Diarrhea

Diarrhea causes a person to go to the bathroom more than usual, and the stool is loose and watery. There are two types of diarrhea, and it is important to understand the causes of each one. Acute diarrhea lasts a few days and then stops. Chronic diarrhea lasts more than a week and may be caused by a more serious problem.

Acute

When a child’s bowel movements are looser than normal, and lasts 1-2 days, the problem may be caused by:

  • Viruses – usually by person-to-person contact. Rotavirus (known by the name stomach flu) is the most common cause of diarrhea in infants and children.
  • Bacteria – usually from food or water contaminated with the bacteria or from person-to-person contact. Shigella is one bacterium that can be passed when a person doesn’t wash their hands after using the bathroom. Everyone in the family should be careful to wash hands frequently, especially after changing the child’s diaper and using the bathroom.
  • Parasites – caused by eating or drinking unsafe food or water that has bacteria or parasites. A person can also get sick if they have traveled to a different country and ate or drank unsafe water or food.
  • Food poisoning – caused by toxins produced by bacteria. Symptoms usually last less than 24 hours and may include abdominal pain and vomiting along with diarrhea.
  • Medications – especially from antibiotics
  • Drinking too much fruit juice
  • Fructose – a sugar found in fruits and honey.
  • Lactose intolerance – from the sugar found in milk.
  • Artificial sweeteners – like sorbitol and mannitol found in sugar-free products.
  • Food allergies

Some of the signs and symptoms of diarrhea may include:

  • Frequent, loose, watery stools
  • Abdominal cramping
  • Fever
  • Blood in the stool
  • Bloating.

In most cases, the diarrhea will stop after a few days.

If your child has diarrhea, it is important to watch for any signs of too much water or salts being lost (dehydration). Children can quickly become dehydrated. Contact your doctor immediately if your child has signs of dehydration. Signs of dehydration (depending on the age of the child) include:

  • Dry, sticky mouth
  • No tears
  • No urine in over 8 hours (or over 12 hours if the child is more than 1 year old)
  • Dark urine
  • Child us unusually fussy or drowsy
  • Child is extremely thirsty
  • Child’s eyes look sunken
  • Infant’s soft spot on top of the head becomes sunken

Other signs that require taking your child to the Emergency Room immediately include:

  • Fever over 103 degrees F (orally), or 104 degrees F (rectally)
  • Severe stomach pain
  • Blood in child’s stool or vomit
  • Child’s poop is black
  • Child’s vomit is green or black
  • Child is difficult to wake up or seems confused
  • Child will not drink
  • Other symptoms that concern you as a parent

Chronic

Diarrhea lasting more than a few days or weeks could be caused by a more serious problem such as:

  • Inflamatory Bowel Disease (IBD) like Crohn’s or Ulcerative Colitis
  • Celiac Disease – a gluten allergy
  • Irritable Bowel Syndrome (IBS).

Testing

Your doctor can usually determine the cause of the diarrhea based on questions such as what foods had been eaten; any contact with someone who is has the same symptoms, or any antibiotic use. If the diarrhea is very severe or bloody, your doctor may:

  • Collect a stool sample to check for bacteria, parasites, or other signs of disease or infection.
  • Blood tests to rule out certain diseases.
  • Fasting tests to see if a food intolerance or allergy is causing the diarrhea.
  • Colonoscopy to look for diseases that cause chronic diarrhea.

Treatment

Drink plenty of clear liquids
The main concern among all children with diarrhea is preventing dehydration and/or rehydrating. Begin by giving the child 1 to 2 ounces of liquid every half hour (avoid giving child more liquid than he or she wants as this can cause vomiting). If your child will not drink, give one spoonful of liquid every few minutes. If your baby will not drink from a bottle, use a syringe without a needle to insert liquid into the mouth. A syringe may be purchased from a drug store, and you should be careful that it has not been used for anything else. DO NOT GIVE CHILD WATER (as it contains too little salt and may make child even more ill).

AVOID:

-Fruit juice
-Soda
-Drinks with caffeine
-Diet drinks

Best Liquids for Your Child:

-Oral rehydration solution (ORS) such as Pedialyte MS, Rehydralyte, Lytren, Ricelyte, Reosol
-Children over age 2 may also have the ORS solutions listed above, but also may have sports drinks such as: Gatorade, Gatorade Light, 10 K, Power Burst, and All Sport.

Gradually add semisolid and low-fiber foods

Your child may not want to eat as much as usual, and this is OK. Offer small amounts of food more frequently throughout the day. If you are breastfeeding your child, you may continue to do so.

Safe Foods:

-Dry toast or crackers
-non-sweetened cereals
-Bananas
-Peeled, raw apples
-Fresh fruit (not canned with sugar)
-Lean meats
-Mashed potatoes (plain)
-Cooked rice (plain)
-Cooked vegetables (plain).
-Yogurt has live bacterial cultures and less lactose than milk.

Avoid:

-Foods with a lot of sugar (cake, pies, cookies, Popsicles, candy)
-Sweetened cereals
-Foods high in fat (fried foods and ice cream)

When to contact the Doctor

DO NOT give your child any medication for diarrhea without checking with your doctor first. Contact the doctor when:

-Your child’s diarrhea has not improved within 3 days
-Your child’s fever has lasted more than 3 days
-Your child will not eat or drink

*Consider meeting with one of our dieticians for a nutritional consult. Call (865) 546-3998 to schedule an appointment.