Diarrhea In A Child, What To Do? Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Diarrhea in a child, what to do?

Diarrhea in a child is an increased excretion of feces that differ from normal stool in color, texture and odor. With diarrhea, there is a loss of water and electrolytes, feces move too quickly through the intestines and do not have time to take shape. Every parent experiences diarrhea at least once in their life, so it is only natural that they have a question about how to help their child.

The symptoms of diarrhea are easy to recognize. In addition to changing the nature of the stool, the child may complain of abdominal pain of a spasmodic or acute nature, possibly the addition of nausea and vomiting, fever, rumbling in the intestines, flatulence, false urge to defecate.

Diarrhea is especially dangerous in childhood, as babies develop dehydration faster than adults. Therefore, contacting a doctor is a mandatory measure, especially when it comes to severe diarrhea.

Content:

• When is a baby's stool considered diarrhea?
• Types of diarrhea in children
• Causes of diarrhea in children
• Causes of diarrhea in an infant
• Symptoms of diarrhea in children
• When does a child need to see a doctor urgently for diarrhea?
• What is the danger of diarrhea for children?
• Diagnosis of diarrhea in children
• Treatment of diarrhea in a child
• Important medical guidelines for treating diarrhea in children

When is a baby's stool considered diarrhea?

It should be noted that not every baby's loose stools can be regarded as diarrhea.

Therefore, it is important to know the following features:

• Observing loose stools in a newborn or nursing baby, you do not need to call your doctor right away. For children at such an early age, loose stools are the absolute norm. Indeed, at this time, the crumb receives exclusively liquid food, which affects the consistency of feces.
• Frequent bowel movements during infancy are also not a sign of diarrhea. At this time, a child's stool can happen up to 10 or more times a day. Sometimes the discharge of liquid feces occurs after each feeding, which is also not a deviation from the norm.
• In children under one year old, feces may periodically be unformed (provided that the child does not suffer from constipation). Diarrhea is indicated by the fact that bowel movements occur more than 3-4 times a day. In this case, the stool becomes watery, liquid, may emit an uncharacteristic fetid odor or contain foreign impurities.
• In children aged 2-3 years and older, the stool should be decorated, there are no pathological impurities in it. At this age, the digestive system works more or less smoothly, therefore, normally, stool occurs no more than 1-2 times a day. If the number of bowel movements increases, and impurities appear in the feces, then diarrhea can be suspected.

Doctors have developed specific assessment criteria that distinguish diarrhea in children of different ages from regular stools:

• If a young child loses more than 15 g / kg / day of feces, then this indicates diarrhea.
• In children aged 3 years and older, the values of normal daily stool volume are close to those of an adult. Therefore, diarrhea is considered to be the loss of feces weighing more than 200 g per day.

Types of diarrhea in children

There are several types of diarrhea in children.

Depending on the mechanism of development of diarrhea occurs:

• Secretory diarrhea, when there is a lot of water and salts in the intestinal lumen, which are released due to the increased secretory function of epithelial cells of the intestinal mucosa. This type of diarrhea can be infectious and non-infectious in origin.
• Exudative diarrhea, which develops against the background of inflammatory bowel disease.
• Hyperkinetic diarrhea, in which there is an increased contraction of the intestinal walls, or a weakening of their motility. This leads to a violation of the movement of intestinal contents.
• Hyperosmolar diarrhea, when there is a malabsorption of fluids and electrolytes in the intestine.

Depending on the duration of the course of diarrhea, distinguish between chronic and acute forms. Chronic diarrhea is one that lasts for two or more weeks. Chronic diarrhea is osmotic when it stops after refusing to eat or certain drugs. When diarrhea continues against the background of starvation of the child, then such it is regarded as secretory. This type of diarrhea in childhood is rare, but poses a serious danger to the baby.

To determine that a child has secretory chronic diarrhea, one should be guided by signs such as increased stool frequency up to 5 times a day or more, while the bowel movements are watery, defecation occurs regardless of the time of day. In this case, you should immediately call the ambulance and hospitalize the child, as there is a direct threat to his life.

