Overview of Diarrhea

Diarrhea is defined as a condition in which a child has loose or watery stools three or more times a day. Children with chronic diarrhea may have loose, watery stools continuously or intermittently for four weeks or more, affecting the health of children of all ages.

Diarrhea that lasts only a short time is called acute diarrhea. Acute diarrhea is a common illness in children, usually lasting only a few days and going away on its own. Acute diarrhea is caused by food or water contaminated with bacteria or a viral infection.

Causes of Diarrhea

Diarrhea is the body’s way of getting rid of germs and most episodes last from a few days to a week. Diarrhea is accompanied by fever, nausea, vomiting, cramps and dehydration. Some of the most common reasons for diarrhea in children include:

• Viral infections such as rotavirus, bacteria such as salmonella and rarely parasites such as giardia. Viruses are the most common cause of diarrhea in children. Along with loose or watery stools, symptoms of a viral gastrointestinal infection often include vomiting, stomach pain, headache, and fever.
• Food poisoning can also cause diarrhea in children. Symptoms usually come on quickly, including vomiting, and tend to go away within 24 hours.
• Other causes of diarrhea include irritable bowel disease, Crohn’s disease, food allergies, and celiac disease.
• Neuroendocrine tumors – tumors that usually originate in the digestive tract.
• Hirschsprung’s disease – a congenital condition in which a child is born without nerve cells in the muscles of part or all of the colon.
• Cystic fibrosis – A genetic condition that causes a buildup of thick mucus that prevents the body from absorbing nutrients from food.
• Eosinophilic gastrointestinal disorders – a complex group of diseases characterized by higher than normal levels of white blood cells, called eosinophils, in organs in the digestive system.
• Zinc Deficiency

Symptoms of Diarrhea

Dehydration is one of the most worrying complications of diarrhea in children. Mild diarrhea usually does not cause significant dehydration, but moderate or severe diarrhea causes dehydration that affects the child’s health. Severe dehydration is very dangerous because it can cause seizures, brain damage, and even death. Parents should quickly take their children to a medical facility if they have the following symptoms:

• Dizziness
• Crams
• Flatulence, abdominal pain, nausea
• Fever
• Bloody stools
• Dry, sticky mouth
• Dark yellow urine, or little or no urine
• Few or no tears when crying
• Cold, dry skin
• Fatigue

Diarrhea Transmission

• By touching the stool of an infected person (such as when touching a dirty diaper)
• By touching an object contaminated with the stool of a person infected with a virus or bacteria and then touching the mouth or food with the contaminated hands.
• Consuming contaminated food or water

People at risk of diarrhea

Children living in large families, with poor hygiene, low maternal education, malnourished children, and children who are not exclusively breastfed for the first 6 months of life… are all at increased risk of developing diarrhea.

Prevention of Diarrhea

• Proper handwashing reduces the spread of bacteria that can cause diarrhea.
• Get the rotavirus vaccine to prevent diarrhea caused by rotavirus.
• When traveling, make sure that anything your child eats and drinks is safe. This is even more important when traveling to developing countries. To ensure safety when traveling:
• Do not drink tap water or use tap water to brush your teeth
• Do not use ice made from tap water
• Do not drink unpasteurized milk (because it does not kill the bacteria that cause diarrhea)
• Do not eat fresh fruits and vegetables that have not been washed and peeled
• Do not eat undercooked meat or fish
• Do not eat food from street vendors

Diagnosis of Diarrhea

Examination: The doctor will ask about the medical history and symptoms of diarrhea.

Tests: Some types of tests that the doctor may prescribe for the child are as follows

• Stool culture to check for abnormal bacteria or parasites in the child’s digestive tract.
• Stool evaluation to check the properties of the stool
• Blood tests to rule out certain diseases
• Ultrasound to rule out abnormalities in the anatomical structure of the digestive system
• Tests to check for food intolerance or allergies.
• Sigmoidoscopy. This test allows the doctor to see the entire colon and part of the small intestine to find the cause of diarrhea, stomach pain, constipation, abnormal growth, and bleeding.

Treatments for Diarrhea

Treatment will depend on the symptoms, age and general health, and severity of the diarrhea.

Dehydration is the main concern with diarrhea. In most cases, the doctor will treat it by replacing lost fluids in a variety of ways, such as rehydration and electrolyte replacement, intravenous fluids. Antibiotics may be prescribed when a bacterial infection is the cause of diarrhea.

Children should drink plenty of fluids, which will help replace the fluids lost from the body. If your child is dehydrated, make sure that:

• Give your child an oral rehydration solution (ORS) that is mixed in the correct proportions.
• Avoid fruit juice or soda, as this can make diarrhea worse.
• Do not give water to children under 12 months of age
• Do not give too much water to children of any age as it can be dangerous.
• Continue breastfeeding as breastfeeding reduces the risk of diarrhoea.
• Continue feeding formula.