I was supposed to post an entry about my son’s previous sickness due to
hot weather as we have thought. But for some reason I do not have the time to
post it.
My son experienced runny watery stool a week ago. Even if he is still
super makulit and active, worries do not leave me. This is
especially when he was having 3-5 watery stools a day and because of this he
had developed nappy diaper rashes. I was really not at ease and keep on
searching on what is causing it. I noticed he have some teeth erupting.
Although he is experiencing loose stool every time he had teeth it was not this
watery.
Then I remember when he was 6 months he also had this problem plus
vomiting. It happened when we brought him in the province and we travelled
during really hot weather. His pediatician prescribed Erceflora, which contains
2 billions of probiotic microorganisms. So we bought it and mixed with his
milk. After a day his runny stool frequency was reduced and after 2 days it is
completely gone. I was relieved, and so I believe this hot weather was really
the cause.
Unfortunately, it came back after 6 days. He had watery stools but it
isn’t as frequent as before. So as always a worried mom, I am thinking of so
many things like infections, lactose intolerance etc. Then I came across this
site about Toddler's Diarrhea. These are some of the
important details:
Case
The parents of a 14 month old boy bring their son to your office with a
2 month history of 2-6 loose, non-foul smelling watery stools per day. At times
there is undigested food in the bowel movement. The parents have gone through
multiple diet changes and now the boy is only eating a low fat, no dairy
products, lots of fruit juices, and minimal protein diet. He has had an
extensive workup including negative stool cultures for bacteria and viruses,
negative stool for ova and parasites, and no neutrophiles or blood in the
stool. How would you approach this problem?
Toddler diarrhea is a common pediatric condition. In infants it is
referred to as chronic diarrhea of infancy and in older children as irritable
bowel syndrome. Common clinical characteristics include:
- Age
between 6-30 months. Most are better by 4 years of age
- 2-6
watery stools per day. There can be periods of days without stools. Many
stools contain undigested material and may drip down the child's leg from
the diaper.
- Normal
weight, height, and head circumference growth curves without falling off
- No
evidence of infection
- Stools
are hematest negative
- The
child looks well and there is no evidence of malnutrition and no history
of abdominal pain
- Growth
may be compromised if the diet manipulations that have been tried to
control the diarrhea have not been enough calories.
- There
is often a history of colic, gastroesophogeal reflux, and family history
of irritable bowel syndrome.
I was partially relieved when I read this. My son had 2-3 watery stool
yesterday, he still active and eats well. I just noticed he is drinking a lot
of fluids because of the humid hot weather now. I cannot give him antidiarrheal
medicine because that might worsen his condition. So I browse further for the
treatment and the following are recommended:
- Increase
fat in the diet
- Decrease
fluid in the diet
- Avoid
fructose and sorbitol- decrease fruit juices
- Increase
dietary fiber
- Normal
diet for age
- Reassurance-
this is difficult because parents have been to many physicians and are
convinced that their child has a serious illness. It is important after
making your recommendations to follow-up soon to reassure again and watch
weight and height gains.
- There
is no role for medications.
- The
parents should be told that there is no serious sequelea and this is not a
precursor to inflammatory bowel disease, chronic diarrhea as adults, or
cancer
- Most
children are better by 4 years of age, and are better by the time they
become potty trained.
- The
APA has recently (Dec 2010) investigated the use of probiotics and
prebiotics in the treatment of gastrointestinal ailments in children. They
preliminary, good data shows that taking probiotics can limit the duration
of infectious diarrhea in children by up to 40 hours, and reduce the
occurrences of diarrhea in children exposed to enteric viral infection
(rota) and started on antibiotics. In healthy children, the use of
probiotics and prebiotics have been found to be completely safe thus
making their use worth a try.
Others recommend the BRAT diet (Banana, Rice, Applesauce, unbuttered
Toast). For the increase in fat, we can give him whole-fat dairy, avocados,
nuts and a little olive oil in his food. To add dietary fiber, we can also give
him fresh fruit, and vegetables, whole grain breads and cereals and beans.
Juice drinks as well as energy drinks (like Gatorade) must be avoided because
of its high sugar content; instead we can give him clear drinks like water,
electrolytes (like Pedialyte) and white grape juice.
There are tons of information in the web but we must not always rely on
it and always look for the true symptoms in our children. Self medication is
not highly recommended as well.
While this diagnosis can help us, we must observe our kids too for
symptoms like any blood or pus in the stool, foul odour and greasy/oily stool,
any weight loss and unhealthy appearance. In such case, we must ask for further
investigation.
