Diarrhea is a common gastrointestinal disorder that affects an estimated 1.3 billion children each year. It is classified as acute or chronic and is caused by abnormal intestinal water and electrolyte transport. Serious complications, such as dehydration and shock, can occur if diarrhea is severe or left untreated. Approximately 220,000 children under the age of 5 are hospitalized in the United States every year due to diarrhea and dehydration. There are many causes of diarrhea in a child.
Viruses
Rotavirus is the most common cause of diarrhea in children, occurring most often between the ages of 3 and 24 months. It peaks during the winter months and is transmitted by the fecal-oral route. Symptoms include a mild to moderate fever followed by vomiting and watery stools. Diaper rash is common due to the frequency of stools and can be minimized by changing diapers often and cleansing the diaper area thoroughly. If the rash becomes significant, it can be treated with over-the-counter remedies. Although there is no cure for rotavirus, the vaccine RotaTeq can be administered to children to significantly prevent the occurrence.
Other viruses that may cause diarrhea in children include enteroviruses, viral gastroenteritis and norovirus.
Bacteria
Escherichia coli, or E.coli, is a food-borne bacterial illness that can be extremely potent in young children. It is most commonly spread through meat that is not cooked thoroughly, but can also be found in lettuce, milk, juice, contaminated water and unpasteurized meats. It can also be spread by touching a contaminated surface. Symptoms of E. coli include bloody stools, stomach cramps, watery diarrhea and mild fever. The bacteria are detected by testing the stool, and they are usually shed in the stool after two to three days. In rare cases, E. coli can lead to hemolytic uremic syndrome (HUS), which can cause kidney failure or death.
Another cause of bacterial diarrhea is salmonella. Salmonella is a gastrointestinal illness caused by the salmonella bacteria and is contracted by consuming contaminated food or water. The most common sources of salmonella are chicken, eggs, pork, beef and unpasteurized milk. Symptoms include fever, stomach cramps, diarrhea, nausea and vomiting. Some children are infected and show no signs of illness. Salmonella is detected by testing the stool and may take two to three weeks to clear even though symptoms have subsided.
Other bacteria that can cause diarrhea in children include campylobacter, shigella and giardia.
Lactose Intolerance
Lactase is an enzyme in the body necessary for the digestion of lactose. When a person is deficient in lactase, he has difficulty digesting lactose, which can cause diarrhea. According to Dr. Richard Grand, Director of the General Clinical Research Center and the Center for Inflammatory Bowel Disease at Boston Children's Hospital, lactose intolerance typically develops between the ages of 2 and 18. "Lactose intolerance is not a food allergy, in which a person might suffer a dangerous reaction," states Dr. Grand, "but a symptom that can grow or decrease in severity according to how much lactose the child consumes." Symptoms of lactose intolerance include diarrhea, abdominal pain, flatulence and bloating.
Antibiotics
Antibiotics are prescribed to kill off harmful bacteria that enter the body. The gastrointestinal tract contains both "good" and "bad" bacteria, and both are necessary to maintain the normal functions of digestion, absorption and elimination. When antibiotics enter the body, both the good and bad bacteria are attacked, disrupting functions such as elimination. This can cause mild and temporary diarrhea that ends when antibiotic treatment is stopped.
References
- Pediatric Views: Lactose Intolerence in Children
- "Wong's Essentials of Pediatric Nursing;" Marilyn J. Hockenberry, PhD, RN-CS, PNP, FAAN; 2005.
- "Whaley and Wong's Essentials of Pediatric Nursing;" Donna L. Wong, PhD, RN, PNP, CPN, FAAN; 1997.
