Diarrhoea in Children
Diarrhoea can be acute (sudden onset and lasts less than 2 weeks) or chronic (persistent). This leaflet deals with acute diarrhoea which is common in children. The most important part of treatment is to give the child lots to drink.
What causes acute diarrhoea?
• Infection of the gut is the common cause. Many bacteria, viruses, and other 'bugs' can cause diarrhoea. Sometimes the bugs come from infected food (food poisoning). Infected water is a cause in some countries. Sometimes it is just 'one of those bugs going about'. Viruses are easily spread from one person to another by close contact, or when an infected person prepares food for others.
• Non-infectious causes of acute diarrhoea are uncommon in children. For example, colitis (inflammation of the gut), food intolerance, and various rare disorders of the gut.
The rest of this leaflet deals only with infectious causes of acute diarrhoea. What are the symptoms of acute infectious diarrhoea?
Symptoms can range from a mild stomach upset for a day or two with slight diarrhoea, to severe watery diarrhoea for several days or longer. Crampy pains in the abdomen (tummy) are common. Pains may ease each time some diarrhoea is passed. Vomiting, high temperature (fever), and headache may also develop.
Can diarrhoea be prevented?
Good hygiene helps to prevent infectious diarrhoea. Always wash your hands, and teach children to wash theirs:
After going to the toilet (and after changing nappies).
Before touching food.
After gardening.
After playing with pets (healthy animals can carry certain harmful bacteria).
Between handling raw meat and food ready to be eaten. (There may be some bacteria on raw meat.)
If a child has infectious diarrhoea, the following are also recommended until symptoms go.
• Regularly clean the toilets they use. Also, wipe the flush handle and toilet seat with disinfectant (such as household bleach) after each time they use the toilet.
• Make sure they wash their hands after going to the toilet. Don't share towels and flannels.
• Do not let them help to prepare food for others.
• They should stay off school, nursery, etc, until symptoms have gone.
What is the treatment for acute infective diarrhoea in children?
Acute diarrhoea usually clears within a week or so (often sooner) as the immune system usually clears the infection. The following are commonly advised until symptoms ease.
• Give the child lots to drink. The aim is to avoid dehydration (low body fluid). Even if the child vomits or feels sick, you should still give frequent sips as some fluid will still be absorbed. Ideally, give water as the main drink, but also give some fruit juice as this contains some sugar. However, any drink is better than none. If the child will only drink their favourite drink then that is fine. (Ice lollies are a useful extra source of fluid.)
• Rehydration drinks may be advised by a doctor or nurse if they are concerned that the child is at risk of
dehydration. You can give these instead of, or in addition to, normal drinks. Rehydration drinks are made from sachets which you can buy from pharmacies. You add the contents of the sachet to water. Rehydration drinks provide a perfect balance of water, salt, and sugar. They are better than just drinking water alone. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea, but are the best drinks to prevent or treat dehydration. (Do not use home made salt drinks as the quantity of salt has to be exact.)
• The child should eat as normally as possible. Do not 'starve' a child with diarrhoea. This used to be
advised but is now known to be wrong. However, if he or she does not want to eat, then that is fine. Drinks are the most important and food can wait until their appetite returns. Offer some food every now and then. Soups and food high in carbohydrate such as bread, pasta, rice and potatoes are best to start with.
• Breast fed babies should continue to breast feed if they will take it. This is in addition to extra rehydration drinks which may be advised. Bottle fed babies should be fed with their normal full strength feeds if they will take it. Again, this is in addition to extra rehydration drinks which may be advised.
• You should not give medicines to stop diarrhoea to young children. They sound attractive remedies, but are unsafe to give to children due to possible complications.
• Give paracetamol or ibuprofen to ease a high temperature or headache.
In most cases the diarrhoea settles with the above measures. However, some gut infections may not clear without other treatment. For example, some infections caused by parasites or by certain bacteria may need an antibiotic or other treatment.
So, if symptoms are severe or persist, a doctor may ask for a stool sample. This is sent to the lab to look for infecting bacteria, parasites, etc.
Are there any complications from acute diarrhoea?
Complications are uncommon. See a doctor if any of the following develop, or if any other symptoms occur that you are concerned about.
Dehydration. Symptoms include: passing little urine, a dry mouth and tongue, drowsiness.
Blood in the diarrhoea.
Vomiting for more than 1 day, or diarrhoea which does not start to settle after 3-4 days.
Pains which are getting worse.
Drowsiness or confusion.
Infections caught abroad.
