Understanding Diarrhoea in Children

Diarrhoea is a common gastrointestinal condition in children; it is characterised by loose or watery stools and increased frequency. Diarrhoea is not a standalone disease but rather a symptom of various underlying conditions

Acute or short-term diarrhoea is the most common gastrointestinal disorder in children and a leading cause of dehydration during childhood. It is characterised by the sudden onset of three or more loose or watery stools per day that typically lasts for 7 to 10 days, with a maximum duration of 14 days.

Chronic or long-term diarrhoea is defined by the passage of loose, watery stools at least 3 times daily for a minimum of 4 weeks, often accompanied by other symptoms. This could indicate underlying medical conditions that may range from digestive tract infections to food allergies, intolerances, and various digestive system disorders.

Causes of Diarrhoea in Children

There are many causes of diarrhoea in children that include viral / bacterial / parasitic infections, side effects of antibiotics, post-infectious diarrhoea, gastrointestinal disorders (celiac disease, inflammatory bowel disease), lactose intolerance, and food allergies.

Symptoms of Diarrhoea in Children

Symptoms can vary from child to child. Common signs that can occur along with watery stools are fever, abdominal pain, bloating, nausea, and vomiting.

Most diarrhoea cases may be resolved on their own and are not serious medical concerns. However, you need to contact your doctor immediately if you find the following symptoms in your child:

• Persistent high fever
• Blood in stool
• Frequent vomiting
• Signs of dehydration (dry, chapped lips, no tears when crying, sunken soft spot on the baby's head, less frequent urination, extreme thirst)

It is important to recognise when medical attention is necessary as dehydration can lead to imbalances in electrolytes like sodium, potassium, and chloride if left untreated. For severe cases with vomiting and dehydration, hospitalisation for intravenous fluids is necessary.

Diagnosis of Diarrhoea in Children

For acute diarrhoea, tests are often unnecessary unless dehydration is suspected. In this case, blood tests and stool samples may be collected for further examination. For chronic diarrhoea, extensive testing is required to identify potential underlying gastrointestinal disorders.

• Stool samples analysis to identify bacterial, viral, or parasitic causes.
• Endoscopic procedures (upper endoscopy, colonoscopy) may be performed with biopsy to assess inflammation.
• Lactose breath hydrogen test to diagnose lactose intolerance.

Treatment and Management for Diarrhoea in Children

Treatment and management decisions are based on the underlying cause identified through diagnostic tests and depending on the child's general health, symptoms, and age.

Oral Rehydration Solutions (ORS) are effective for mild dehydration in children, and they can be obtained from a pharmacy.

Avoid dairy products and eat a bland diet of bananas, applesauce, rice, and toast (BRAT diet) initially. It is important to resume a child's regular diet as soon as possible, including breastfeeding for infants and regular formula or solids for older children.

In certain cases, antibiotics may be prescribed for specific bacterial or parasitic infections, though they often do not alter the duration or severity of diarrhoea. Probiotics may help alleviate symptoms by restoring the balance of gut bacteria.

Medications to slow bowel movements are generally not recommended for acute diarrhoea but may be considered for chronic cases.

Prevention of Diarrhoea in Children

• Get your child vaccinated with a rotavirus vaccine, which helps reduce the risk of severe diarrhoea due to viral infection.
• Encourage regular and thorough handwashing with soap and water, especially before eating and after using the bathroom.
• Maintain clean and hygienic living environments, including regularly cleaning and disinfecting surfaces and toilets.
• Ensure drinking water is clean and safe and food is properly prepared, cooked, and stored to prevent contamination.
• Eat a balanced diet rich in vegetables, whole grains, and lean proteins to support overall health and strengthen the immune system.
• Limit exposure to potential sources of infection, such as untreated water sources, contaminated foods, and contact with individuals who are ill with diarrhoea or gastrointestinal infections.
• If you are travelling with your child, follow proper travel safety methods, such as avoid uncooked food, unpasteurised milk, unwashed raw vegetables and fruits, and untreated tap water.

Make an Appointment at Gleneagles Hospitals

If you notice concerning signs of your child's diarrhoea, get in touch with us to book an appointment today for a consultation, or visit our Paediatric Care Department at your nearest Gleneagles Hospital.