Managing Diarrhea In Children

Managing Diarrhea In Children

“Diarrhoea is usually watery and there is no blood or pus in the stool”

Diarrhoeal disease is very common in infants and young children. These are caused by more than 100

different bacteria, protozoa or viruses. The majority of diarrhoeas are viral in origin. Diarrhoeas of less

than 14 days duration are called acute and are presumed to be infective in origin.

When it exceeds 14 days it is called chronic or persistent. Dysentery is a more serious form of diarrhea,

where the stools are tinged with blood and mucus. The diarrhea can be quite severe, characterized by

colicky pains and frequent purging in a child with dysentery.

Causes of acute diarrhoea

Infection of the gut is the common cause. Many bacteria, viruses and other ‘germs’ can lead to

diarrhoea. Sometimes the germs come from infected food (food poisoning). Infected water is also a

source of bacteria. Sometimes it can just be ‘one of those germs going about’. Viruses are easily spread

from one person to another by close contact, or when an infected person prepares food for others.

Non-infectious causes of acute diarrhoea are uncommon in children. For example, colitis (inflammation

of the gut), food intolerance and other various rare disorders of the gut.

Symptoms

There may be a prodrome of low-grade fever, body pain, headache and even upper respiratory tract

symptoms. The diarrhoea is usually watery and there is no blood or pus in the stool. Vomiting often

accompanies the diarrhoea and gastroenteritis can be manifested by vomiting alone. Abdominal cramps

may occur. Usually the diarrhoea is self-limiting (2 - 7 days) and none of the true diarrhoea viruses cause

chronic diarrhoea. However re-infections with the same virus like rotavirus can occur in childhood.

The most worrying aspect of diarrhoea is dehydration, which means that too much liquid has been

drained out of the child’s body. So as soon as diarrhoea starts, it is essential to give the child extra drinks

to replace the liquid lost. In spite of the frequent loose stools, the baby does not look very ill. A

paediatrician must be consulted immediately if the baby, less than 6 months of age, has blood in the

stool (dysentery), has frequent vomiting, significant abdominal pain or fullness of abdomen, or urinates

less frequently and is extremely thirsty and has dry lips and mouth with poor intake of liquids, has high

fever, weight loss or is malnourished. Apollo Cradle has a new born screening package called “In Safe

Hands” conducts special screening on babies suffering from intense diarrhoea soon after their birth.

Treatment

As long as the child looks well and is taking adequate fluids and food, loose stools are not a great

concern. Children should continue to eat a normal diet including formula or milk while they have mild

diarrhoea. Oral Rehydration Therapy (ORT) is the cheap, simple and effective way to treat dehydration

caused by diarrhoea. When diarrhoea occurs, essential fluids and salts are lost from the body and must

be replaced. ORT is the giving of fluid by mouth to prevent dehydration that is a result of diarrhoea.

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