Acute diarrhea lasts no more than 2-3 days.

They also distinguish the types of diarrhea in children, depending on the cause that caused it:

• Infectious.
• Alimentary.
• Toxic.
• Dyspeptic.
• Medication.
• Neurogenic.
• Functional.

Causes of diarrhea in children

Diarrhea does not happen on its own. It is always a consequence of any disease, or a disturbance in the functioning of the digestive system.

In children, diarrhea is most often caused by the following:

• Infection in the intestines.
• Hereditary diseases of the gastrointestinal tract.
• Food poisoning.
• Power supply errors.

These reasons need to be considered in more detail.

Infection as a cause of diarrhea

Normally, the intestines are inhabited by bacteria that are responsible for digesting food. These bacteria are classified as "useful", as they enable the human body to exist. When pathogenic strains, viruses or parasites enter the intestine, inflammation of the organ occurs. This most often leads to diarrhea. In this way, the body tries to bring out infectious agents, which should not be in the intestines.

• Viruses that most often provoke the development of diarrhea in childhood: rotaviruses, adenoviruses.
• Bacteria that more often than others provoke intestinal inflammation in childhood: salmonella, dysentery bacillus, E. coli.
• Parasites that most often cause diarrhea in children: roundworms, amoebas, pinworms.

Having penetrated into the intestinal lumen, the pathogenic flora settles on its walls, causing an inflammatory reaction. This leads to increased peristalsis, which entails a rapid evacuation of feces.

The more actively the pathogenic flora multiplies, the more the intestinal walls are damaged. They lose the ability to absorb liquid, their mucous membrane begins to produce inflammatory exudate. As a result, a large volume of fluid accumulates in the intestinal lumen, as well as undigested food. All this comes out in the form of copious bowel movements, that is, the child develops diarrhea.

The most common routes of infection in a child's body are:

• Unwashed hands.
• Seed food.
• Dirty things used in everyday life.
• Infected personal hygiene items.
• Eating expired food.
• Contact with another sick child. Intestinal viruses are transmitted in this way.

Hereditary diseases of the gastrointestinal tract as a cause of diarrhea

There are diseases of the digestive system, the cause of which lies in genetic disorders. More often than others, children have lactase deficiency. At the same time, too little lactase enzyme is produced in the intestine. In these children, diarrhea develops after eating milk or dairy products.

Gluten intolerance (celiac disease) is less common. In this case, the child's body is not able to digest grain crops. Also, sucrose-isomaltase deficiency, when there are not enough enzymes in the body that can break down sugars, are also rare genetic diseases of the intestine. Therefore, their intake with food will cause diarrhea.

Congenital atrophy of the intestinal mucosa leads to diarrhea in the infant, since full absorption of nutrients from food becomes impossible.

Food poisoning as a cause of diarrhea

Food poisoning in childhood is common.

It can be triggered by the following factors:

• Eating expired prepared foods.
• Spoiled vegetables or fruits, stale meat or fish on the child's table.
• Poisoning with toxic substances, poisonous plants or fungi.
• Accidental intake of alcohol or a large dose of medication.

The toxins that enter the intestine damage its mucous membrane, cause an inflammatory reaction, increase peristalsis, which prevents the absorption of fluid from the intestinal lumen. As a result, the child develops diarrhea.

Nutritional errors as a cause of diarrhea

Errors in nutrition lead to the fact that the work of the digestive system fails. This causes various pathological reactions from the body, including diarrhea.

