Diarrhea refers to looseness of the stools, not to the frequency of bowel movements. (Frequent bowel movements with normal stools are not diarrhea.) The number of loose bowel movements per day measures the seriousness of the diarrhea.
Diarrhea in children over the age of five differs in several ways from diarrhea in infants and younger children. Diarrhea is less likely to cause dehydration (a serious loss of body fluids) in older children. The older and large the child becomes, the smaller the chances of dehydration. Serious dehydration is unlikely past six years of age-unless diarrhea is combined with vomiting, which keeps the child from drinking enough liquids.
Viruses in the intestine are the most common cause of diarrhea in older children. Dysentery bacteria and parasites in the intestine are the next most common causes. Respiratory viruses and reactions to certain foods are the least likely cause of diarrhea in older children.
Other diseases may cause long-term, frequent diarrhea in older children (though they are rare or unknown in infants). Ulcerative colitis is a condition in which ulcers frequently appear in the colon (large intestine). Regional enteritis (Crohn’s disease) is a recurring inflammation in the small intestine. The cause of these two diseases is not known. Cystic fibrosis is an inherited disease that affects the lungs, pancreas, sweat glands, and sometimes the liver and other organs. It often causes frequent diarrhea with foul-smelling stools.
Signs and symptoms
Loose, watery stools are the major symptom. There may be mucus or flecks of red blood in the stools. The child may have cramps. There may also be fever, loss of appetite, vomiting, and weight loss, depending on the cause of the diarrhea.
Home care
If the child has both diarrhea and vomiting, treat vomiting first by restricting the child’s diet to clear liquids only. Once the vomiting stops treat the diarrhea by limiting or not reintroducing solid foods – especially those with roughage, fruits (except bananas and apples), vegetables, butter, fatty meats, and peanut butter. Do not give the child milk, since milk may further aggravate diarrhea.
Precautions
• Do not give anti-diarrheal medications to children, since side effects are common and can be dangerous.
• Isolate an infant from children who are ill with vomiting and diarrhea.
• If there is blood in the stools, high fever, prostration (extreme weakness or collapse), or severe or prolonged diarrhea (more than two to three days), call your doctor. Dysentery may be the cause.
• Report frequent, repeated diarrhea to your doctors. Frequent diarrhea may be a symptom of colitis, enteritis, or cystic fibrosis, especially if there is weight loss.
Medical treatment
Your doctor’s treatment will be the same as home treatment. If necessary, the doctor may request blood tests, X rays of the large and small intestines, and sigmoidoscopy (an examination of the large intestine). In severe cases, hospitalization may be ordered.
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