Diarrhea: General Overview

Excerpt from Natural Baby and Childcare

Anyone who has had diarrhea can attest that it is not a pleasant experience. The term refers to either increased frequency of stool and /or loose, watery stools. Infants and young children can lose a lot of fluid rapidly with diarrhea and need to be monitored to avoid dehydration.  Otherwise, most cases of acute diarrhea usually resolve on their own within several days.

Diarrhea is not an illness; it is a symptom resulting from various conditions, such as infections (virus, bacteria or parasite), food poisoning, and nervous stomach, and from medications such as antibiotics.  Dysentery has been commonly applied to severe diarrhea illnesses (often with bloody diarrhea). In addition, it is not unusual for children to have loose stools while teething.  

Rotavirus

Nausea, vomiting, cramps, bloating, and diarrhea with urgency are common symptoms in acute diarrhea. If your child begins with upset stomach, vomiting, and fever followed by watery diarrhea, it probably is caused by a virus— in the United States, often the rotavirus. Rotavirus affects children from three months to two years old. It is the most common cause of bouts of diarrhea, especially in daycare centers. A child who has had rotavirus once may have repeat infections, although subsequent bouts tend to be less severe than the original. It is more common in the winter. Also known as acute viral gastroenteritis, there is no specific conventional treatment for it other than supportive therapy such as fluids and rest. 

In developing countries, thousands of children die each year from rotavirus. In the United States, according to the CDC (Center for Disease Control), “for persons with healthy immune systems, rotavirus gastroenteritis is a self-limited illness, lasting for only a few days.”  Still, the U.S. Food and Drug Administration approved a live virus vaccine (Rotashield) using a genetic human-monkey strain of rotavirus to be given to children beginning in 1998. Due to severe side effects following the vaccine, including vomiting, diarrhea, and bowel obstruction known as intussusception, the vaccine has been suspended.. According to the National Vaccine Information Center, “There were reports that in order to be able to finance delivery of Rotashield to Third World populations, where the infection is a serious health threat, the richer countries like the U.S. would have to use it.”

Shigella, Salmonella, and other Bacteria

Bacteria can also cause diarrhea, and these include Shigella, E.coli, Salmonella, Campylobacter, Yersinia entercolitica, Vibrio cholera and Clostridium difficile.  The latter is found in children who have diarrhea after taking antibiotics. Bacterial infections include symptoms such as bloody diarrhea with mucus, fever, and stomach cramps.  Some bacterial infections are treated with antibiotics (Shigella), while Salmonella has become resistant to antibiotics and may actually prolong its contagious period if treated with unnecessary medication.

Parasites

Parasites also account for diarrhea illnesses and include Entamoeba histolytica (traveller’s diarrhea), Giardia lamblia (contaminated water), and Cryptosporidium (from pets and day care).  Parasitic infections cause illnesses with large amounts of loss of appetite, cramps and watery diarrhea.  Entamoeba (amebic dysentery) can present with bloody diarrhea. Diagnosis is confirmed by a positive ova and parasite (O&P) stool test.  Conventional treatment for parasites is with antiparasitic medications such as metronidazole. 

Food Poisoning

Diarrhea can also occur from food poisoning in which the food becomes contaminated with a virus, bacterium, parasite, or pesticides. Within hours of eating the contaminated food, symptoms of nausea, vomiting, cramps, fever, and diarrhea begin.  Within a few days, most symptoms clear.

When to seek medical attention:

• Diarrhea that is not resolving
• Signs of dehydration, which can be caused by frequent vomiting, copious diarrhea, or both:  increased thirst, dry mouth, weight loss, dry tears, infrequent urination, listlessness, lethargy, and sunken eyes (sunken fontanelle in babies)
• Babies less than six months old
• Severe abdominal pain
• Bloody stool
• Lack of thirst (loss of appetite for food is not uncommon, though)