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child with sad face due to stomach troublesDiarrhea is defined as the passage of frequent watery stools.

Why do children get diarrhea?
There are many possible causes of diarrhea. In a younger child, drinking too much fruit juice alone might cause diarrhea. Other causes range from food poisoning to an inflamed colon, with many causes in between.

A note about breastfeeding infants
The normal breastfeeding stools are watery or seedy and frequent. If the stools become completely water with little or no solid bits, or the frequency suddenly increases, only then it is considered to be diarrhea.

Toddler Diarrhea
In one word: Juice! If your toddler is active, happy, playful yet has several loose stools a day, and is a big juice drinker then you are likely dealing with a juice induced diarrhea. Cut back on the juice (or even better, cut it out!) and the diarrhea will resolve. A note about juice – unless your child is constipated and you are using prune juice as a treatment, there is nothing good or useful about juice. It is equivalent to dessert. The only drinks a toddler should have on a regular basis are water and milk. What about watered-down juice? It is teaching children to only drink flavored beverages, not water, and these children are more likely to become our next generation of soda drinkers.

Viral Gastroenteritis
Commonly known as the stomach flu. Your child will often have a fever, vomiting and cramping with diarrhea. Diarrhea after the stomach flu can last up to two weeks. Usually it resolves in less than seven days. Avoiding dairy is one way to decrease the diarrhea. Rice water is also very helpful in slowing down the diarrhea and helping the body get back to normal quickly. (see vomiting information page for rice water instructions) Using a probiotic daily, such as acidophilus, might also help restore balance to the stomach more quickly and shorten the duration of diarrhea. For more information, please see the information page on vomiting.

Infectious Diarrhea and Food Poisoning
If many people in one group or household begin having symptoms at the same time, or within a few hours of one another, and if those symptoms include vomiting, diarrhea, +/- headache and fever, you are likely dealing with food poisoning. If there is blood in the stool, or if the symptoms are severe, contact your physician.

Medication side effect
If your child is on an antibiotic for any reason it is likely to result in some diarrhea. Adding constipating foods to their diet while they are on the antibiotic can help – bananas, apples, rice, toast/bread items (aka the BRAT diet). Using a probiotic daily, such as acidophilus, might also help restore balance to the stomach more quickly and shorten the duration of diarrhea.

Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is a condition of spastic colon. If your child is school-aged and has alternating diarrhea and constipation with some abdominal pain, nausea, bloating and/or gas, and if this happens primarily during times of stress, you might be dealing with IBS. An increase in dietary fiber will help, and an examination by your child’s physician is in order – call during regular office hours.

Malabsorption Disorder
Malabsorption Disorder is a condition in which the body does not take necessary nutrients out of the food that your child eats. The stools are often very bulky and foul smelling, Your child will likely grow and gain weight very slowly. If you are not seeing your physician regularly for check ups then you should contact him/her during regular office hours for an evaluation .

Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammation of the colon. The most common types are Crohn’s Disease and Ulcerative colitis. Symptoms include chronic diarrhea, possible bloody stools, often abdominal or joint pain, loss of appetite and fatigue. Your child should be evaluated by his/her physician – call during regular office hours.

Should you be worried?
The main concern from diarrhea alone is dehydration. If your child does not have vomiting with the diarrhea then dehydration is easier to combat/avoid. Limit dairy, avoid sweet/sugary drinks, use the BRAT diet described above, and try a probiotic. If your child has vomiting and diarrhea see the vomiting information page for detailed instructions about rehydration guidelines. If your child has diarrhea for more than two weeks you should see your child’s pediatrician – call during regular office hours.

If your child has diarrhea and is/has any of the following you should contact and see a physician immediately:

-Monique Araya, MD, FAAP

The medical information on this Web site is provided for educational purposes only. The information provided in this site, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider.
If you believe you have a medical emergency you should call 911 or your physician immediately. If you have any questions regarding your health or a medical condition, you should promptly consult your physician. If you feel that something is just not right – remember, no one knows your child like you do!