Saturday, April 13, 2019

Diarrhea and Vomiting in Children: Symptoms, Causes and Diagnosis

Diarrhea and Vomiting in Children: Symptoms, Causes and Diagnosis

Diarrhea is a common problem in children. While many causes are self-limiting and benign, diarrhea can also be caused by serious conditions that require investigation and treatment. In general, we will define diarrhea as acute or chronic. The vast majority of diarrhea is acute and is less than two weeks before presentation. If a patient has diarrhea for more than two weeks, we will call it chronic

What is Diarrhea in Children?

Diarrhea means having 3 or more watery stools a day. The age and diet of the child affect the consistency and frequency of stool. For example, in the first month of life, a change in stool consistency is more specific for diarrhea than the absolute number of stools. Breastfed babies typically have several malformed yellow-green stools per day. Recognizing diarrhea in children is important because, given their small size, they have limited fluid supplies and are at high risk of developing dehydration. Acute diarrhea lasted less than 2 weeks, beyond which it is considered chronic. Acute diarrhea is most commonly infectious

What are Signs and Symptoms of Diarrhea in Children?

Diarrhea and vomiting are two common symptoms of acute gastroenteritis diarrhea includes loose stools which sometimes have a bad smell, mucus and sticky stools and vomit usually also vomits water, for example the child will not be able to tolerate any food or drink and these symptoms of diarrhea and vomiting are seen in children with a stomach infection, noting that what we call acute gastroenteritis is the most common cause of diarrhea and vomiting, these symptoms are associated with fever and stomach pain

 Bloody stools



 Loss of control of bowel movements

 Nausea or vomiting

• Pain or cramping in the abdomen

What is Types of Diarrhea?

There are two conditions for not getting lost. Inflammatory bowel disease can present with abdominal pain and watery or bloody diarrhea, depending on the anatomy involved. Weight loss, growth retardation, extraintestinal manifestations (oral ulcers, joint pain, rash), or a positive family history may suggest IBD or celiac disease. Suspicion of any of the conditions should lead to immediate referral for further investigation so as not to delay necessary treatment

 Acute watery diarrhea 80%

 Bloody diarrhea (dysentery) 10%

 Persistent diarrhea 10%

What is Causes of Diarrhea in Children? 

 Infection: Most often it is related to viral gastroenteritis and does not require investigation. Care is supportive to ensure adequate hydration. Diarrhea can also be caused by bacteria or parasites from contaminated food or water. Faecal cultures or microscopic analyzes for parasites may be indicated. Some infections need to be reported to public health. Diarrhea caused by C. difficile can be acute or chronic. It usually starts out as water, but can progress to contain blood

  • Viral: rotavirus, norovirus, enteric adenovirus, sapovirus, astrovirus
  • Bacterial: Salmonella, Shigella, Yersinia, Campylobacter, Escherichia coli, Aeromonas hydrophila, Vibrio species, Clostridium difficile
  • Parasites: Giardia lamblia, Entamoeba histolytica, Cryptosporidium

 Food poisoning: It can also cause diarrhea in children. Symptoms usually appear quickly, they can include vomiting

 Dietary disorders: Food allergies, including food intolerances (such as lactose) or functional diarrhea ("infantile diarrhea"). These improve with dietary changes

 Malabsorption or secretory diseases: inflammatory bowel disease, Crohn's disease, ulcerative colitis and celiac disease

 Medications: Such as laxatives or antibiotics can cause diarrhea in childs as well as in adults

How Diagnosis Diarrhea in Children?

The diagnosis is based on the medical history provided by the parents and caregivers and is also guided by the clinical examination of the child, for example we can see that the child is dehydrated or weak and sick, the treatment options are mainly rehydration, therefore that the point is to avoid weight loss in children we must rehydrate them adequately we must also support them with the appropriate type of complementary diet there are specific items we must give and we must not give during diarrhea there are specific treatments available to control vomiting and diarrhea through the use of drugs as prescribed by the doctor

You can order tests for C. difficile to diagnose the cause of the diarrhea when no other infectious or non-infectious cause has been found, if the child has been taking antibiotics in the past month and has had diarrhea for several days. Testing for C. difficile may be required to confirm the presence of the toxin, possibly accompanied by abdominal pain, poor appetite, and fever

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