pediatrics
Diarrhea in Children
Treatment of Diarrhea in Children
Specific causes of diarrhea are treated (eg, gluten-free diet for children with celiac disease). General treatment focuses on hydration, which can usually be done orally. IV hydration is rarely essential. (CAUTION: Treatment [eg, Solutions (ORS) should contain complex carbohydrate or 2% glucose and 50 to 90 mEq/L (50 to 90 mmol/L) sodium. Sports drinks, sodas, juices, and similar drinks do not meet these criteria and should not be used. They generally have too little sodium and too much carbohydrate to take advantage of sodium/glucose cotransport, and the osmotic effect of the excess carbohydrate may result in additional fluid loss. ORS is recommended by the World Health Organization and is widely available in the US without a prescription. Premixed solutions are also available at most pharmacies and supermarkets. If the child is also vomiting, small, frequent amounts are used, starting with 5 mL every 5 minutes and increasing gradually as tolerated ( see Oral Rehydration ). If the child is not vomiting, the initial amount is not restricted. In either case, generally 50 mL/kg is given over 4 hours for mild dehydration, and 100 mL/kg is given over 4 hours for moderate dehydration. For each diarrheal stool, an additional 10 mL/kg (up to 240 mL) is given. After 4 hours, the patient is reassessed. If signs of dehydration persist, the same volume is repeated. 