diarrheal diseases in children

WHAT ARE DIARRHEAL DISEASES?

Diarrheal diseases are the most common cause of illness in children. Diarrhea is when bowel movements are loose and watery and the child needs to go to the bathroom quite often. Quite often, diarrhea lasts for one or two days and go away on its own, but if it lasts for more than two days, it could be signs of a more serious problem.

Diarrhea that lasts for one or two days (Acute or Short-term Diarrhea) may be caused by bacteria contaminated food or water, or it may happen if the child gets sick from a virus. And Diarrhea that lasts for more than two days, maybe for a few weeks (Chronic or Long-term Diarrhea) may be because of some other health problem, such as, irritable bowel syndrome – a condition that affects the child’s large intestine and causes painful abdominal and bowel symptoms because the large intestine or the colon doesn’t work the way it should.

In children, repeated and persistent exposure to infections like diarrhea may cause intestinal inflammation and damage in the gut. This damage in the gut inhibits the absorption of nutrients in the body and can eventually lead to malnutrition and long-term health consequences – stunted physical growth, impaired cognitive development, and/ or increased chances of getting opportunistic infections including pneumonia.

Severe diarrhea in children mean that the child has a serious health issue and you should immediately consult your child’s pediatrician or pediatric gastroenterologist.

WHAT CAUSES DIARRHEA IN CHILDREN?

The reasons for a child getting diarrhea are many, including the following:

• Bacterial infection
• Viral infection
• Difficulty in digesting certain foods
• Certain food allergies
• Parasites that enter the child’s body through food or water
• Reaction to certain medicines
• Intestinal disease, such as Inflammatory Bowel Disease
• Functional bowel disorders, such as Irritable Bowel Syndrome
• Stomach or gallbladder surgery

WHAT ARE THE SYMPTOMS OF DIARRHEA IN CHILDREN?

Not all children with diarrhea have the same symptoms. The symptoms could include:

• Abdominal pain
• Cramping
• Bloating or swelling
• Upset stomach that causes nausea
• Fever, in some cases
• Blood stools
• Dehydration

More or less the symptoms of diarrhea may appeal like other health problems, and severe diarrhea may be signs of a serious health concern.

WHAT ARE THE POSSIBLE COMPLICATIONS OF DIARRHEA IN CHILDREN?

The greatest and most common complication of diarrhea in children is dehydration and is more likely to happen to young children with a weakened immune system.

Dehydration may either be mild, moderate or severe:

Mild Dehydration is the loss of fluid

Moderate & Severe Dehydration puts a lot of stress on the heart and lungs and in certain worst cases, it can lead to shock that can actually be life-threatening.

WHEN SHOULD YOU CALL YOUR CHILD’S PEDIATRICIAN OR PEDIATRIC GASTROENTEROLOGIST?

If your child is younger than 6 months and has any of the following symptoms, you should immediately contact your child’s doctor: 

• No wet diaper or does not urinate for 6 hours or more
• Constant abdominal pain
• Blood in the stool
• Frequent vomiting
• Refusal to drink liquids
• High fever
• Less frequent urination – wets fewer than six diapers per day
• Frequent diarrhea
• No tears when crying
• Hard or fast breathing

HOW IS DIARRHEA DIAGNOSED IN A CHILD?

Your child’s Pediatric Gastroenterologist will initially ask about the symptoms and health history, give your child a physical exam and may ask for the following tests:

• Blood tests to show infections
• Routine stool test to detect germs that could be the reason for the diarrhea
• In some cases, an X-ray to check for problems in the child’s digestive tract
• An endoscopy to examine the insides of the esophagus, stomach and small intestine. Small samples from the esophagus, stomach or small intestine may be taken to test for the causes of diarrhea.
• A colonoscopy to examine the insides of the large intestine where samples of colon mucosa may be taken and tested for the causes of diarrhea
• A CT Scan of the abdomen may also be needed, but that depends on the possible underlying cause or causes of diarrhea

WHAT CAN YOU, AS A MOTHER DO IF YOUR CHILD HAS DIARRHEA?

If your child has diarrhea, all mothers need to worry about is dehydration and you would need to give your child extra liquids in smaller quantities and more often, until the child starts feel better.

In cases of Mild Diarrhea (2-5 watery bowel movements in a day), keep your child on their regular diet, and offer more breast milk or formula in smaller amounts and more often. Avoid fruit juices or liquids that are high on sugar as they can worsen the diarrhea. And if your child eats solid foods, choose foods with more starch, such as cereals and crackers.

In cases of Moderate to Severe Diarrhea (6 or more watery bowel movements in a day), you may need to give your child ORS (Oral Rehydration Solution) to help prevent dehydration. The ORS is used to replace the electrolytes (salts) and fluids that the child needs. Just remember that the ORS should not be given as the only fluid for more than six hours and also that the ORS should not be mixed with formula.

AMOUNT OF LIQUID TO BE GIVEN TO CHILDREN TO PREVENT DEHYDRATION:

MOST IMPORTANTLY, DO NOT GIVE MEDICINES TO STOP THE DIARRHEA UNLESS YOUR CHILD’S PEDIATRICIAN SPECIFICALLY PRESCRIBES IT.

HOW IS DIARRHEA IN CHILDREN TREATED?

The treatment of diarrhea in children largely depends on the child’s symptoms, age, overall general health, the cause and the severity of the condition.

In most children, diarrhea leads to dehydration in children, and the treatment includes replacement of lost fluids by offering glucose-electrolyte solutions – drinks that have the right balance of water, sugar and salts. Apart from this, antibiotics may also be prescribed when the cause of diarrhea is bacterial infection.