children s health issues
Diarrhea in Children
Evaluation of Diarrhea in Children
Certain symptoms are cause for concern. They include Signs of dehydration, such as decreased urination, lethargy or listlessness, crying without tears, extreme thirst, and a dry mouth Ill appearance High fever Blood in stool Pain in the abdomen and, when touched, extreme tenderness Bleeding in the skin (seen as tiny reddish purple dots [petechiae] or splotches [purpura]) Children with any warning signs should be evaluated by a doctor right away, as should those who have had more than 3 or 4 episodes of diarrhea and are not drinking or are drinking very little. If children have no warning signs and are drinking and urinating normally, the doctor should be called if diarrhea lasts 2 days or more or if there are more than 6 to 8 episodes of diarrhea a day. If diarrhea is mild, a doctor’s visit is unnecessary. Children with diarrhea for 14 days or more should be seen by a doctor. Doctors first ask questions about symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause and the tests that may need to be done ( see Table: Some Causes and Features of Diarrhea ). Doctors ask what the BMs look like, how frequent they are, how long they last, and whether the child has other symptoms, such as fever, vomiting, or abdominal pain. Doctors also ask about potential causes, such as diet, use of antibiotics, consumption of possibly contaminated food, recent contact with animals, and recent travel. A physical examination is done, looking for symptoms of dehydration and disorders that can cause diarrhea. The abdomen is checked for swelling and tenderness. Doctors also evaluate the child's Physical Growth of Infants and Children . If diarrhea lasts less than 2 weeks and warning signs are not present, the cause is probably gastroenteritis due to a virus, and testing is usually unnecessary. However, if doctors suspect another cause, tests are done to check for it. Tests are typically done when children have warning signs. If they have signs of dehydration, blood tests are done to measure levels of electrolytes (sodium, potassium, calcium, and other minerals necessary to maintain the fluid balance in the body). If other warning signs are present, tests may include a complete blood cell count, urine tests, examination and analysis of stool, abdominal x-rays, or a combination. 