Diarrhea is an increase in the looseness (usually runny or watery) and frequency of bowel movements per day. Diarrhea that lasts less than one week is considered to be acute diarrhea, while diarrhea lasting longer than four weeks is called chronic diarrhea. Most acute cases of diarrhea are caused by gastrointestinal (GI) infections and clear up within a few days. Children under age 3 have an average of 1-3 episodes of acute diarrhea per year. If your child is experiencing diarrhea that lasts longer than 1-2 weeks, he may need diagnostic testing to check for any underlying medical conditions.

Acute Diarrhea in Children

Acute diarrhea, lasting less than one week, can be caused by infections, food poisoning, allergic reaction to food, and medications such as antibiotics.  Acute diarrhea usually stops once the child’s body clears the infection or toxin. Most children with acute diarrhea do not need treatment with medication.  If the diarrhea is lasting longer than one or two weeks, then further testing may be needed.

Chronic Diarrhea in Children

Chronic diarrhea, persisting for more than 4 weeks, can be caused by Inflammatory Bowel Disease, Celiac Disease, Irritable Bowel Syndrome, food allergies, lactose intolerance, and leakage of stool around hard stool stuck in the rectum.  The treatment of your child’s diarrhea depends on the cause.

Causes of Diarrhea in Children

Diarrhea can have many different causes, with the most predominant being viruses and bacteria. Because these are highly contagious, children often become infected through person-to-person contact, such as at day care facilities, or by touching contaminated surfaces and then putting their fingers in their mouths. Diarrhea is the body’s way of eliminating these germs from the digestive tract. Common GI infections that cause diarrhea include:

• Viral gastroenteritis (stomach flu)
• Shigella bacteria
• Rotavirus infection
• Food-borne bacteria, such as E.coli, salmonella enteritidis, and campylobacter (food poisoning): Usually spread through contaminated or undercooked food, swimming pools, or petting zoos.
• Parasites, such as Giardia and Cryptosporidium: Easily spread in recreational water or contaminated drinking water, as well as unpasteurized milk.

If a virus, bacterial infection, or parasite brings on diarrhea, your child may experience other symptoms including:

• Headache
• Fever
• Nausea
• Vomiting
• Weight loss
• Loss of appetite
• Dehydration

Diarrhea caused by infection typically lasts a few days and is not a serious condition as long as the child stays hydrated. Other causes of diarrhea can be:

• Food allergies
• Change in diet, such as an increase in fruit or juice
• Lactose intolerance
• Medications, such as laxatives or antibiotics
• Irritable bowel syndrome
• Inflammatory bowel disease
• Celiac Disease or Cystic Fibrosis: These conditions can interfere with food digestion and cause diarrhea.
• Crohn’s Disease
• Leakage of stool around hard stool stuck in the rectum

Treating Diarrhea in Children

Treatment for diarrhea in children can usually be done at home with rest and plenty of fluids. One of the biggest concerns when a child has diarrhea is dehydration. A child with a mild case of diarrhea can typically eat and drink normally. A child with moderate to severe diarrhea loses a significant amount of fluids quickly, therefore needs to take in extra fluids to replenish the loss. If a child is younger than 1 year old and is experiencing diarrhea, you should take dehydration prevention measures immediately

Dehydration Prevention Measures

• Increase the frequency of breastfeeding or bottle-feeding.
• Use an oral rehydration solution (ORS) to keep your child hydrated. These generally have names ending in “lyte” and can be found in most drugstores or grocery stores. Give your child 1/2 ounce every 10 minutes for an hour and gradually increase.
• Cereal or strained bananas can be used to replace fluids if your child has had them before.
• Older children can rehydrate with popsicles and ORS products. Liquids such as water, soda, and fruit juice so not have the nutrients and minerals to rehydrate quickly, and are not recommended. Signs of dehydration include:
• Dry, sticky mouth
• Dizziness or light-headedness
• Dry, cool skin
• Lack of urine or small amounts of dark, yellow urine: During a 6-8 hour period for an infant, or 12 hours for an older child.
• Few or no tears when crying
• Lethargy or irritability
• Sunken eyes
• Soft spot on top of head looks sunken

Children who are under 6 months of age or who have other health concerns should be monitored carefully, as they can dehydrate rapidly. If your child is showing signs of dehydration, call your doctor immediately.

Other treatments for diarrhea may include:

• Antibiotics: To prevent spread of infection, especially in younger children.
• Antiparasitic medicines
• IV fluids: Given at a hospital if diarrhea is severe and dehydration is an immediate concern.

Preventing Diarrhea in Children

While all cases of diarrhea can’t be avoided, there are some easy preventative measures that you can take to lessen your child’s risk of getting diarrhea:

• Frequent hand washing: Have your child wash his hands after every bathroom visit and before meals and snacks. Parents should wash hands after diaper changes.
• Do not let your child drink or brush teeth with untreated water, or drink unpasteurized milk.
• Store and prepare all foods according to the packaging.
• Wash fruits and vegetables thoroughly.
• Keep bathroom and kitchen counters disinfected and wiped down.
• Have your child vaccinated: Research shows that the rotavirus vaccine can prevent 75% of rotavirus infections.
• Keep animal feeding areas away from family eating areas.
• Don’t wash animal feeding bowls or cages in the kitchen sink.

When to Call Your Doctor About Diarrhea

If your child has diarrhea and is under 6 months of age, you should consult your doctor right away. Always monitor your child for symptoms of dehydration and call your doctor if your child:

• Has severe or prolonged diarrhea
• Has fever over 102° (or 100.4° if under 6 months)
• Has blood or mucus in the stool
• Vomits repeatedly or vomits bloody green or yellow fluids
• Refuses liquids
• Exhibits signs of dehydration
• Has severe stomach pain

If you would like more information about gastrointestinal (GI) digestive disorders and nutrition in children, please contact Dr. Mona Dave’s Frisco Office.