Diarrhea in Children, Causes, Symptoms and Treatments


Diarrhea in Children: Causes and Treatments

Why do children get diarrhea more often than adults? How can you treat your child's discomfort? WebMD tells you about the causes of diarrhea and home treatments for it.

Diarrhea in Children: Common Causes and Treatments

Diarrhea is the body's way of ridding itself of germs, and most episodes last a few days to a week. Diarrhea often occurs with fever, nausea, vomitingcramps, and dehydration. Some of the most common reasons kids get diarrhea include:
  • Infection from viruses like rotavirus, bacteria like salmonella and, rarely, parasites like giardia. Viruses are the most common cause of a child's diarrhea. Along with loose or watery stools, symptoms of a viral gastroenteritis infection often include vomiting, stomachache, headache, and fever.
When treating viral gastroenteritis -- which can last 5-14 days -- it's important to prevent fluid loss. Offer additional breast milk or an oral rehydration solution (ORS) to infants and young children. Water alone doesn't have enough sodium, potassium, and other nutrients to safely rehydrate very young children. Be sure to talk to your doctor about the amount of fluids your child needs, how to make sure he or she gets them, when to give them, and how to watch for dehydration.
Older children with diarrhea can drink anything they like to stay hydrated, including ORS and brand-name products (their names usually end in "lyte"). Popsicles can also be a good way to get fluids into a child who's been vomiting and needs to rehydrate slowly.





 

What Is Rotavirus?

If you look at a rotavirus through a microscope, it has a round shape. The Latin word for wheel is “rota,” which explains how the virus got its name.
This easily spread virus causes inflammation in the stomach and intestines. From late winter to early spring, it can cause severe diarrheavomitingfeverabdominal pain, and dehydrationin infants, young children, and some adults.
While there are medications to help with the symptoms, there is no medicine that can cure rotavirus. Even children who have been vaccinated against rotavirus may still get it more than once.

 

How Do You Get It?

If your child has rotavirus, it's present in their poop before symptoms start and up to 10 days after they taper off. During that time, when your child wipes after using the toilet, rotavirus can spread to his hands.
If he doesn't wash his hands, the virus can spread to everything he touches, including things such as:
  • Crayons and markers
  • Food
  • Surfaces such as sinks and kitchen counters
  • Toys, including shared electronics such as iPads and remote controls
  • Utensils
  • Water
If you touch your child's unwashed hands or any object he’s contaminated and then touch your mouth, you can be infected as well.

Who Is More Likely to Get This?

Anyone can get rotavirus, but it most commonly affects:
  • Infants
  • Young children
  • Close relatives
  • Those who work with children, such as nannies or child-care employees

Symptoms

If your child has been exposed to rotavirus, symptoms won't show up for about 2 days. It usually starts with a fever, vomiting, and stomach pain, which fades just as diarrhea begins. As the virus works its way through your child's system, the diarrhea can hang on for 5 to 7 days.
Adults often have similar symptoms, but they tend to be less severe.

When to Call a Doctor

Check in with your doctor if your child has the following symptoms:
  • Lethargy and drinking less fluids
  • Frequent vomiting
  • Stools that are black or contain blood or pus
  • Any temperature in a baby younger than 6 months
  • A temperature for more than 24 hours, if your child is older than 6 months

With all the vomiting and diarrhea, your child may not feel like eating or drinking. This can cause your child to get dehydrated, which might even become life-threatening and require him being put in the hospital.
Older adults, especially those with other illnesses or conditions, might also get dehydrated.
Call your doctor if you notice any combination of these symptoms of dehydration:

 

Diagnosis

Your doctor will likely base a diagnosis on a physical exam and questions about symptoms.
In some cases, he may have a lab analyze a sample of your child’s stool.

Treatments

There's no specific medicine to treat rotavirus. Antibiotics can't touch it and neither can antiviral drugs.
Your doctor may suggest medicine to help with the symptoms. Ask about rehydration fluids to replace minerals lost through vomiting and diarrhea.

 

At-Home Care

Rotavirus usually works its way through your child's system over the course of a week. During that time, give your child plenty of fluids to offset dehydration, including:
  • Water
  • Broth
  • Ginger ale, or clear sodas
  • Ice chips
Bland foods, such as crackers, are best. Steer clear of apple juice, milk, cheese, sugary foods, and anything else that might increase vomiting or diarrhea.

 

Prevention

Frequent hand washing and disinfecting surfaces helps, but nothing is a guarantee.
The CDC recommends getting your child vaccinated against rotavirus. This will make him less likely to get it and, if he does get it, the symptoms will be less severe.







What Is Salmonella?

