Diarrhea in Children

What is diarrhea in children?

Diarrhea is when bowel movements (stools) are loose and watery. Your child may also need to go to the bathroom more often.

Diarrhea is a common problem. It may last 1 or 2 days and go away on its own. If diarrhea lasts more than 2 days, your child may have a more serious problem.

Diarrhea may be either:

• Short-term (acute). Diarrhea that lasts 1 or 2 days and goes away. This may be caused by food or water that was contaminated by bacteria (bacterial infection). Or it may happen if your child gets sick from a virus.

• Long-term (chronic). Diarrhea that lasts for a few weeks. This may be caused by another health problem, such as irritable bowel syndrome. It can also be caused by an intestinal disease, such as ulcerative colitis, Crohn’s disease, or celiac disease. Giardia may also cause chronic diarrhea.

What causes diarrhea in a child?

Diarrhea may be caused by many things, including:

• Bacterial infection

• Viral infection

• Trouble digesting certain things (food intolerance)

• An immune system response to certain foods (food allergy)

• Parasites that enter the body through food or water

• Reaction to medicines

• An intestinal disease, such as inflammatory bowel disease

• A problem with how the stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome

• Surgery on the stomach or gallbladder

Children who visit some foreign countries are at risk for traveler's diarrhea. This is caused by having food or water that isn't safe because of bacteria, viruses, or parasites.

Severe diarrhea may mean a child has a serious disease. Talk with your child's healthcare provider if symptoms don’t go away. Also talk with the provider if symptoms stop your child from doing daily activities. It may be hard to find out what is causing your child’s diarrhea. 

What are the symptoms of diarrhea in a child?

Symptoms can occur a bit differently in each child. They can include:

• Cramping

• Belly (abdominal) pain

• Swelling (bloating)

• Upset stomach (nausea)

• Urgent need to use the bathroom

• Fever

• Bloody stools

• Loss of body fluids (dehydration)

• Incontinence

The symptoms of diarrhea may look like other health problems. Severe, persistent, or bloody diarrhea may be a sign of a serious disease. Make sure your child sees their healthcare provider for a diagnosis.

How is diarrhea diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. Your child may have lab tests to check blood and urine.

Other tests may include:

• A stool culture. This checks for abnormal bacteria or parasites in your child’s digestive tract. A small stool sample is taken and sent to a lab to be looked at. Sometimes a quick rectal swab, done in the office, can also check for infection.

• A stool evaluation. This checks the stool for blood or fat.

• Blood tests. These are done to rule out certain diseases.

• Imaging tests. These can rule out structural problems.

• Other tests. Tests may be done to check for food intolerance or allergies.

• A sigmoidoscopy or colonoscopy. These are done to check the inside of part or all of your child’s large intestine.

How is diarrhea treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on the cause and how severe the condition is.

Dehydration is the major concern with diarrhea. In most cases, treatment includes replacing lost fluids. Antibiotics may be prescribed when bacterial infections are the cause.

Children should drink lots of fluids. This helps replace the lost body fluids. If your child is dehydrated:

• Offer drinks called glucose-electrolyte solutions. These fluids have the right balance of water, sugar, and salts. Some are available as ice pops.

• Stay away from commercial sports drinks. These don't have the right balance for a child with severe diarrhea and dehydration.

• Don't give juice or soda. They may make diarrhea worse.

• Don't give plain water to your baby.

• Don't give too much plain water to kids of any age. It can be dangerous.

• Keep breastfeeding your baby. Breastfed babies often have less diarrhea.

• Keep feeding your baby formula, if you were already doing so.

What are possible complications of diarrhea in a child?

The greatest complication of diarrhea is dehydration. This is more likely with young children and those with a weakened immune system. Dehydration can be mild, moderate, or severe. Mild dehydration is the loss of fluid. Moderate or severe dehydration puts stress on the heart and lungs. In the worst cases, it can lead to shock, which is life-threatening.

What can I do to help prevent diarrhea in my child?

Correct handwashing can reduce the spread of bacteria that may cause diarrhea. Alcohol-based sanitizers are also helpful.

A rotavirus vaccine can prevent diarrhea and vomiting caused by rotaviruses. Rotavirus is a viral infection of the digestive tract. It can cause dehydration. Ask your child's healthcare provider which vaccines are right for your child.

When you travel, make sure anything your child eats and drinks is safe. This is even more important if you travel to developing countries.

Travel safety tips for drinking and eating include:

• Not drinking tap water or using it to brush teeth

• Not using ice made from tap water

• Not drinking unpasteurized milk (milk that hasn't gone through a process to kill certain bacteria)

• Not eating raw fruits and vegetables unless you wash and peel them yourself

• Not eating raw or undercooked meat or fish

• Not eating food from street vendors or food trucks

Talk with your child's healthcare provider before traveling.

When should I call my child's healthcare provider?

Call your child's healthcare provider if your child is a baby younger than 6 months old or has any of these symptoms:

• Belly pain

• Blood in the stool

• Frequent vomiting

• Doesn’t want to drink liquids

• High fever

• Dry, sticky mouth

• Weight loss

• Urinates less frequently (wets fewer than 6 diapers per day)

• Frequent diarrhea

• Extreme thirst

• No tears when crying

• Sunken soft spot (fontanelle) on baby’s head

Key points about diarrhea in children

• Diarrhea is loose, watery bowel movements (stool). Your child may also have to go to the bathroom more often.

• It may be caused by many things, including bacterial infection or viral infection.

• Dehydration is the major concern with diarrhea. In most cases, treatment involves replacing lost fluids.

• Correct handwashing can help prevent diarrhea. The rotavirus vaccine can prevent diarrhea caused by that virus.

• When you travel, make sure anything your child eats and drinks is safe.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.