Diarrhea
What is diarrhea?
Diarrhea is defined as having watery/loose stools, increased frequency of bowel movements, or both. It is a common problem for children of all ages.
In most cases, diarrhea lasts only a few days or up to two weeks and goes away on its own. These short-term (or acute) episodes are usually related to bacterial or viral infections and accounts for almost 10% of all childhood hospital admissions.
When diarrhea lasts over two weeks, it is considered chronic diarrhea. Reasons for chronic diarrhea vary. It can be diagnosed in otherwise healthy children, but other diseases may need long-term medical care.
The causes for acute and chronic diarrhea are different and we approach them differently.
The most common causes of acute diarrhea are:
- Viruses, bacteria, or parasites (“stomach bugs”)
- Food poisoning
- Medications, especially antibiotics
- An immune response to certain foods (food allergies)
- Toxic substances
For chronic diarrhea, symptoms may include, but are not limited to:
- Infections with bacteria, viruses, or parasites (eg. Giardia)
- Functional bowel disorders, such as irritable bowel syndrome
- Toddler’s diarrhea: A consequence of faster colon movement that is often worsened by excessive sugar intake (eg. juice)
- Leakage of loose stool (fecal soiling) from severe constipation
- Food allergies (eg. milk and soy allergies in infants)
- Trouble digesting certain food, such as lactose intolerance
- Inflammatory bowel disease (eg. Crohn’s disease or ulcerative colitis)
- Celiac disease
- Poor intestinal absorption – malabsorption
- Reaction to medications
The biggest risk of diarrhea is dehydration, meaning that the child has lost too much fluid and does not have enough fluid in their body. It may lead to an electrolyte imbalance, making the body unable to function normally.
Call the doctor if your child has:
- Blood, mucus, or pus in the stool
- Black or tarry stool
- Severe abdominal pain
- More than eight stools in eight hours
- Fever and diarrhea lasting more than 2-3 days
- Frequent or severe vomiting and is not able to keep any fluids down. Infants younger than 3 months of age and children who are vomiting are at the highest risk for dehydration
- Unexplained weight loss
- Lethargy (less energy or activity (not sitting up at all or not looking around)
- Chronic diarrhea, or diarrhea that keeps returning from time to time
If your child has signs of dehydration, seek medical help immediately.
Your doctor will obtain a complete medical history and perform a physical examination on your child. More information such as blood work, stool studies, or endoscopy may be needed to determine the cause of diarrhea.
How do We Treat Diarrhea?
Once your doctor determines the most likely cause of your child’s diarrhea, he or she will discuss with you what is the best option. In general, acute diarrhea is often caused by a virus and will improve on its own after the body clears the infection. Antibiotics will often worsen diarrhea. Other infections (eg. parasites) may be treated differently.
Making sure your child drinks enough fluid to replace the loss from diarrhea is critical to prevent dehydration. Your child can continue to eat a regular diet. Replace fluid with a glucose-electrolyte solution such as Pedialyte instead of plain water, soda, or concentrated juice. Restriction of milk or other dairy products might help, but is often not necessary. If your child cannot keep enough fluids in the body, hospitalization and intravenous fluid are recommended.
The treatment of your child’s diarrhea depends on the cause. Our doctors will work with you to determine the best treatment for your child’s diarrhea.
- Lethargy, less active than usual or difficult to wake, not acting like him or herself
- Sunken eyes, no tears when crying
- Dry and sticky mouth
- Urinates less compared to your child’s baseline (decreased number of wet diapers in a day)