Diarrhea in Children
What is diarrhea?
Diarrhea is when stools (bowel movements) are loose and watery. Your child may also need to go to the bathroom more often.
Diarrhea is a common problem. It may last 1 or 2 days and go away on its own. If diarrhea lasts more than 2 days, your child may have a more serious problem.
Diarrhea may be either:
Short-term (acute). Diarrhea that lasts 1 or 2 days and goes away. This may be caused by food or water that was contaminated by bacteria (bacterial infection). Or it may happen if your child gets sick from a virus.
Long-term (chronic). Diarrhea that lasts for a few weeks. This may be caused by another health problem such as irritable bowel syndrome. It can also be caused by an intestinal disease. This includes ulcerative colitis, Crohn’s disease, or celiac disease. Giardia may also cause chronic diarrhea.
What causes diarrhea?
Diarrhea may be caused by many things, including:
- Bacterial infection
- Viral infection
- Trouble digesting certain things (food intolerance)
- An immune system response to certain foods (food allergy)
- Parasites that enter the body through food or water
- Reaction to medicines
- An intestinal disease, such as inflammatory bowel disease
- A problem with how the stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome
- Surgery on the stomach or gallbladder
Children who visit some foreign countries are at risk for traveler's diarrhea. This is caused by having food or water that is not safe because of bacteria, viruses, or parasites.
Severe diarrhea may mean a child has a serious disease. Talk with your child's healthcare provider if symptoms don’t go away. Also talk with the provider if symptoms stop your child from doing daily activities. It may be hard to find out what is causing your child’s diarrhea.
What are the symptoms of diarrhea?
Symptoms can occur a bit differently in each child. They can include:
- Belly (abdominal) pain
- Swelling (bloating)
- Upset stomach (nausea)
- Urgent need to use the bathroom
- Bloody stools
- Loss of body fluids (dehydration)
The symptoms of diarrhea may look like other health problems. Severe diarrhea may be a sign of a serious disease. Make sure your child sees his or her healthcare provider for a diagnosis.
How is diarrhea diagnosed?
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Your child may have lab tests to check blood and urine.
Other tests may include:
- A stool culture to check for abnormal bacteria or parasites in your child’s digestive tract. A small stool sample is taken and sent to a lab.
- A stool evaluation to check the stool for blood or fat
- Blood tests to rule out certain diseases
- Imaging tests to rule out structural problems
- Tests to check for food intolerance or allergies
- A sigmoidoscopy. This test lets the healthcare provider check the inside of part of your child’s large intestine. It helps to tell what is causing diarrhea, stomach pain, constipation, abnormal growths, and bleeding. It uses a short, flexible, lighted tube (sigmoidoscope). The tube is put into your child’s intestine through the rectum. This tube blows air into the intestine to make it swell. This makes it easier to see inside.
How is diarrhea treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Dehydration is the major concern with diarrhea. In most cases, treatment includes replacing lost fluids. Antibiotics may be prescribed when bacterial infections are the cause.
Children should drink lots of fluids. This helps replace the lost body fluids. If your child is dehydrated, be sure to:
- Offer drinks called glucose-electrolyte solutions. These fluids have the right balance of water, sugar, and salts. Some are available as popsicles.
- Avoid juice or soda. They may make diarrhea worse.
- Not give plain water to your baby
- Not give too much plain water to kids of any age. It can be dangerous.
- Keep breastfeeding your baby. Breastfed babies often have less diarrhea.
- Keep feeding your baby formula, if you were already doing so
What are the complications of diarrhea?The greatest complication of diarrhea is dehydration. This is more likely with young children and those with a weakened immune system. Dehydration can be mild, moderate, or severe. Mild dehydration is the loss of fluid. Moderate or severe dehydration puts stress on the heart and lungs. In the worst cases it can lead to shock, which is life-threatening.
What can I do to prevent diarrhea?
Proper handwashing can reduce the spread of bacteria that may cause diarrhea.
A rotavirus vaccine can prevent diarrhea caused by rotaviruses. Ask your child's healthcare provider which vaccines are right for your child.
When you travel, make sure anything your child eats and drinks is safe. This is even more important if you travel to developing countries.
Travel safety tips for drinking and eating include:
- Not drinking tap water or using it to brush teeth
- Not using ice made from tap water
- Not drinking unpasteurized milk (milk that has not gone through a process to kill certain bacteria)
- Not eating raw fruits and vegetables unless you wash and peel them yourself
- Not eating raw or undercooked meat or fish
- Not eating food from street vendors or food trucks
Talk with your child's healthcare provider before traveling.
When should I call my child's healthcare provider?
Call your child's provider if your child is less than 6 months old or has any of the following symptoms:
- Belly pain
- Blood in the stool
- Frequent vomiting
- Doesn’t want to drink liquids
- High fever
- Dry, sticky mouth
- Weight loss
- Urinates less frequently (wets fewer than 6 diapers per day)
- Frequent diarrhea
- Extreme thirst
- No tears when crying
- Sunken soft spot (fontanelle) on baby’s head
Key points about diarrhea
- Diarrhea is loose, watery stool. Your child may also have to go to the bathroom more often.
- It may be caused by many things, including bacterial infection or viral infection.
- Dehydration is the major concern with diarrhea.
- In most cases, treatment involves replacing lost fluids.
- The rotavirus vaccine can prevent diarrhea caused by that virus.
- Proper handwashing can help prevent diarrhea.
- When you travel, make sure anything your child eats and drinks is safe.
Tips to help you get the most from a visit to your child’s health care provider:
- Before your visit, write down questions you want answered.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
- Freeborn, Donna, PhD, CNM, FNP
- Goode, Paula, RN, BSN, MSN