Paediatric diarrhoea Home A-Z Health Information Health Library A-Z Paediatric Diarrhoea Overview Paediatric diarrhoea, a common yet potentially dangerous condition, is characterised by frequent, loose, or watery stools, which can lead to dehydration, malnutrition, and even death. It poses a significant health impact on children worldwide. Our hospital has advanced diagnostic imaging and treatment protocols which play an essential role in managing and mitigating the consequences of paediatric diarrhoea. Causes and Risk factors Paediatric diarrhoea can be triggered by both infectious and non-infectious factors. Infectious agents include viruses, bacteria, and parasites.Viral infections: Viral gastroenteritis, which is often caused by rotavirus and norovirus, is the most common cause of acute diarrhoea in children.Bacterial infections: Pathogens, such as Escherichia coli, Salmonella, and Shigella, can cause severe diarrhoea and are often associated with severe symptoms.Parasitic infections: Amoebiasis and other parasitic infections, though less common, can occur in regions with poor sanitation.Non-infectious causes: The non-infectious causes of paediatric diarrhoea include food allergies, lactose intolerance, inflammatory bowel disease (IBD), and celiac disease.Antibiotic use: Prolonged broad-spectrum antibiotic therapy may cause antibiotic-associated diarrhoea. Symptoms The symptoms of diarrhoea vary in severity depending on the cause and extent of dehydration.Frequent loose stools: The primary symptom of diarrhoea is frequent loose stools, which is often accompanied by cramping.Abdominal pain and cramping: Abdominal pain and cramping are common complaints associated with diarrhoea.Fever and vomiting: Fever and vomiting may occur in cases of viral or bacterial infection.Dehydration: Dehydration, a critical concern in paediatric diarrhoea, can manifest as dry mouth, sunken eyes, decreased urination, lethargy, and, in severe cases, shock. Diagnosis Diagnosis of paediatric diarrhoea in a hospital setting involves a thorough evaluation.Detailed medical history and physical examination: Obtaining a detailed medical history and physical examination, such as assessing stool frequency, consistency, duration, and other associated symptoms is crucial in determining the cause and severity of paediatric diarrhoea.Stool analysis: This includes microscopy, culture, and sensitivity tests for detecting bacterial pathogens, tests for detecting ova and parasites, and stool PCR for identifying viral pathogens.Blood tests: Complete blood count (CBC), electrolytes, renal function tests, and inflammation markers are common tests prescribed to assess the cause of diarrhoea and determine its subsequent treatment.Imaging and endoscopy: Imaging and endoscopy are used in cases of chronic diarrhoea or when an underlying pathology (such as IBD) is suspected. Treatment The management of paediatric diarrhoea focuses on rehydration, managing the underlying cause, and preventing complications.Oral rehydration therapy (ORT): This is the first line of treatment for mild to moderate dehydration. ORT solutions, which contain an appropriate balance of salts and glucose, are highly effective and can be administered at home or in healthcare settings.Intravenous (IV) rehydration: IV rehydration is necessary in cases of severe dehydration or when ORT is not feasible. Tertiary care hospitals are well-equipped to provide IV fluids and monitor critically ill children.Specific treatments for diarrhoea include:Viral diarrhoea: Viral diarrhoea can generally be managed with supportive care, including hydration and dietary adjustments.Bacterial diarrhoea: Antibiotics are used for certain bacterial infections, but they are used judiciously to avoid resistance and complications.Parasitic infections: Parasitic infections are generally treated with antiparasitic medications.Non-infectious causes: Non-infectious causes are managed according to the underlying condition, such as dietary modifications for lactose intolerance or immunosuppressive therapy for IBD.Nutritional support: Nutritional support is crucial in paediatric diarrhoea management. Continued feeding or breastfeeding is encouraged to maintain nutritional status and promote recovery. Prevention and public health measures Diarrhoea prevention measures in children focus on reducing exposure to pathogens and improving sanitation.Vaccination: Rotavirus vaccination plays a key role in preventing viral gastroenteritis.Hygiene: Proper handwashing, safe food preparation, and clean drinking water can reduce diarrhoeal illness.Nutritional support: Ensuring adequate nutrition during episodes of diarrhoea helps prevent malnutrition and promotes faster recovery.