Clinical Reference Systems: Pediatric Advisor 10.0

Description

Diarrhea is the sudden increase in the frequency and looseness of bowel movements. Mild diarrhea is the passage of a few loose or mushy bowel movements. Severe diarrhea is the passage of many watery bowel movements. The best indicator of the severity of the diarrhea is its frequency.

The main complication of diarrhea is dehydration from excessive loss of body fluids. Symptoms of dehydration are a dry mouth, the absence of tears, infrequent urination (for example, none in 12 hours), and a darker, concentrated urine. The main goal of diarrhea treatment is to prevent dehydration.

Cause

Diarrhea is usually caused by a viral infection of the lining of the intestines (gastroenteritis). Sometimes it is caused by bacteria or parasites. Bacterial diarrhea usually causes blood or lots of mucus in the stools. Occasionally a food allergy or drinking too much fruit juice may cause diarrhea. If you have just one or two loose bowel movements, the cause was probably something unusual you ate.

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 by making sure you drink enough fluids to replace the fluids lost in the diarrhea. Don't expect a quick return to solid bowel movements.

Home Care

1. Diet

   Eat a regular diet with a few simple changes:

   • Eat more foods containing starch since these are easily digested during diarrhea. Examples are cereals, breads, crackers, rice, mashed potatoes and noodles.
   • Drink more water or diluted KOOL-Aid.
   • Avoid fruit juices because they make diarrhea worse.
   • Eat or drink less milk and milk products (except active-culture yogurt) for a few days.
   • Avoid beans or any other foods that cause loose bowel movements.

   You can go back to your normal diet 1 day after the diarrhea is gone, which is usually in 3 or 4 days.

2. Common mistakes

   The most dangerous myth is that the intestine should be "put to rest"; avoiding fluids can cause dehydration. There is no effective, safe drug for diarrhea. Extra fluids and diet therapy work best.

3. Prevention

   Diarrhea is very contagious. Always wash your hands after using the toilet. This is crucial for keeping everyone in the family from getting diarrhea.

4. Vomiting with diarrhea

   If you vomit more than twice, treatment of the vomiting should take priority over the treatment of diarrhea until you have gone 8 hours without vomiting.

   (For further information see Vomiting .)

Call Your Physician Immediately If:

• You have signs of dehydration (no urine in more than 12 hours, very dry mouth, no tears).
• Any blood appears in the diarrhea.
• Your diarrhea is severe (more than 8 BMs in the last 8 hours).
• The diarrhea is watery AND you have also vomited the clear fluids three or more times.

Call Your Physician During Office Hours If:

• Mucus or pus appears in your BMs.
• You have a fever (over 100 degrees F, or 37.8 degrees C) for more than three days.
• Mild diarrhea lasts more than 2 weeks.
• You have other concerns or questions.