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Diarrhoea (children)

 


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Class
Gastro-intestinal system
Description
Diarrhoea describes uncontrollable bowel movements that produce loose, watery stools. These bowel movements tend to be very frequent, occur randomly and are often accompanied by stomach ache and vomiting. Although diarrhoea is a common problem which often gets better by itself, sufferers should be careful they do not dehydrate, as large amounts of water can be lost during a bout of diarrhoea.

Diarrhoea in children can be life-threatening and should not be taken lightly. There is a serious risk of children quickly becoming dehydrated as so much of their small volume of body fluids can be lost with each bout of diarrhoea. The risk of a child becoming dehydrated is even more dangerous if the child also is vomiting or is sweating because of a high temperature or hot weather. Under weight children or frail children are at particular risk of suffering dehydration because they have less water to lose than healthy children and they may be less able to withstand the debilitating effects of diarrhoea.

Urgent medical help should be obtained if a child has diarrhoea and is refusing liquids, is abnormally drowsy, or is showing signs of dehydration such as sunken eyes, dry lips, dry tongue, is not urinating or has dark-coloured urine, or if the stools are blood-stained.
Causes
The most common cause of severe diarrhoea in children is a virus called rotavirus. Nearly all children catch this virus by the time they are five. Rotavirus cause gastroenteritis, an infection of the child's digestive system. The infection damages the lining of the intestines allowing fluids and salts to leak into the bowel, increasing the watery consistency of the stools and stimulating vigorous contractions of the muscles in the wall of the intestine that increase the frequency of bowel motions.

Bacterial infections can also cause diarrhoea. Food contamination, due to undercooked or poorly stored food is a major culprit in introducing these germs into the gut. Water, if it has not been filtered or treated, can also carry germs that cause diarrhoea. Not washing hands after going to the toilet can also pass diarrhoea-causing bacteria from person to person.

If diarrhoea persists for more than two weeks it is said to be chronic. In this case, the chronic diarrhoea is usually a symptom of some other long term illness such as ulcerative colitis, Crohn's disease or irritable bowel syndrome. A sensitivity to gluten or lactose can also be a cause of chronic diarrhoea.
Symptoms
It is essential that the fluids lost by children as a result of diarrhoea are restored as soon as possible to avoid dehydration; the younger the child and the smaller the child, the greater the need to act quickly.

Children should be encouraged to drink as much fluids as possible, preferably in the form of water or rehydration supplements. Caffeinated drinks such as cola and tea, fruit juices and fizzy drinks should be avoided as they may make dehydration worse by stimulating urination. Children should also be encouraged to eat. Small amounts of easily digestible plain foods, such as boiled rice or dry toast, given at intervals, are better than large meals. Dairy products and fresh foods should be temporarily avoided as they may stimulate the bowel.

Anti-diarrhoeal medicines are not recommended for children under 12 years of age. For children over 12 years of age, anti-diarrhoeal medicines containing codeine phosphate or loperamide reduce the spasm of the gut and help stem the flow of diarrhoea. If the child has a fever, or if an infection is suspected, anti-diarrhoeal medicines should not be used and medical advice should be obtained.

Children should be kept away from school or swimming pools for 48 hours after diarrhoea has stopped to avoid spreading the risk of diarrhoea to other children. Particular care should be taken with personal hygiene, washing hands thoroughly after going to the toilet and before food preparation.
When to consult your pharmacist
Your pharmacy stocks a wide range of rehydration supplements that can be purchased without a prescription. It is a good idea to keep a supply of the products at home in case they are suddenly needed.

When purchasing these items always let your pharmacist know the age of your child and whether she or he has any other illnesses or is taking any other medicines.
When to consult your doctor
Seek urgent medical help if your child is showing any of the symptoms described above, particularly if you have a young child or your child is refusing liquids.

If your child gets persistent attacks of diarrhoea, visit your doctor to find its cause.
Useful Tips
  • Adopt good food hygiene in the kitchen - minimise the spread of bacteria by covering foods kept in the fridge and cleaning work surfaces thoroughly
  • Wash hands before handling food - this reduces the chance of any germs passing from your hands to the food
  • Take care when drinking water abroad - stick to bottled water and avoid salads that may have been washed with contaminated water - avoid ice in drinks!
  • Anti-diarrhoeal medicines are not recommended for children under 12 years old


Reviewed on 21/01/2010


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