DIARRHEA

Definition:

Diarrhea is the sudden increase in the frequency and looseness of bowel movements.  Mild diarrhea is the passage of a few loose or mushy stools.  Moderate diarrhea gives many watery stools.  The bestindicator of the severity of the diarrhea is its frequency. 

A green stool also points to very rapid passage and moderate to severe diarrhea.

 

Cause

Diarrhea is usually caused by a viral infection of the intestines (gastroenteritis).  If only 1 or 2 loose stools are passed, the cause  was probably something unusual in the child's diet.

 

Expected course

Diarrhea usually lasts from several days to a week,regardless of the type of treatment. The main goal of therapy is to prevent dehydration excessive water loss) by giving enough oral fluids to keep up with the fluids lost in the diarrhea.  Don't expect a quick return to solid stools.  Since one loose stool can mean nothing,don't start dietary changes until there have been at least two.

 

Call Our Office - IMMEDIATELY if:

Your child has not urinated in more than 8 hours

Crying produces no tears

The mouth is dry rather than moist

Any blood appears in the diarrhea

Severe abdominal cramps are present

More than 8 diarrhea stools have occurred in the last 8 hours

The diarrhea is watery AND your child has vomited clear fluids 3 or more times

Your child is acting very sick

 

If your child has vomited more than once, treatment of the vomiting has priority over the treatment of diarrhea until your child has gone eight (8) hours without vomiting.

 

During office hours if:

Mucous or pus is present in the stools

The diarrhea has caused loss of bowel control in a toilet-trained child

Your child was exposed to someone with bacterial diarrhea (especially foreign travel)

Abdominal cramps come and go for more than 12 hours

fever has been present for more than 24 hours

Your child is on any medicines that could cause diarrhea

Diarrhea has been present for more than 1 week

Diarrhea is a recurrent problem for your child

       

 

Diet

Dietary changes are the mainstay of home treatment for diarrhea.  The optimal diet depends on your child's age and the severity of the diarrhea. A diet for mild diarrhea (mushy stools) in children less than 2 yrs. Give extra fluids by mixing your baby's formula or milk  with 1 or 2 ounces of extra water per bottle.

 

 

If your baby is on solids, offer only the BRAT DIET:

BANANAS

RICE

Apples/Applesauce 

TEA or TOAST

Avoid other foods temporarily.

 

 

Diet for moderate diarrhea (watery or frequent stools) in  children less than 1 year old

Clear fluids for 24 hours such as:

Pedialyte,available in most pharmacies and supermarkets.

JellO water can be used.. JellO water must be mixed (one package per quart of water, or twice as much water as usual).  Don't use any red-colored JellO water because it can look like blood.  Give your baby as much of the liquid as he wants.  Diarrhea makes children thirsty and your job is to prevent dehydration.

If your baby wants solids, offer applesauce, strained bananas, strained carrots and rice cereal with water.

 

Diet for moderate diarrhea (watery or frequent stools) in children 1 to 2 years old. During this week water, Kool Aid, or soft drinks can be used for fluids. After 24 hours on clear fluids, gradually phase in the following special solids:

 

Day  1 :  Clear fluids and popsicles.  If your toddler is hungry, add some foods from the day 2 list.

Day  2 :  Saltine crackers,toast, rice, applesauce, bland
soups

Day  3 :  Lean meats, soft-boiled eggs, noodles, and yogurt

Days 4-5:  Soft cooked fruits and vegetables (for example: pears,
carrots, potatoes)

Days 6-7:  Regular diet but no milk products

Day  8:  Milk and milk products can gradually be added

 

 

Avoid cheeses, which contain 80% of the lactose found in milk.

Diet for mild or moderate diarrhea in children over 2 years o ld   For the child who is toilet-trained for bowel movements,the approach to diarrhea is the same as what any adult would do; namely, eat a regular diet with a few simple changes. Avoid raw fruits and vegetables, bran products,beans, spices, and any other foods that cause loose BMs. Increase the intake of water or clear fluids (ones you can see through). Reduce or eliminate the intake of milk and milk products (exception: active-culture yogurt is fine).  A normal diet can be resumed 1 day after the diarrhea isgone,
which is usually in 3 or 4 days.

 

 

Home Care for DIARRHEA:  Other Aspects

Common mistakes

Using boiled skim milk or any concentrated solution can cause serious complications for babies with diarrhea because they contain too much salt. Kool- Aid or soda pop should not be used as the only food because they contain little or no salt. Use only the fluids mentioned.  Clear fluids alone should only be used for 24 hours because the body needs more calories than they can provide.  The most dangerous myth is that the intestine should be "put to rest"; restricting fluids can cause dehydration. 

Keep in mind that there is no effective, safe drug for diarrhea and that extra water and diet therapy work best.

 

 

Prevention: 

Diarrhea is very contagious.  Hand washing after diaper changing or using the toilet is crucial for keeping everyone in the family from getting diarrhea.

 

 

Call our office later if

Any signs of dehydration occur

Your child is vomiting

Diarrhea becomes severe (such as a bowel movement every hour for more than 8 hours)

 Any blood, pus, or mucous appears in the diarrhea

 Abdominal pain develops and lasts more than 12 hours

 Diarrrhea does not improve after 48 hours on the special diet

 Mild diarrhea lasts more than a week