Dear Doctors: After our 4-year-old daughter started daycare, she had a few episodes of diarrhea. It lasted only a day or two each time, but it’s not something that happened while we were home during the pandemic. What causes it? Is it dangerous? What’s the best way to treat it?
Dear Reader: Although it can be alarming for the parent and scary and uncomfortable for the child, diarrhea is a common problem in younger children. This is particularly true for those under the age of 5.
Most diarrhea in children in the United States is caused by gastrointestinal viruses, which can occur in group situations such as daycare. They are often transmitted due to lapses in personal hygiene. Considering how young children interact with the world through the sense of touch and how often their fingers wind up in their mouths, their being susceptible to viral diarrhea isn’t that surprising. Additional causes can be bacterial infection, food allergies or intolerance, parasitic infection or a reaction to a medication, vitamin or supplement.
Symptoms include passing loose or watery stools several times a day, often accompanied by cramping or bloating. Some children feel nauseated, experience vomiting and develop a fever.
Your question refers to what is known as acute diarrhea. This lasts anywhere from a day or two to up to three weeks. Diarrhea that continues beyond three weeks is known as chronic and may be an indicator of a more serious problem. Chronic diarrhea can be a symptom of a disease or of a functional disorder in which the bowel is not working as it should.
Any time severe or ongoing diarrhea occurs -- or when it is accompanied by a fever of 102 degrees or higher, severe abdominal or rectal pain, stools that contain blood or that appear black and tarry -- it’s important to seek medical care.
All forms of diarrhea should be taken seriously. That’s because, even in the short term, the loss of fluids that occurs during diarrhea can lead to dehydration. With a young child’s small size, this can happen quickly. Symptoms of dehydration include an increase in thirst, a dry mouth, a lack of energy and a decrease in both the frequency of urination and the output of urine. For infants, this may mean they have gone three or more hours without wetting a diaper.
When someone becomes dehydrated, the loss of fluid in the body becomes evident in the elasticity of their skin. That is, when the skin is pinched and released, it fails to immediately rebound to its original shape. This is known as a decrease in turgor and is a symptom of dehydration.
A child with the mild form of diarrhea that you have described can safely be treated at home. This includes encouraging them to rest, to drink fluids throughout the day and to follow a healthy diet. Medications to slow bowel movements are available, but check with your doctor before using them. When diarrhea is accompanied by vomiting, oral rehydration solutions are recommended. It’s important for the child and their caregivers to wash their hands, particularly after using or helping with the bathroom.
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