Diarrhea In Children

Diarrhea occurs when the colon (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.

Diarrhea in children can be accompanied by the following symptoms:

• abdominal distress and cramping, which may disrupt sleep
• in more serious situations, pus or blood in the stool
• 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

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 or parasites 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

Diarrhea is very contagious if it is caused by an infection. It is important always to wash one's hand thoroughly, particularly in the following situations:

• after cleaning aquariums or touching pets
• after diaper changes
• before and after handling food, especially poultry

Persons with diarrhea should not handle or cook food that will be eaten by others.

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.

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 professional will take a history of the child's symptoms. He or she will then do a physical exam, looking 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.

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 body's organs to get enough oxygen and nutrients, and can be fatal if severe enough and not treated promptly.

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 occasionally lead to nutritional problems.

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.

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.

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 professional may recommend clear fluids for the first 6 to 24 hours. Diarrhea makes children very thirsty. Because the main goal in treatment of diarrhea is to prevent dehydration, persons need plenty of oral fluids if they can keep them down.

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 and bowel irritation.

If diarrhea becomes severe or if vomiting prevents the intake of enough oral fluids, fluids must be given through an intravenous tube (IV). Hospitalization is sometimes necessary in this case. If unusual symptoms are present or if the child is acting very sick, the healthcare professional may look for conditions that may require further treatment. Medications or surgery may be needed.

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.

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 professional 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 professional should be notified.

Most cases of diarrhea last 3 to 5 days. A healthcare professional 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
• malaise (sickness), that is more than mild
• vomiting and inability to keep fluids down
• weight loss

Any other new or worsening symptoms should also be reported to the healthcare professional.