Diarrhoea in Children: Symptoms, Diagnosis, Treatment, Prevention

Diarrhoea can lead to illness in young children, and it is a concern for the health and well-being of many children under 5. In this article, we will understand what diarrhoea is, its causes, and how to treat it.

What Is Diarrhoea?

Diarrhoea is characterised by loose or watery stools and increased frequency, commonly experienced by children. It is not a standalone illness but rather a symptom of various underlying conditions. While often not severe, it is crucial to recognise when medical attention is necessary as it can lead to dehydration and imbalances in electrolytes like sodium, potassium, and chloride if left untreated.

Diarrhoea can broadly be classified into the following two categories:

• Chronic diarrhoea (long-term): This is defined by the passage of loose, watery stools at least 3 times daily for a minimum of 4 weeks, often accompanied by other symptoms. The underlying causes can range from digestive tract infections to food allergies, intolerances, and various digestive system disorders.
• Acute diarrhoea (short-term): The most common gastrointestinal disorder in children and a leading cause of dehydration during childhood. It is characterised by the sudden onset of 3 or more loose or watery stools per day. This typically lasts for 7 to 10 days, with a maximum duration of 14 days.

What Are the Causes of Diarrhoea in Children?

There are numerous causes of diarrhoea in children. Some of them are:

• Viral infections
• Bacterial infections
• Side effects of antibiotics
• Parasitic infections
• Post-infectious diarrhoea
• Chronic nonspecific diarrhoea
• Celiac disease
• Inflammatory bowel disease
• Lactose intolerance
• Irritable bowel syndrome
• Food allergies

What Are the Symptoms of Diarrhoea in Children?

Other than loose stools, diarrhoea has no fixed symptom and can vary from child to child. However, the following are some other signs that can occur along with watery stools:

• Fever
• Blood in stools
• Signs of dehydration (indicated by dry, chapped lips)
• Abdominal pain
• Bloating
• Nausea or vomiting
• Increased irritability and fussiness
• Increased sleepiness/decreased energy level

When Is Diarrhoea Serious?

If your child's diarrhoea lasts more than 2 weeks, it could indicate a severe problem or an underlying medical condition.

How Is Diarrhoea in Children Diagnosed?

When diagnosing acute diarrhoea, tests are often unnecessary unless dehydration is suspected, in which case blood tests may be ordered. Stool samples may be collected, especially if blood is present, to pinpoint the cause, but results can take several days.

Chronic diarrhoea typically requires extensive testing, including blood tests to check for anaemia, inflammation, and other conditions like Celiac disease.

• Stool studies may also be conducted to identify bacterial, viral, or parasitic causes.
• Imaging tests like X-rays are not routine but may be used in specific cases.
• Endoscopic procedures, such as upper endoscopy and colonoscopy, may be performed with biopsy to assess inflammation and diagnose conditions like Celiac disease or inflammatory bowel disease.
• Lactose intolerance can be diagnosed with a lactose breath hydrogen test.

Treatment decisions are based on the underlying cause identified through diagnostic tests.

How Is Diarrhoea in Children Treated and Managed?

Treating diarrhoea depends on the child's general health, symptoms, and age.

Oral Rehydration Solutions (ORS)

Oral rehydration solutions are effective for mild dehydration in children and can be obtained over the counter. These solutions are preferred over other drinks like juices or sports drinks, which can exacerbate diarrhoea. Severe cases with vomiting and dehydration may necessitate hospitalisation for intravenous fluids.

Resume regular diet

It is crucial to resume a child's regular diet as soon as possible, including breastfeeding for infants and regular formula or solids for older children. Dairy may be avoided initially, and a bland diet comprising foods like bananas, applesauce, rice, and toast can be introduced.

Medications

Antibiotics may be prescribed for specific bacterial or parasitic infections, though they often do not alter the duration or severity of diarrhoea. Probiotics may help alleviate symptoms by restoring the balance of gut bacteria. However, medications to slow bowel movements are generally not recommended for acute diarrhoea but may be considered for chronic cases.

How to Prevent Diarrhoea in Children?

Good hand hygiene

Teach your children about the importance of good hygiene at home or school. Encourage regular and thorough handwashing with soap and water, especially before eating and after using the bathroom to prevent the transmission of infections within the family.

Vaccination

You could also talk to your doctor to get your child vaccinated with a rotavirus vaccine, which helps prevent diarrhoea.

Clean water

Provide safe and clean drinking water and ensure that food is properly prepared, cooked, and stored to prevent contamination. Avoid giving untreated water or uncooked foods, particularly when travelling to areas with poor sanitation.

Breastfeeding

Promote and support breastfeeding, as breast milk provides essential nutrients and antibodies that help protect infants against infections, including diarrhoea.

Proper sanitation

Maintain clean and hygienic living environments, including regularly cleaning and disinfecting surfaces, toilets, and diaper-changing areas. Proper disposal of diapers and faeces is essential to prevent the spread of infections.

Encourage healthy eating

Promote a balanced diet rich in fruits, vegetables, whole grains, and lean proteins to support overall health and strengthen the immune system.

Limit exposure to contaminants

Minimise exposure to potential sources of infection, such as untreated water sources, contaminated foods, and contact with individuals who are ill with diarrhoea or gastrointestinal infections.

Precautions when traveling

If you are travelling with your child, ensure that you follow proper travel safety methods, such as:

• Do not use ice made from tap water.
• Avoid uncooked meat or fish.
• Avoid eating food from food trucks.
• Avoid unpasteurised milk.
• Do not eat unwashed raw vegetables and fruits.
• Refrain from overindulging in food.

When Should You Take Your Child to the Hospital?

As mentioned earlier in the article, most diarrhoea cases may be resolved on their own and are not serious medical concerns. However, you need to contact your doctor immediately if you find the following symptoms in your child:

• Blood in the stools
• Frequent vomiting
• Vomiting bloody green or yellow fluid
• Dry, sticky mouth with chapped lips
• Weight loss
• High fever
• Extreme thirst
• No tears when crying
• Sunken soft spot on the baby's head
• Less frequent urination
• Diarrhoea that does not resolve in 2 to 3 days.

Make an Appointment at Pantai Hospitals

Diarrhoea is a common problem for babies and young children. It usually goes away within a few days and does not call for medical treatment. That said, if your child’s symptoms worsen, consult a doctor.

Get in touch with us to book an appointment today if you notice concerning signs of your child's diarrhoea, or visit our Paediatric Care Department at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.