In childhood, diarrhea most often develops as a result of the following dietary disorders:

• Excessive food intake. If the child overeats, then the food begins to strongly press on the intestinal walls from the inside. This provokes increased peristalsis and too rapid movement of food masses along the intestinal lumen. At the same time, nutrients from food are not completely absorbed. The child develops diarrhea. Particles of undigested food will be present in the stool.
• The presence of an excessive amount of fruits and vegetables on the menu. Vegetables and fruits are rough and contain a lot of indigestible dietary fiber. There are especially many of them in the peel. The child's intestines are not always able to cope with such food, as it causes irritation and increased motility. All this provokes the development of diarrhea.
• Eating spices, spices, garlic, hot peppers, very salty or sour foods.
• Too fatty food. Diarrhea in this case is the result of a violation in the functioning of the liver and gallbladder, which are not able to produce enough acids to digest fatty foods.

Causes of diarrhea in an infant

Diarrhea in infants most often develops for other reasons than in children over a year old.

Introducing new foods (starting complementary foods) almost always causes stool change. In this way, the body reacts to food that is new to it. Stool can turn greenish when parents offer their child fruits and vegetables. Discoloration of stool is not a sign of diarrhea; it is a normal variation. However, if the stool becomes more frequent, becomes liquid, a sour smell begins to emanate from it, and foam or water appears in the feces, then you should think about the fact that the child is developing diarrhea.

The causes of diarrhea in an infant after complementary feeding can be as follows:

• Complementary foods were introduced too early. Parents should take into account that the body of a nursing baby will be ready to accept new food for him no earlier than 5-6 months. Until that time, breast milk is enough for him to grow and develop. Only after 5 months, enzymes begin to be produced in the child's body, which are able to break down food that is more complex in composition. The fact that the baby is ready to accept complementary foods is indicated by the following factors: double weight gain after birth, the child reflexively does not push the spoon out with his tongue, can sit on his own, clamps objects in his hand and pulls them to his mouth.
• The parents offered the baby too large a portion. If you do not follow the recommendations for the dosage of products for a particular age period, then this can provoke diarrhea.
• The child develops an allergy to the new product. Intolerance to a substance that is part of the food can provoke an allergic reaction in the baby, which is often manifested by diarrhea. Perhaps the child's body does not perceive gluten, in this case we are talking about such a pathology as celiac disease. If this problem is not detected in a timely manner, then diarrhea becomes chronic. The baby begins to gain weight poorly, allergic rashes appear on the skin.
• New products were introduced too often. They need to be given to the child gradually. New dishes should be offered at intervals of 5-7 days. This is the optimal time for the organs of the digestive system to adapt.

Feeding the baby with artificial formula. Infants who receive artificial nutrition are more likely to suffer from diarrhea than infants who were breastfed. The composition of breast milk is optimal, the balance of proteins and fats in it is such that the baby's intestines absorb it 100%. Artificial mixtures are perceived by the baby's body worse, so diarrhea may develop with overfeeding.

Intestinal infection. Intestinal infections can also cause diarrhea in infants. Rotaviruses, enteroviruses, salmonella, shigella, Escherichia coli, staphylococci are capable of causing increased frequency and liquefaction of stools. In infancy, children are more likely to become infected by the fecal-oral route, when parents do not follow the rules of personal hygiene.

Other causes of diarrhea in infants:

• Dysbacteriosis while taking antibiotics.
• Inaccuracies in the nutrition of a mother who is breastfeeding. Diarrhea often develops in children after the mother has eaten beets, cucumbers, pears.
• Teething of deciduous teeth can cause loose stools. This cause of diarrhea is physiological and does not require treatment.
• Lactase deficiency, which will cause diarrhea from the first days of a child's life.
• Cystic fibrosis.
• Infection of a child with worms. In this case, diarrhea will alternate with constipation.
• ARVI. Children under one year old have weak immune defenses, so even a common cold can affect the normal digestion of food and provoke diarrhea.

Symptoms of diarrhea in children

The main symptom of diarrhea is the child's bowel movements and thinning. It becomes loose and watery.

Diarrhea in childhood can be accompanied by symptoms such as:

• Bloating.
• Rumbling in the stomach.
• False urge to empty the bowels.
• Enhanced gas separation.
• Lack of appetite.
• Sleep disturbances.
• Nausea and vomiting.
• Anxiety, tearfulness.

