Diarrhea in Children

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

What is going on in the body?

Diarrhea occurs when the colon or large intestine becomes irritated. This can be caused by many things, including infection, chemical toxins, inflammation, stress, or anxiety. The colon 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 the body with increased frequency.

What are the signs and symptoms of the condition?

Diarrhea in children can cause the following symptoms: · abdominal distress and 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

What are the causes and risks of the condition?

Most of the time, diarrhea in children is caused by the viruses that cause gastroenteritis. 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 bowel syndrome · inherited birth defects, such as cystic fibrosis · the introduction of a new food · toxins from contaminated food

What can be done to prevent the condition?

Diarrhea is very contagious if it is caused by an infection. It is important to use 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

Food poisoning can also be minimized by cleaning all utensils, cleaning cooking or preparing surfaces, and cooking meat until it is cooked through and no longer pink.

How is the condition diagnosed?

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

A healthcare provider will take a history of the child's symptoms. He or she will 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 a colonoscope is used to view the interior of the intestine. This can help determine the cause of the diarrhea.

What are the long-term effects of the condition?

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

If the illness is caused by a serious infection or the child becomes extremely dehydrated, there may be more serious long-term effects. If a child becomes severely dehydrated, the amount of fluid in the bloodstream decreases. This makes it difficult for the bodily 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 in children around the world.

Diarrhea, especially in toddlers, can last a long time. If it is accompanied by persistent loss of appetite, it can lead to nutritional problems. This, however, is unusual. Diarrhea can sometimes cause temporary problems digesting milk products, a condition known as lactose intolerance. This usually resolves on its own. If a child is still in 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 is important to wash hands well to prevent spreading germs. The elderly, young children, or others who have weakened immune systems are at increased risk. Diarrhea can cause more serious symptoms in these individuals.

What are the treatments for the condition?

Diarrhea in children is treated by replacing the fluid in the body. Usually this is done through oral feedings. Most of the time, the child can maintain a normal diet if the diarrhea is mild. Some children are not able to tolerate cow's milk when they have diarrhea. A toddler or young child who is still breast-feeding can continue nursing.

If the diarrhea is moderate, a healthcare provider may recommend clear fluids for the first 6 to 24 hours. Diarrhea makes children very thirsty. Usually the healthcare provider will recommend giving plenty of fluids if the child is not vomiting. 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 be added slowly. Avoiding raw fruits and vegetables, beans, fatty foods, and spicy foods may also be helpful while the child has diarrhea. Reducing the intake of milk and other milk products for the first few days with diarrhea may also reduce 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 through the tube. Hospitalization is sometimes necessary in this case. If unusual symptoms are present or if the child is acting very sick, the healthcare provider may look for conditions that may require further treatment. Medications or surgery may be needed.

What are the side effects of the treatments?

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

What happens after treatment for the condition?

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

How is the condition monitored?

Most cases of diarrhea last 3 to 5 days. A healthcare provider should be called immediately 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 be reported to the healthcare provider.

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