It’s summer, and like many people, maybe you want to celebrate with a picnic. Perhaps some of your favorites -- like fried chicken and deviled eggs – are served. But when you get up the next morning, you feel sick to your stomach and have diarrhea.
You might have a salmonella infection.
The infection itself is called “salmonellosis.” But most people know it by the name salmonella, which is actually the name of the bacteria that causes the infection.
Along with having the runs when you go to the bathroom, you can also have a fever, along with pain and cramping in your stomach. Most people who get salmonella get better on their own, at home, within 4 to 7 days.

Sources of Salmonella

There are many possible sources of a salmonella infection. Some of them are:
Meat. Some of our favorite proteins to cook and eat have the bacteria. They include:
  • Poultry (chicken, turkey, or duck)
  • Beef and veal
  • Pork
Fertilizer. The most common way to get salmonella is by eating meat or eggs or drinking milk that’s contaminated. But you can also get it by eating fruits or vegetables that have been in contact with manure from animals that have it.
Animal poop is often used in fertilizer for fruits and vegetables, which is how produce such as lettuce, spinach, or strawberries can also be a source of salmonella in people.
Water. Produce can be contaminated another way, too. While animal poop is still the culprit, it’s not because of manure being put directly on the fields, but contaminated water used to help the produce grow.
Cooking. If you cook a lot at home, the way you prepare your food could also be a source of your infection.
If you let juices from contaminated chicken or steak come into contact with your lettuce or spinach salad, you could get sick.
Handwashing. If you go to the bathroom but don’t wash your handswell, you could get an infection. If you change your baby’s stinky diaper and forget to wash your hands after, you might contract a salmonella infection, too.
Pets. Some that may carry the bacteria include:
  • Dogs
  • Cats
  • Birds
  • Reptiles (such as lizards, snakes, and turtles)
You or your child could pet a dog or cat and, without knowing it, touch poop hidden in fur. If you then put your fingers in your mouth, you could get an infection.

 

How Common Is It?

Salmonella infections (also often referred to, generally, as food poisoning) are quite common. Throughout the world, tens of millions of cases are reported every year.
Most people get over it without treatment, but some cases are so severe people need to go to the hospital. In rare cases it’s life-threatening.
Infections are more common in the summer than the winter – after all, people host more picnics when it’s hot than cold.
Children are more likely than adults to get an infection. In addition to young children, older adults and people with weak immune systems are most likely to be infected.

 

Symptoms

Most of the symptoms you’ll have from a salmonella infection will be stomach-related:
Even though most symptoms usually don’t last more than a week, in some cases it can take several months for your bowel movements to get back to normal.

 

Possible Complications

A small number of people who get a salmonella infection get pain in their joints. You might hear a doctor or nurse call it reactive arthritis. This can last for several months, or even longer.
If you get this joint pain, you also could develop pain while peeing or your eyes could get sore, get itchy, or sting.
Dehydration can be problem with this because you’ve lost too much fluid from having runny and watery poop. Signs of dehydration include:
If the salmonella infection gets into your blood, it can infect your body’s tissues, such as:
  • The tissues around your brain and spinal cord
  • The lining of your heart or heart valves
  • Your bones or bone marrow
  • The lining of blood vessels
These infections can lead to serious diseases.

When Should I Call a Doctor?

If you have a salmonella infection, it usually goes away on its own after a few days. But if you still are having symptoms more than a week after first getting the infection, you might want to see a doctor.
If a young child, older adult, or person with a weakened immune system has an infection, they should see a doctor if they have any of these symptoms for more than a couple of days:

Diagnosis and Tests
Your doctor may want you to have blood tests, or he might want a stool sample.
Sometimes, the doctor may want to do further testing to help figure the exact kind of bacteria you have. This can help health officials trace the source if there is an outbreak in your area.

Treatments

For healthy adults: If you have diarrhea with your salmonella infection, you should drink a lot of water and other fluids. Your doctor might suggest you drink a rehydration liquid, like Pedialyte, if your diarrhea is severe.
If your doctor confirms that you have a salmonella infection, he might prescribe antibiotics. You need to be sure you finish the prescription and take it exactly as directed.

For children: If your child has a healthy immune system, the doctor may not prescribe any treatment, but rather let the infection run its course. But if your kid has a bad fever, you may want to give her acetaminophen (Tylenol). And, as with adults, she’ll need lots of water.
In special cases: Infants, the elderly, and people with weakened immune systems may need antibiotics. Doctors decide this on a case-by-case basis. There are several types of the bacteria that have become resistant, meaning they can’t be stopped by antibiotics.