These symptoms do not always accompany diarrhea. However, the more there are, the more severe the course of the disease.

If a child develops an intestinal infection or food poisoning occurs, mucus and undigested food particles will be present in the stool. In a severe course of the disease, blood impurities may appear.

An increase in body temperature against the background of diarrhea is a very frequent companion of intestinal infections and food poisoning.

If a child develops diarrhea, which is not accompanied by a hyperthermic reaction, then it may indicate inaccuracies in nutrition, dysbiosis, allergies, or a parasitic infection. It is possible that the child is simply teething.

When does a child need to see a doctor urgently for diarrhea?

Diarrhea in childhood can pose a real threat to your baby's health and life. Therefore, if the following conditions occur, you should consult a doctor:

• There are signs of dehydration.
• Diarrhea develops in a child under the age of one year.
• Diarrhea does not stop for 2 days or more.
• There is mucus or blood in the stool.
• The stool turns green or black.
• Diarrhea is accompanied by fever.
• The child is experiencing severe abdominal pain.
• Diarrhea develops with medication.

What is the danger of diarrhea for children?

Along with liquid feces, nutrients are quickly excreted from the child's body, as well as a large amount of water. This is a dangerous acute metabolic disorder and dehydration. So, for one bowel movement, a young child loses on average 100 ml of fluid. In children over 1-2 years old, with each act, up to 200 ml of water or more can come out. If the volume of lost fluid exceeds 10 ml per kilogram of weight, then dehydration will come very quickly. It is this condition that is the main danger of diarrhea.

Signs of dehydration in a child:

• Dry mucous membranes and skin, cracks.
• Dark circles under the eyes.
• In children under one year old, the fontanelle sinks.
• The child becomes lethargic, sleepy.
• Darkening of urine, a sharp decrease in its volume.

Dehydration in childhood occurs very quickly, since the weight of the baby is small. This process is aggravated by vomiting and frequent regurgitation. Therefore, at the first sign of dehydration, hospitalization is necessary.

If parents with diarrhea cannot give the child a drink, then you need to call a doctor or go to the hospital yourself. Otherwise, dehydration cannot be avoided.

In addition to water, salts are excreted from the body during diarrhea. Sodium imbalance threatens electrolyte metabolism failure. With serious violations, even cardiac arrest is possible.

The chronic course of diarrhea is dangerous because the child will constantly lack the nutrients that he needs for normal growth. Such children begin to quickly lag behind in physical development, lose weight, become lethargic and apathetic, they develop vitamin deficiency.

In addition, constant irritation of the skin around the anus leads to the formation of itching and diaper rash. The formation of an anal fissure is possible, in severe cases, rectal prolapse is observed.

Diagnosis of diarrhea in children

To identify the cause that led to the development of diarrhea in a child, you need to consult a doctor. The doctor will carefully listen to the complaints of the parents, if possible, he will interview the patient himself. The doctor will then examine the child.

If necessary, the following studies are prescribed:

• Blood sampling for general and biochemical analysis.
• Feces sampling for coprogram.
• Bacterial examination of feces and vomit.
• Study of feces for dysbiosis.
• Scraping of worm eggs.
• Conducting contrast radiography with barium sulfate. This procedure is rarely prescribed. It provides information about intestinal motility and its general condition.

As an additional study, an ultrasound of the abdominal organs can be prescribed.

Treatment of diarrhea in a child

As mentioned, the main danger in diarrhea is dehydration, accompanied by the excretion of salts necessary for the normal functioning of the body. Therefore, the primary task is to restore the water-electrolyte balance. This procedure is called rehydration.

Rehydration should begin after the first episode of diarrhea in the child. For this purpose, ready-made pharmaceutical preparations are used: Regidron, Glucosolan, Tsitroglucosolan, etc. A bag with a drug is dissolved in a liter of warm boiled water and given to the child to drink in small portions.

