Diarrhea

Most children suffer from diarrhea at some time but it is often caused by an infection that does  not last long.

 

There are times however, when diarrhea can be dangerous so it is important to know what to do and look for with diarrhea.

 

Causes of Diarrhea

Diarrhea is frequent runny or watery bowel movements (poop) usually brought on by a gastrointestinal infection caused by viruses, bacteria, or parasites.

 

The specific germs that cause diarrhea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene. For example, developing countries with poor sanitation or where human waste is used as fertilizer often have outbreaks of diarrhea when intestinal bacteria or parasites contaminate crops or drinking water.

 

In developed countries, including the United States, diarrhea outbreaks are more often linked to contaminated water supplies, person-to-person contact in places such as child-care centers, or "food poisoning" (when people get sick from improperly processed or preserved foods contaminated with bacteria).

 

In general, infections that cause diarrhea are highly contagious. Most cases can be spread to others for as long as someone has diarrhea, and some infections can be contagious even longer.

 

Diarrheal infections can be spread through:

 

  • dirty hands

  • contaminated food or water

  • some pets

  • direct contact with fecal matter (i.e., from dirty diapers or the toilet)

 

Anything that the infectious germs come in contact with can become contaminated. This includes toys, changing tables, surfaces in restrooms, even the hands of someone preparing food. Kids can become infected by touching a contaminated surface, such as a toilet or toy, and then putting their fingers in their mouths.

 

Viruses

A common cause of diarrhea is viral gastroenteritis (often called the "stomach flu," it also can cause nausea and vomiting). Many different viruses can cause viral gastroenteritis, which can pass through a household, school, or day-care center quickly because it's highly infectious.

 

Although the symptoms usually last just a few days, affected children (especially infants) who are unable to get adequate fluid intake can become dehydrated.

 

Rotavirus infection is a frequent cause of viral gastroenteritis in children. Rotavirus usually causes explosive, watery diarrhea, although not all will show symptoms. Rotavirus has commonly caused outbreaks of diarrhea during the winter and early spring months, especially in child-care centers and children's hospitals.  However, a vaccine now recommended for infants has been found to prevent approximately 75% of cases of rotavirus infection and 98% of the severe cases that require hospitalization.

 

Prevention

Although it's almost impossible to prevent children from ever getting infections that cause diarrhea, here are some things to help lessen the likelihood:

 

  • Make sure children wash their hands well and often, especially after using the toilet and before eating. Hand washing is the most effective way to prevent diarrheal infections that are passed from person to person. Dirty hands carry infectious germs into the body when children bite their nails, suck their thumbs, eat with their fingers, or put any part of their hands into their mouths.

  • Keep bathroom surfaces clean to help prevent the spread of infectious germs.

  • Wash fruits and vegetables thoroughly before eating, since foodand water also can carry infectious germs.

  • Wash kitchen counters and cooking utensils thoroughly after they've been in contact with raw meat, especially poultry.

  • Refrigerate meats as soon as possible after bringing them home from the supermarket, and cook them until they're no longer pink. After meals, refrigerate all leftovers as soon as possible.

  • Exercise caution when buying prepared foods from street vendors. 

  • Don't wash pet cages or bowls in the same sink that you use to prepare family meals.

  • Keep pets' feeding areas separate from family eating areas.

Signs and Symptoms

Symptoms typically start with crampy abdominal pain followed by diarrhea that usually lasts no more than a few days. Infections with many of the viruses, bacteria, and parasites that cause diarrhea also can bring on other symptoms, such as:

 

  • fever

  • loss of appetite

  • nausea

  • vomiting

  • weight loss

  • dehydration

 

In cases of viral gastroenteritis, kids often develop fever and vomiting first, followed by diarrhea.

 

When to Call the Doctor

Call your doctor if your child has diarrhea and is younger than 6 months old or has:

 

  • a severe or prolonged episode of diarrhea

  • fever of 102°F or higher

  • repeated vomiting, or refusal to drink fluids

  • severe abdominal pain

  • diarrhea that contains blood or mucus

 

Call the doctor immediately if your child seems to be dehydrated. Signs of dehydration include:

 

  • dry or sticky mouth

  • few or no tears when crying

  • eyes that look sunken into the head

  • soft spot (fontanelle) on top of the head that looks sunken

  • lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)

  • lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)

  • dry, cool skin

  • lethargy or irritability

  • fatigue or dizziness in an older child

 

Caring for Your Child

Mild diarrhea is usually no cause for concern as long as your child is acting normally and drinking and eating enough. Mild diarrhea usually passes within a few days and kids recover completely with care at home, rest, and plenty of fluids.

 

A child with mild diarrhea who isn't dehydrated or vomiting can continue eating and drinking the usual foods and fluids, including breast milk or formula for infants and milk for children over 1 year old. In fact, continuing a regular diet may even reduce the duration of the diarrhea episode, while also offering proper nutrition. Of course, you may want to give a child smaller portions of food until the diarrhea ends.