Prevention

Even though salmonella can hide in a variety of foods, you can do a lot of things yourself to help ensure the sneaky bacteria doesn’t invade your gut:
  • Avoid eating raw or barely cooked eggs.
  • Don’t eat raw or undercooked beef, pork, or poultry.
  • Refrigerate food properly, both before cooking it and after serving it.
  • Wash your hands well with soap and warm water before, and after, handling food.
  • Keep kitchen surfaces clean before preparing food on them.
  • Do not mix cooked food with raw food or use the same utensils to prepare them – for example, don’t use the same knife to slice mushrooms that you used to cut raw chicken, and use different plates or cutting boards to slice them on.
  • Cook each kind of meat to its correct minimum temperature.
  • Wash your hands with soap and water after touching animals, their toys, and their bedding.
  • Wash raw fruits and vegetables well, and peel them if possible.










Viral gastroenteritis (stomach flu)

 

Gastroenteritis flu can be caused by many different kinds of viruses. The main types are rotavirus and norovirus. Rotavirus is the world's most common cause of diarrhea in infants and young children. Norovirus is the most common cause of serious gastroenteritis and also foodborne disease outbreaks in the U.S.


Overview

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever.
The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by ingesting contaminated food or water. If you're otherwise healthy, you'll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.
There's no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defense.

Symptoms

Illustration of stomach and intestines

 

Viral gastroenteritis

Although it's commonly called stomach flu, gastroenteritis isn't the same as influenza. Real flu (influenza) affects only your respiratory system — your nose, throat and lungs. Gastroenteritis, on the other hand, attacks your intestines, causing signs and symptoms, such as:
·         Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
·         Abdominal cramps and pain
·         Nausea, vomiting or both
·         Occasional muscle aches or headache
·         Low-grade fever
Depending on the cause, viral gastroenteritis symptoms may appear within one to three days after you're infected and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may persist as long as 10 days.
Because the symptoms are similar, it's easy to confuse viral diarrhea with diarrhea caused by bacteria, such as Clostridium difficile, salmonella and E. coli, or parasites, such as giardia.

 

When to see a doctor

If you're an adult, call your doctor if:
·         You're not able to keep liquids down for 24 hours
·         You've been vomiting for more than two days
·         You're vomiting blood
·         You're dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
·         You notice blood in your bowel movements
·         You have a fever above 104 F (40 C)

 

For infants and children

See your doctor right away if your child:
·         Has a fever of 102 F (38.9 C) or higher
·         Seems lethargic or very irritable
·         Is in a lot of discomfort or pain
·         Has bloody diarrhea
·         Seems dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them
If you have an infant, remember that while spitting up may be an everyday occurrence for your baby, vomiting is not. Babies vomit for a variety of reasons, many of which may require medical attention.
Call your baby's doctor right away if your baby:
·         Has vomiting that lasts more than several hours
·         Hasn't had a wet diaper in six hours
·         Has bloody stools or severe diarrhea
·         Has a sunken soft spot (fontanel) on the top of his or her head
·         Has a dry mouth or cries without tears
·         Is unusually sleepy, drowsy or unresponsive

 

Causes

You're most likely to contract viral gastroenteritis when you eat or drink contaminated food or water, or if you share utensils, towels or food with someone who's infected.
A number of viruses can cause gastroenteritis, including:
·         Noroviruses. Both children and adults are affected by noroviruses, the most common cause of foodborne illness worldwide. Norovirus infection can sweep through families and communities. It's especially likely to spread among people in confined spaces. In most cases, you pick up the virus from contaminated food or water, although person-to-person transmission also is possible.
·         Rotavirus. Worldwide, this is the most common cause of viral gastroenteritis in children, who are usually infected when they put their fingers or other objects contaminated with the virus into their mouths. The infection is most severe in infants and young children. Adults infected with rotavirus may not have symptoms, but can still spread the illness — of particular concern in institutional settings because infected adults unknowingly can pass the virus to others. A vaccine against viral gastroenteritis is available in some countries, including the United States, and appears to be effective in preventing the infection.
Some shellfish, especially raw or undercooked oysters, also can make you sick. Although contaminated drinking water is a cause of viral diarrhea, in many cases the virus is passed through the fecal-oral route — that is, someone with a virus handles food you eat without washing his or her hands after using the toilet.

Risk factors

Gastroenteritis occurs all over the world, affecting people of every age, race and background.
People who may be more susceptible to gastroenteritis include:
·         Young children. Children in child care centers or elementary schools may be especially vulnerable because it takes time for a child's immune system to mature.
·         Older adults. Adult immune systems tend to become less efficient later in life. Older adults in nursing homes, in particular, are vulnerable because their immune systems weaken and they live in close contact with others who may pass along germs.
·         Schoolchildren, churchgoers or dormitory residents. Anywhere that groups of people come together in close quarters can be an environment for an intestinal infection to get passed.
·         Anyone with a weakened immune system. If your resistance to infection is low — for instance, if your immune system is compromised by HIV/AIDS, chemotherapy or another medical condition — you may be especially at risk.
Each gastrointestinal virus has a season when it's most active. If you live in the Northern Hemisphere, for instance, you're more likely to have rotavirus or norovirus infections between October and April.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water and essential salts and minerals. If you're healthy and drink enough to replace fluids you lose from vomiting and diarrhea, dehydration shouldn't be a problem.
Infants, older adults and people with suppressed immune systems may become severely dehydrated when they lose more fluids than they can replace. Hospitalization might be needed so that lost fluids can be replaced intravenously. Dehydration can be fatal, but rarely.

