- Diarrhea is the sudden increase in the number and looseness of stools
- Diarrhea means 2 or more watery or very loose stools. Reason: 1 loose stool can be normal with changes in diet.
Causes of Acute Diarrhea
- Virus (such as Rotavirus). An infection of the intestines from a virus is the most common cause.
- Bacteria (such as Salmonella). Less common cause. Diarrhea often contains streaks of blood.
- Food Poisoning. This causes rapid vomiting and diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
- Giardia (a parasite). More likely in child care center outbreaks.
- Traveler's Diarrhea. Caused by germs in food or drink. Suspect this if it follows recent foreign travel.
- Serious Causes. Most bacterial diarrhea goes away on its own. A few can cause a severe large bowel infection (such as Shigella colitis). C. difficile is a serious cause that can occur after being on strong antibiotics.
- Serious Complication: Dehydration. This is the health problem where the body has lost too much fluid. (See below for more on this).
Causes of Recurrent Diarrhea
- Cow's Milk Allergy. Can cause loose, slimy stools in babies. Can be blood-streaked. Starts within the first 2 months of life. Need to avoid cow's milk formulas.
- Toddler's Diarrhea. Toddlers who pass 3 to 6 sloppy stools per day. Stools may run out of the diaper. Symptoms begin at age 1. Symptoms resolve at age 3 or 4, after toilet trained. Harmless and no impact on growth. Fruit juice makes it worse. The cause is rapid transit time from stomach to anus. May develop irritable bowel syndrome (IBS) in adult years.
- Lactose Intolerance. Lactose is the sugar in milk. Many people cannot absorb lactose. The gut bacteria convert the lactose to gas. The main symptoms are a lot of gas, loose stools and stomach bloating. Onset usually at age 4 or 5. This most often runs in the family (genetic).
- Mild: 2-5 watery stools per day
- Moderate: 6-9 watery stools per day
- Severe: 10 or more watery stools per day
- The main risk of diarrhea is dehydration.
- Loose or runny stools do not cause dehydration.
- Frequent, watery stools can cause dehydration.
Dehydration: How to Know
- Dehydration means that the body has lost too much fluid. This can happen with vomiting and/or diarrhea. A weight loss of more than 3% is needed. Mild diarrhea or mild vomiting does not cause this. Neither does a small decrease in fluid intake.
- Dehydration is the most important complication of diarrhea. Dehydration is a reason to see your doctor right away.
- These are signs of dehydration:
- Decreased urine (no urine in more than 8 hours) happens early in dehydration. So does a dark yellow color. If the urine is light straw colored, your child is not dehydrated.
- Dry tongue and inside of the mouth. Dry lips are not helpful.
- Dry eyes with decreased or absent tears
- In babies, a depressed or sunken soft spot
- Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
- Fussy, tired out or acting ill. If your child is alert, happy and playful, he or she is not dehydrated.
- A child with severe dehydration becomes too weak to stand. They can also be very dizzy when trying to stand.
Diarrhea in Breastfed Babies: How to Tell
- Diarrhea in a breastfed baby is sometimes hard to tell.
- Normal breastfed stools are loose (often runny and seedy). Stools are yellow, but sometimes can be green. The green color is from bile. Runny stools can even be bordered by a water ring. These are all normal stools.
- Breastfed babies often pass more than 6 stools per day. Until 2 months of age, they may pass a stool after each feeding. But, if stools suddenly increase in number and looseness, suspect diarrhea. If it lasts for 3 or more stools, the baby has diarrhea.
- If the stools contain mucus, blood or smell bad, this points to diarrhea.
- Other clues to diarrhea are poor eating, acting sick, or a fever.
Diarrhea in Formula-Fed Infants: How to Tell
- Formula-fed babies pass 1 to 8 stools per day during the first week. Then it starts to slow down to 1 to 4 per day. This lasts until 2 months of age.
- The stools are yellow in color and thick like peanut butter.
- Suspect diarrhea if the stools suddenly increase in number or looseness. If it lasts for 3 or more stools, the baby has diarrhea.
- If the stools contain mucus, blood, or smells bad, this points to diarrhea.
- Other clues to diarrhea are poor eating, acting sick or a fever.
- After 2 months of age, most babies pass 1 or 2 stools per day. They can also pass 1 every other day. They no longer appear to have mild diarrhea.