Diarrhea happens to all of us, but if it is frequent or persistent, it may be something that needs to be addressed. Diarrhea can cause a tremendous loss of nutrients, and can also cause dehydration. Children with feeding tubes, especially those who are still catching up on growth and nutrition, should be treated for diarrhea to prevent further nutritional consequences.
Symptoms of Diarrhea
- Loose, watery stools
- Frequent stools
- Urgency with stooling
- Blood in the stool
- Stool that is particularly unpleasant smelling
- Abdominal cramps or pain
Causes of Diarrhea
Illness or Infection
Viral illness, bacterial infection, or parasitic infection are the most common causes of diarrhea. Viral diarrheas and some bacterial diarrheas are typically short-lived and resolves on its own after a few days, though children need to be monitored closely for dehydration. Severe bacterial and parasitic infections usually require treatment from a physician. Especially common in children with complex medical issues is a bacterial infection called C. diff or Clostridium difficile, which causes particularly foul-smelling diarrhea.
Some children have erratic motility, which may include fast motility in the intestines, or intestinal spasms. These can lead to diarrhea, since the food or formula passes too quickly for water and nutrients to be absorbed.
Children who have had a pyloromyotomy or pyloroplasty, as well as some children who have fundoplication surgery, may develop dumping syndrome, in which food or formula is “dumped” too quickly into the intestines. This condition causes diarrhea and can also cause blood sugar fluctuations. Other surgeries on the GI tract, especially removal of any portion of the bowel, may also cause diarrhea.
In young children, a common culprit for diarrhea is diet. Children who are receiving too much fruit, fruit juice, sweeteners, or artificial sweeteners may have diarrhea. In addition, allergies and intolerances are common causes of diarrhea. Lactose intolerance is likely the most common, but children may be sensitive or allergic to almost any food or ingredient. Too much fiber can also lead to diarrhea.
Medications such as antibiotics frequently cause diarrhea. Sometimes this is due to the medication itself, and other times it is due to the effect of the medication on the good bacteria in the gut.
Inflammatory bowel diseases, including Crohn’s and colitis, also frequently cause diarrhea. Functional bowel disorders, such as irritable bowel syndrome, may also cause diarrhea or constipation.
Other medical conditions that often cause diarrhea include disorders that affect absorption such as cystic fibrosis, metabolic disorders, and endocrine or pancreas conditions.
During periods of acute diarrhea, the most important treatment is adequate hydration. Your child may require Pedialyte or increased free water to make up for all the stool losses. If you use a blenderized diet, you may want to change the blend to include more simple foods like bananas, rice, and simple cereals. If diarrhea continues for more than a few days, becomes severe, or dehydration occurs, see your child’s doctor.
The treatment of chronic diarrhea will depend entirely on the cause. The following are typical treatments:
- Changes in diet, such as changing formulas or the ingredients in a blenderized diet to account for intolerances, allergies, sugar content, fat content, and fiber levels
- Using probiotics
- Treating dumping syndrome by administering corn starch with feeds
- Treating absorption issues with enzymes
- Anti-diarrheal or motility slowing medications, only in certain chronic conditions
- Treating functional disorders such as irritable bowel syndrome
- Stopping or reducing medications that cause diarrhea
- Appropriate treatment for inflammatory bowel diseases and other underlying medical conditions
- Antibiotics or antiparasitics for infectious diarrhea