Diarrhea

What is diarrhea?

Frequent, loose or watery bowel movements (or stools) are known as diarrhea.

However, normal bowel movements patterns are different from child to child.

Your child's age can be a factor; young infants often have many loose bowel movements each day, while older children may go up to a few days between bowel movements.

So, when evaluating your child, it is important to compare the consistency and frequency of his bowel movements before and after he gets sick.

Causes of diarrhea

There are many causes of diarrhea including: food poisoning, allergic reactions or intolerance to certain foods. Diarrhea can also be a side effect of common medications such as antibiotics. However, in children, the more common cause of diarrhea is gastroenteritis, a viral infection of the stomach and intestines. In many of these cases, diarrhea often starts suddenly and usually lasts from a day to a week.

If a child has diarrhea for more than 2 weeks, this is known as chronic diarrhea. Chronic diarrhea in children can be serious because it can lead to poor nutrition, which then causes weight loss and poor body growth.

Some uncommon diseases can give a child chronic diarrhea. If your child's stools are loose, grey and foul-smelling, this can indicate that your child has celiac disease, or a sensitivity to gluten, a protein found in wheat and grains. Diarrhea combined with stomach pain may mean that your child has Crohn's disease, an inflammation of the lining of the intestines.

Lactose intolerance, or the inability to digest lactose (a sugar found in milk), can also cause diarrhea. This condition usually runs in families or can show up in children as they get older. Contact your doctor if you think your child has chronic diarrhea.

Gastroenteritis

Children who suddenly get loose and frequent bowel movements most likely have acute gastroenteritis, an infection of the stomach and intestines. Other common symptoms of gastroenteritis may include nausea and/or vomiting, usually starting 24 to 48 hours before the diarrhea and fever.

Gastroenteritis is usually caused by a virus, but can also be caused by bacteria. Viral infections of the intestinal tract tend to be milder and may be associated with respiratory symptoms (sore throat, congestion, or earache), but gastroenteritis caused by bacterial infections is usually more severe and can result in diarrhea that contains blood. Diarrhea that occurs while or after travelling to a foreign country is often caused by bacteria.

Most cases of gastroenteritis are self-limited, meaning that they do not require any specific treatment and the child will get better after a few days. The most important thing a parent can do is to make sure your sick child drinks enough fluids to prevent dehydration. 

Home treatment

• Try to make sure that your child is drinking enough liquids to replace the fluids, salts and calories she is losing through diarrhea. 
• If your child's case of diarrhea is mild -- that is, not watery and fewer than 5 bowel movements per day -- she can continue her normal diet. 
• Avoid fruit juices or soft drinks because they have high sugar content and can make the diarrhea worse. 
• If your infant is being breast-fed, continue to give her breast milk and feed your child more often than usual. If you child does not want to breastfeed, try giving her small sips of breastmilk by bottle, cup or spoon. 
• Infants who have been receiving formula can continue taking their regular, full-strength formula. 
• In addition to breast milk and formula, you can give your child one of several specially prepared oral rehydration solutions (i.e. Pedialyte, Ricelyte, or Kao Lectrolyte). These solutions help to quickly replace the fluids and salts that are lost through diarrhea, and can be bought at your local drugstore or supermarket. Talk to your doctor about how much electrolyte solution you should give to your child. 
• Children older than 1 year old can be given their regular diet, including undiluted milk and water. Some juices, such as blueberry juice or carrot juice, are known to help to stop diarrhea. Rice, cereal, plain noodles, and other foods high in starches (carbohydrates) are helpful because these foods will help bind the loose stools.

When to seek medical advice

See the doctor immediately or call 911 if:

• Your child is showing signs of dehydration. These signs include: listlessness, lethargy, dry lips or mouth, or lack of urination for more than 4 to 6 hours in a baby or more than 6 to 8 hours in an older child. 
• Be aware that young children, especially infants less than 6 months old, will become dehydrated much more quickly than older children. 
• Dehydrated infants will 1 year old will have a sunken fontanel (the soft spot on top of the head). 
• There is blood in the child's stools or diarrhea is accompanied by severe pain in the abdomen, or high fever. 
• Your child's diarrhea is accompanied by severe stomach pain or a high fever.

Make an appointment with your doctor if:

• Your child has had a fever and diarrhea for more than 3 days. 
• Your child has a fever after returning home from a trip to a foreign country. 
• Your child has had a mild case of diarrhea that has lasted for more than 1 week. 
• There is pus or mucus in your child's diarrhea. 
• Your child's diarrhea is accompanied by a change in behavior, appetite, or loss of weight. 
• You are unsure of your child's condition.