What Is Chronic Diarrhea?

Diarrhea is when you have loose, watery stools several times a day. This condition generally goes away within a day or two without medical treatment. Diarrhea that continues for four weeks (even if it comes and goes) is considered to be chronic diarrhea.

When diarrhea lasts for several days, it can lead to dehydration. Infants and young children are especially vulnerable to dehydration caused by diarrhea. During episodes of diarrhea, the body loses the fluids and electrolytes it needs to function correctly. Electrolytes are minerals that affect your muscle function, the amount of water in your body, and the acidity of your blood.

Call your child’s doctor or pediatrician right away if they have diarrhea lasting more than 24 hours, especially if they also have a fever. Chronic diarrhea can lead to shock or organ damage in infants and young children.

Diarrhea is also a major cause of malnutrition in children under the age of 5. Many of these cases are due to contaminated water and food. In developing countries, a child under the age of 3 is likely to have three episodes of diarrhea a year. Each incident deprives the child of nutrition needed for growth. Continued episodes of diarrhea can therefore cause malnutrition. Malnutrition can continue the cycle of diarrhea.

Around the world, diarrhea is the second leading cause of death in children under age 5. It takes the lives of approximately 760,000 children each year.

What Causes Diarrhea?

The cause of diarrhea in children isn’t always found. However, common causes include:

  • too much fruit or fruit juice
  • use of antibiotics or other medications (in baby or breastfeeding mother)
  • allergies or sensitivities to particular foods
  • dietary changes (in baby or breastfeeding mother)

Severe diarrhea can be caused by:

Children visiting foreign countries (especially developing countries) are at risk of getting traveler’s diarrhea. This condition usually occurs when someone consumes contaminated water or food.

What Are the Symptoms of Diarrhea?

Infants often produce loose stools, so this shouldn’t be immediate cause for concern. However, a sudden increase in watery stools — especially if they’re accompanied by congestion or fever — may be a sign of diarrhea in infants and young children. Other symptoms include:

  • abdominal pain or cramping
  • nausea
  • urgency to use the bathroom, or loss of bowel control
  • fever and chills
  • dehydration

What Are the Symptoms of Dehydration?

Dehydration is when the body no longer has enough fluids to work properly. In infants and young children, dehydration can progress rapidly. It can lead to more serious health complications if it isn’t treated quickly. Complications of dehydration include shock, organ damage, and coma.

Signs of dehydration include:

  • dry mouth
  • dry/sunken eyes
  • sunken cheeks
  • no tears when crying
  • irritability
  • dry skin
  • fatigue

The following symptoms can indicate severe dehydration:

  • more than eight hours have passed without urination
  • child is extremely listless
  • the soft spot on top of your infant’s head (fontanelle) appears sunken
  • pinched skin does not spring back
  • high fever
  • unconsciousness

Call your child’s doctor or go to the hospital immediately if your child shows signs of dehydration.

Caring for Your Child at Home

Treating your child at home is usually effective when they have a mild case of diarrhea. It’s important to note that over-the-counter medications used to treat diarrhea in adults shouldn’t be given to infants or children. Talk to your child’s doctor before using over-the-counter anti-diarrheal medicines.

You can care for your child at home in the following ways:

  • Make sure your child drinks plenty of fluids.
  • Do not feed them foods that seem to trigger diarrhea.
  • Wash your hands often — especially after each diaper change — to avoid spreading bacteria in the home.

You should continue breast-feeding when your baby has diarrhea. Breast milk can help ease symptoms of diarrhea and speed up recovery.

Monitor your child carefully, looking for signs of dehydration. Call your child’s doctor right away if you think your child is dehydrated.

Change your child’s diaper immediately after a bowel movement. This can help prevent diaper rash and irritation. Use water instead of wipes, which can further irritate the skin. Over-the-counter creams with zinc oxide (such as Desitin) can also help soothe and protect skin.

When to Take Your Child to the Doctor

Take your child to the doctor if they’ve had diarrhea for more than two days. You should also take them to the doctor if they show any of the following symptoms:

  • fever
  • bloody diarrhea
  • severe diarrhea (more than eight stools in eight hours)
  • diarrhea accompanied by vomiting
  • abdominal pain or cramping
  • recurring diarrhea

Diarrhea in infants and young children can quickly lead to dehydration, which is a dangerous condition. Don’t hesitate to call a doctor.

How Is Chronic Diarrhea Diagnosed?

The doctor will want to determine the cause of your child’s diarrhea if the condition becomes chronic (long-term). A complete medical history and physical examination will be required. Be prepared to provide information about your child’s diet, eating habits, and medications. Your child’s doctor may use the following tests to determine the cause:

  • blood tests (to check for disease)
  • stool culture (to check for bacteria and parasites)
  • allergy tests

Depending on the results of these tests, further testing may be needed.

How Is Chronic Diarrhea Treated?

The treatment plan for your child will depend on the cause and severity of their diarrhea.

Your child may need to stay in the hospital if they’re experiencing chronic diarrhea or dehydration. They’ll likely be given fluids containing electrolytes to help restore balance.

It’s important to follow the doctor’s advice carefully. Avoid giving your child foods or liquids that trigger diarrhea. Stick with bland foods instead (such as potatoes, toast, or bananas) until the diarrhea has subsided.

How Can Diarrhea Be Prevented?

Diarrhea can’t always be prevented. However, you can lower your child’s risk of getting diarrhea by practicing good hygiene and following safe food preparation guidelines.

Traveler’s Diarrhea

Speak with your child’s doctor if you’re planning on traveling with your child to a foreign country. The doctor will be able to give you specific information on how to avoid traveler’s diarrhea. Here are some preparatory measures to keep in mind:

  • Use bottled water for drinking, making ice cubes, cooking, and brushing teeth.
  • Avoid unpasteurized milk or milk products.
  • Wash and peel raw fruits and vegetables.
  • Avoid eating raw or undercooked meat, poultry, fish, and shellfish.
  • Avoid getting food from street vendors.
  • Pack some snacks from home for your child.
  • Practice proper hygiene and wash your child’s hands often.
  • Pack hand cleansers or wipes in case there aren’t hand-washing facilities.

Rotavirus

The U.S. Food and Drug Administration (FDA) has approved two oral vaccines that can help prevent rotavirus infections in children (RotaTeq and Rotarix). Both are given in multiple doses to babies during their first months of life. Ask your child’s doctor if these vaccines are recommended for your child.