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 When should you worry about diarrhea?

 (. Diarrhea is frequent bowel movements of watery or loose stools

 that differ from a child's normal pattern. Diarrhea sometimes contains blood or mucus. Mild diarrhea can be difficult to distinguish because The number of bowel movements and the consistency of stools vary with age and diet in healthy children. For example, the stools of breast-fed infants who have not eaten solid food are often loose stools that are frequent and considered normal. These infants have diarrhea. However, watery stools that persist for more than 24 hours is not considered normal.

Children with diarrhea can have a decreased appetite and have vomiting and weight loss or a fever. If the diarrhea is severe or lasts a long time, dehydration is likely. Infants and young children can become dehydrated more quickly, sometimes in less than a day.

Diarrhea causes 1.5 million deaths annually worldwide, most of them in underdeveloped countries. In the United States, diarrhea accounts for about 9% of hospital admissions for children under five years of age.

the reasons

Possible causes of diarrhea depend on whether it lasts less than two weeks (acute) or more than two weeks (chronic). Most cases of diarrhea are acute.

Common causes

Acute diarrhea usually results from the following reasons:

• Infectious gastroenteritis
• food poisoning
• use of antibiotics
• food allergy
• Gastroenteritis is usually caused by infection with a virus, but it may be caused by infection with a bacteria or parasite.
• Food poisoning usually refers to diarrhea, vomiting, or both caused by eating food contaminated with toxins produced by certain germs, such as staphylococci or clostridia.

Some antibiotics can change the types and number of bacteria in the intestines. As a result, diarrhea can occur. Sometimes antibiotics allow particularly dangerous bacteria to multiply, such as Clostridium difficile. Clostridium difficile is released by Clostridium difficile. ).

Chronic diarrhea usually occurs due to the following reasons:

• Nutritional factors, such as lactose intolerance or overeating of certain foods
• Infections (especially those caused by parasites)
• Celiac disease
• inflammatory bowel disease

Less common causes

• Acute diarrhea can also result from more serious disorders such as appendicitis and intussusception and hemolytic-uremic syndrome (a complication of certain bacterial infections). Abdominal pain, bloody stools, fever, and a poor appearance.
• Chronic diarrhea may also result from disorders that affect food absorption (malabsorption disorders), such as cystic fibrosis and a weakened immune system (due to a disorder such as AIDS or the use of certain drugs).

Sometimes diarrhea is caused by constipation. When hard stools collect in the rectum, loose stools can leak from its surroundings into a child's underwear.

EvaluationWarning signs

Some symptoms are cause for concern. They include the following:

Signs of dehydration, such as decreased urination, lethargy or listlessness, crying without tears, extreme thirst, and dry mouth

• bad appearance
• high fever
• blood in stool
• Abdominal pain and severe tenderness when touched
• Bleeding into the skin (appears as small reddish-purple dots [petechiae] or spots [purpura])

When should you see a doctor?

Children who develop any warning signs should be evaluated immediately by a doctor, as do children who have had more than 3 or 4 episodes of diarrhea and do not drink or drink very little fluids.

If children do not have warning signs and are drinking and urinating normally, contact the doctor if the diarrhea lasts for two days or more or if there are more than 6-8 episodes of diarrhea per day. If the diarrhea is mild, it is not necessary to see the doctor. The doctor should Screen children who have had diarrhea for 14 days or more.

What will the doctor do?

Doctors first ask about symptoms and medical history. Then the doctor performs a physical examination. The results of their medical history and physical examination often indicate the cause and which tests may be needed (see Table: Some Causes and Features of Diarrhea).

Doctors ask about stool characteristics, how often and for how long, and whether the child has other symptoms, such as fever, vomiting, or abdominal pain.

Doctors also ask about possible causes, such as diet, antibiotic use, food that may have been contaminated, recent contact with animals, and recent travel.

A physical examination is done to check for symptoms of dehydration