infection. It is important touse good hand-washing technique, particularly in the following situations:

  • after cleaning aquariums or touching pets
  • after diaper changes
  • before and after handling food, especially poultry
  • Foodpoisoning can also be minimized by cleaning all utensils, cleaningcooking or preparing surfaces, and cooking meat until it is cooked through andno longer pink.

    What are the long-term effects of the condition?

    Usually there are no serious long-term effects if diarrhea in children iseffectively treated. In countries where access to intravenous fluids andmedication is limited, children may suffer from other diseases or diarrhea maybe fatal.

    If the illness is caused by a serious infection or the child becomes extremelydehydrated, there may bemore serious long-term effects. If a child becomes severely dehydrated, theamount of fluid in the bloodstream decreases. This makes it difficult for thebodily organs to get enough oxygen and nutrients. If this is severe enough,this can cause death. Diarrhea is one of the leading causes of death inchildren around the world.

    Diarrhea, especially in toddlers, can last a long time. If it is accompanied bypersistent loss of appetite, it can lead to nutritionalproblems. This, however, is unusual. Diarrhea can sometimes cause temporaryproblems digesting milk products, a condition known as lactoseintolerance. This usually resolves on its own. If a child is stillin diapers, diarrhea may cause severe diaper rash.

    What are the risks to others?

    Diarrhea caused by a virus or bacterial infection may be contagious. It isimportant to wash hands well to prevent spreading germs. The elderly, youngchildren, or others who have weakened immune systems are at increased risk.Diarrhea can cause more serious symptoms in these individuals.

    Treatment & Monitoring

    What are the treatments for the condition?

    Diarrhea in children is treated by replacing the fluid in the body. Usuallythis is done through oral feedings. Most of the time, the child can maintain anormal diet if the diarrhea is mild. Some children are not able to toleratecow’s milk when they have diarrhea. A toddler or young child who is stillbreast-feeding can continue nursing.

    If the diarrhea is moderate, a healthcare provider may recommend clear fluidsfor the first 6 to 24 hours. Diarrhea makes children very thirsty. Usually thehealthcare provider will recommend giving plenty of fluids if the child is notvomiting. The main goal in treatment of diarrhea is to prevent dehydration.Prepared drinks such as Pedialyte or Resol can help replace water and salts,known as electrolytes, that are lost through the diarrhea. White grape juice may be used instead if an electrolyte solution is not available.

    After the first 6 to 24 hours of a clear liquid diet, bland foods may be added.These include bananas, rice, applesauce, and dry toast. Additional foods can beadded slowly. Avoiding raw fruits and vegetables, beans, fatty foods, and spicyfoods may also be helpful while the child has diarrhea. Reducing the intake ofmilk and other milk products for the first few days with diarrhea may alsoreduce stomach irritation.

    If diarrhea becomes severe, fluids may be given through an treatment with intravenous tube, or IV. A tube is put into a vein in the child and fluids are given throughthe tube. Hospitalization is sometimes necessary in this case. If unusualsymptoms are present or if the child is acting very sick, the healthcare providermay look for conditions that may require further treatment. Medications orsurgery may be needed.

    What are the side effects of the treatments?

    There are generally few side effects to the above treatments. If medicationsare needed for the underlying cause of the diarrhea, there may be side effectsto the medications. These include further stomach upset or allergicreactions.

    What happens after treatment for the condition?

    A few days of diarrhea generally are not a cause for concern. The exceptionwould be if the child is not taking drinking enough fluid to compensate for theliquid lost in the diarrhea. A healthcare provider may recommend progressing toa regular diet slowly or may recommend avoiding milk products for a limitedperiod of time. If diarrhea continues despite treatment, the healthcareprovider should be notified.

    How is the condition monitored?

    Most cases of diarrhea last 3 to 5 days. A healthcare provider should be calledimmediately if any of the following apply:

  • blood or pus in the stool
  • changes in the child’s regular behavior
  • decreased intake of fluids, accompanied by diarrhea
  • decreased urination
  • diarrhea that lasts for more than 5 days
  • no tears when the child cries
  • persistent high fever
  • severe abdominal distress
  • sickness that is more than just mild
  • vomiting and inability to keep fluids down
  • weight loss
  • Any other new or worsening symptoms should also bereported to the healthcare provider.

    Article type: xmedgeneral