Prevention

The best way to prevent the spread of intestinal infections is to follow these precautions:
·         Get your child vaccinated. A vaccine against gastroenteritis caused by the rotavirus is available in some countries, including the United States. Given to children in the first year of life, the vaccine appears to be effective in preventing severe symptoms of this illness.
·         Wash your hands thoroughly. And make sure your children do, too. If your children are older, teach them to wash their hands, especially after using the toilet. It's best to use warm water and soap and to rub hands vigorously for at least 20 seconds, remembering to wash around cuticles, beneath fingernails and in the creases of the hands. Then rinse thoroughly. Carry towelettes and hand sanitizer for times when soap and water aren't available.
·         Use separate personal items around your home. Avoid sharing eating utensils, glasses and plates. Use separate towels in the bathroom.
·         Keep your distance. Avoid close contact with anyone who has the virus, if possible.
·         Disinfect hard surfaces. If someone in your home has viral gastroenteritis, disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture of two cups of bleach to one gallon of water.
·         Check out your child care center. Make sure the center has separate rooms for changing diapers and preparing or serving food. The room with the diaper-changing table should have a sink as well as a sanitary way to dispose of diapers.

Take precautions when traveling

When you're traveling in other countries, you can become sick from contaminated food or water. You may be able to reduce your risk by following these tips:
·         Drink only well-sealed bottled or carbonated water.
·         Avoid ice cubes, because they may be made from contaminated water.
·         Use bottled water to brush your teeth.
·         Avoid raw food — including peeled fruits, raw vegetables and salads — that has been touched by human hands.
·         Avoid undercooked meat and fish.

 








Gastroenteritis

When you have diarrhea and vomiting, you may say you have the "stomach flu." These symptoms often are due to a condition called gastroenteritis.
With gastroenteritis, your stomach and intestines are irritated and inflamed. The cause is typically a viral or bacterial infection.

 

Symptoms of Gastroenteritis

With gastroenteritis, the main symptoms you probably have are watery diarrhea and vomiting. You might also have stomach pain, cramping, fever, nausea, and a headache.
Because of diarrhea and vomiting, you also can become dehydrated. Watch for signs of dehydration, such as dry skin and a dry mouth, feeling lightheaded, and being really thirsty. Call your doctor if you have any of these symptoms.

 

Stomach Flu and Children

Children can get dehydrated quickly, so if your child has the stomach flu, it's important that you look for signs that he is very thirsty or has dry skin or a dry mouth. If you have a baby, look for fewer, drier diapers.

Keep children with gastroenteritis out of day care or school until all symptoms are gone. Check with your doctor before giving your child any medicine. Drugs used to control diarrhea and vomiting aren't usually given to children younger than 5.
To help prevent rotavirus -- the most common cause of stomach flu for children -- there are two vaccines that can be given to infants. Talk to your doctor about the vaccines.

 

What Causes Gastroenteritis

There are many ways gastroenteritis can be spread:
  • Contact with someone who has the virus
  • Contaminated food or water
  • Unwashed hands after going to the bathroom or changing a diaper
The most common cause of gastroenteritis is a virus. Gastroenteritis flucan be caused by many different kinds of viruses. The main types are rotavirus and norovirus.
Rotavirus is the world's most common cause of diarrhea in infants and young children. Norovirus is the most common cause of serious gastroenteritis and also foodborne disease outbreaks in the U.S.

Although not as common, bacteria such as E. coli and salmonella can also trigger the stomach flu. Salmonella and campylobacter bacteria are the most common bacterial causes of gastroenteritis in the U.S. and are usually spread by undercooked poultry, eggs, or poultry juices. Salmonella can also be spread through pet reptiles or live poultry.
Another bacteria, shigella, is often passed around in day care centers. It typically is spread from person to person, and common sources of infection are contaminated food and drinking water.

Parasites can also cause gastroenteritis, but it's not common. You can pick up organisms such as giardia and cryptosporidium in contaminated swimming pools or by drinking contaminated water.
There are also other unusual ways to get gastroenteritis:
  • Heavy metals (arsenic, cadmium, lead, or mercury) in drinking water
  • Eating a lot of acidic foods, like citrus fruit and tomatoes
  • Toxins that might be found in certain seafood
  • Medications such as antibiotics, antacids, laxatives, and chemotherapy drugs






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