When you cannot get a ready-made rehydration solution, you can make it yourself. To do this, dissolve a teaspoon of salt and sugar in a liter of warm boiled water, as well as 0.5 tablespoon of soda. If the baby is breastfed, then it must be applied to the breast as often as possible.

When diarrhea is caused by food or drug poisoning or toxic infection, the child should be given sorbent drugs. They absorb harmful substances that are in the intestines, and prevent their absorption into the systemic circulation. These drugs include: Enterosgel, Smecta, activated carbon, Polysorb, Polyphepan.

However, taking sorbents is not always justified. For example, they are not prescribed for diarrhea caused by dysbiosis. In this case, the child is prescribed drugs that regulate the balance of the intestinal microflora. It can be the following medicines: Bifiform, Lactobacterin, Linex, Hilak Forte, Bifikol, etc.

Bacterial intestinal infections require intestinal antibiotics. The drugs of choice are: Enterofuril, Furazolidone, Enterol, Levomycetin, Sulgin, Phtalazol. Antibiotics should be prescribed by a doctor after a bacterial stool test.

Drugs that are aimed at reducing the activity of intestinal motility are rarely prescribed in childhood. The doctor can prescribe them, provided there are good reasons for it. These are drugs such as Imodium, Loperamide, Suprilol. They should not be used for diarrhea caused by infection or food poisoning.

In addition to symptomatic therapy, the main treatment is mandatory, aimed at eliminating the cause of diarrhea. You may need to remove inflammation from the pancreas, or treat allergies, colitis, enteritis.

Treatment of diarrhea should be accompanied by an adequate dietary regimen that maintains normal growth and development. Excessive strictness of parents when observing a diet can lead to an energy deficit.

In this regard, there are the following recommendations:

• It is necessary to exclude from the child's menu all products that increase gas formation: milk, sweet fruits, legumes, bread, apples, pastries, grapes, cabbage.
• Smoked, salty, spicy, fatty and fried foods should be removed from the diet.
• The menu should contain enveloping and slimy dishes: mashed soups, rice broth, porridge on the water. You can offer your child dairy-free mashed potatoes with vegetable oil.
• Steamed and steamed vegetables, fruit from compote are allowed.
• In addition to water, you can offer your child a compote based on blueberries and lingonberries.
• Fermented milk drinks are given with caution, after consulting a doctor.
• If the diarrhea subsides, and the child is hungry, then you can give him wheat crackers and sweet tea.

Lactose (milk sugar) intolerance does not require milk to be completely excluded. Fluctuations in carbohydrate intolerance have wide individual boundaries that do not depend on enzyme deficiency. However, it is necessary to start therapy with a strict lactose-free diet. When diarrhea has stopped, dairy products can be reintroduced with care.

If a child is diagnosed with secondary lactose intolerance, which is often observed at an early age, then you should refrain from using standard milk formulas for at least 4 weeks. Children who cannot stand whole milk can be offered milk hydrolyzed with lactase.

If parasites are found in a child, specific anthelmintic treatment should be carried out.

Important medical guidelines for treating diarrhea in children

• For the treatment of diarrhea in a child, you cannot independently prescribe drugs to him. Those medicines that are suitable for adults can be dangerous to the health of the baby.
• If a child takes antibiotics, then in parallel he should drink a course of probiotics, which will avoid the development of dysbiosis. The interval between taking medications should be at least an hour. Otherwise, the effect cannot be achieved.
• A child who develops diarrhea should be at home. He cannot be sent to kindergarten or school.
• You should not give your child drugs to stop diarrhea (Loperamide, Imodium) unless recommended by the doctor.
• Do not exceed the dosage of the drug at your own discretion.
• With the development of diarrhea in a child under one year old, a medical consultation is required.
• The child should be washed after each bowel movement. Be sure to lubricate the anal passage with baby cream, which is the prevention of the formation of irritation and diaper rash.
• It is important to monitor the well-being of the child, control the rise in body temperature, and prevent dehydration. If you feel worse, you should call an ambulance.

Author of the article: Sokolova Praskovya Fedorovna, pediatrician