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Diarrhea in Children

By Dr Ananya Mandal, MD

In most cases diarrhea in children recovers completely in a week with little or no treatment. However, there is still a high risk of death due to diarrhea especially among children less than 5 years of age. This is mainly because of the danger of losing too much fluid and electrolytes if diarrhea occurs rapidly. This is called dehydration and needs to be the primary treatment aim while treating diarrhea in children.

Diarrhea in children

Diarrhea is usually caused by a virus is children. The commonest cause is rotavirus infection. Rotavirus is usually passed on through infected stools. The child may catch the infection via unwashed hands or contaminated foods and toys.

The viral infection leads to inflammation of the lining of the intestines, so food and water are not absorbed properly. There is rapid loss of water and electrolytes along with loose watery stools. There may be accompanying vomiting. The risk of dehydration is very high.

Symptoms of diarrhea in children

Common symptoms associated with diarrhea include:-

  • Loose watery stools - three or more frequency a day
  • Change in consistency of stools from usual (stools may become loose or less formed)
  • Nausea and vomiting may be seen
  • High temperature or fever over 38ºC (100.4ºF)
  • Moderate to severe abdominal cramps
  • Headache
  • Loss of appetite. Babies and infants may refuse to feed
  • There may be a metallic or bitter taste in the mouth

With severe episodes of diarrhea there may be dehydration as well. Babies having six or more episodes of diarrhoea in the past 24 hours are at risk of dehydration.

Children with over six episodes of watery diarrhoea in the past 24 hours along with vomiting, bloody diarrhea and diarrhea that lasts for longer than two weeks are at risk of dehydration and need urgent attention.

Symptoms of dehydration in children

  • Increased thirst
  • Cold, pale and clammy skin
  • Irritable or drowsy
  • Passing urine infrequently and passing dark coloured urine
  • Cold hands and feet
  • Dry tongue
  • Sunken eyes and no tears
  • There are sunken cheeks and sunken soft spot over the skull
  • Skin stays pinched up and takes time to return to normal.

Management of diarrhea in children

Viral diarrhoeas have no specific treatments against them. These are usually managed by preventing and treating dehydration and replacing the lost fluid and electrolytes. Antibiotics work for bacterial infections like Salmonella.

In children, diarrhea should not be treated using medicines such as loperamide that stops the bowel movements. These medicines can have side effects in children.

The child needs to be given adequate fluids, breastfeeding should be continued and oral rehydration solution (ORS) should be offered. ORS is a WHO recommended solution that replaces fluids and electrolytes. Sugary drinks and fizzy drinks should be avoided as they aggravate dehydration.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Mar 24, 2013

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