Why do children get diarrhea more often than adults? How can you treat your child's discomfort?

WebMD tells you about the causes of diarrhea and home treatments for it.

Diarrhea in Children: Common Causes and Treatments
Diarrhea is the body's way of ridding itself of germs, and most episodes last a few days to a week.
Diarrhea often occurs with fever, nausea, vomiting, cramps, and dehydration. Some of the most
common reasons kids get diarrhea include:
Infection from viruses like rotavirus, bacteria like salmonella and, rarely, parasites like giardia.
Viruses are the most common cause of a child's diarrhea. Along with loose or watery stools,
symptoms of a viral gastroenteritis infection often include vomiting, stomachache, headache, and
fever.
When treating viral gastroenteritis -- which can last 5-14 days -- it's important to prevent fluid loss.
Offer additional breast milk or an oral rehydration solution (ORS) to infants and young children.
Water alone doesn't have enough sodium, potassium, and other nutrients to safely rehydrate very
young children. Be sure to talk to your doctor about the amount of fluids your child needs, how to
make sure he or she gets them, and when to give them.
Older children with diarrhea can drink anything they like to stay hydrated, including ORS and
brand-name products (their names usually end in "lyte"). Popsicles can also be a good way to get
fluids into a child who's been vomiting and needs to rehydrate slowly.
Be sure to consult with a doctor if you have travelled outside of the country recently; your child
may need to have his or her stool tested.
Medications like laxatives or antibiotics can also lead to diarrhea in children as well as adults.
For mild diarrhea caused by medication, keep your child safely hydrated. If a course of antibiotics
is causing your child's diarrhea, be sure to continue the medication and call your doctor. Your
doctor may recommend reducing the dose, changing your diet, adding a probiotic or switching to a
different antibiotic.
Studies show that yogurt with live cultures or probiotics can help ease diarrhea caused by
antibiotics. Cultures and probiotics help replenish healthy gut bacteria killed by antibiotics.
Food poisoning can also cause diarrhea in kids. Symptoms usually come on quickly, may include
vomiting, and tend to go away within 24 hours.
Treatment for food poisoning-related diarrhea is the same as for the diarrhea caused by infection:
Keep your child hydrated and call your doctor with any questions.
Other causes of diarrhea include irritable bowel disease, Crohn's disease, food allergies, and celiac
disease. If you're not sure what's causing your child's diarrhea, give your doctor a call.
Children and Diarrhea: Recognizing Dehydration
Dehydration is one of the most worrisome complications of diarrhea in children. Mild diarrhea usually
doesn't cause significant fluid loss, but moderate or severe diarrhea can.
Severe dehydration is dangerous; it can cause seizures, brain damage, even death. Know the signs
of dehydration. Call your doctor if your child has:
Dizziness and light-headedness
Dry, sticky mouth
Dark yellow urine, or very little or no urine
Few or no tears when crying
Cool, dry skin
Lack of energy



Diarrhea in diabetes, Introduction and more:
The passage of loose and frequent stools with a sense of urgency is not uncommon with diabetics.
Little research has been done in this area.
Chronic diarrhea does occur in the general population and needs investigation when it interferes
with daily routines. Investigations into causes of diarrhea are similar to those covered above under
constipation.
Causes of diarrhea in diabetics are thought to be related to:
Celiac disease (wheat or gluten intolerance)
Small bowel bacterial overgrowth
Ano-rectal disorders
Inadequate breakdown of sugars (fructose, lactose and sorbitol) in the small intestine
Constipation can be a cause of diarrhea: more liquid stool may escape around a hard stool
impaction.
Pancreatic insufficiency
Problems of altered motility related to a malfunctioning gut nervous system as well as to excessive
gut secretions brought on by diabetes are also thought to play a role in diabetic diarrhea.
Celiac disease is a genetic inability to digest specific proteins found in grains. Poor digestion of the
protein, or gluten, often causes problems of chronic diarrhea, weight loss and fatigue. Celiac
disease is found in association with Type 1 diabetes. A simple blood test screens for celiac disease
in Type 1 diabetics who have a history of diarrhea. A small bowel tissue biopsy taken during an
endoscopic procedure of the upper gut is often used to confirm the diagnosis of celiac disease.
A word about sorbitol and naturally occurring sugars
Many people may have a hereditary difficulty in digesting some very common sugars such as lactose
(natural sugar found in milk) and fructose (natural sugar found in fruits). For those people who are
lactose- or fructose-sensitive, consumption of these sugars quickly produces symptoms of bloating,
belching, abdominal cramps and diarrhea.
Whether diabetics have more trouble than others in digesting sugars is not known for
sure, but sorbitol, a sweetener commonly found in diabetic foods, has proven to be a potent
laxative - even in amounts as small as 10 grams.
What is sorbitol?
Sorbitol is a sweetening agent frequently added to commercial diabetic and calorie-reduced food
products. It has a little over half the amount of calories compared to regular table sugar (sucrose)
and is not easily absorbed by the gut. Sorbitol is a naturally occurring sugar, but is commercially
formulated through the hydrogenation of glucose (an example of glucose is honey). It is found in
dietetic syrups, cake mixes and a wide variety of candies. Many individual packages of these
candies or flavoured drinks (sodas) contain more than 10 grams of sorbitol. This food additive -
even in small amounts - may produce profuse, watery diarrhea and abdominal pain, cramping and
bloating.
Many of the problems of digesting sugars such as fructose, lactose and sorbitol are related to the
amount that is consumed and the individual's sensitivity. Therefore, one should simply experiment
and find what level can be tolerated. Cutting back on how much you eat or drink of these items
allows you to still enjoy these foods while controlling symptoms.
Diarrhea alert: Sorbitol, a common sweetener found in calorie-reduced and commercial
diabetic foods may cause profuse, watery diarrhea.
Nocturnal diarrhea/stool incontinence
A small number of diabetics - often Type 1 diabetics - may suffer from the embarrassing and
troublesome problem of nocturnal fecal incontinence.
A normally functioning colon is quiet, or non-active, during sleep. Loss of bowel function at night
and the involuntary release of stool (incontinence) are usually related to long-standing diabetes and
generally reflect damage to a branch of the autonomic nerves that help to inhibit bowel activity
during sleep. Furthermore, a weakened anal sphincter muscle (also caused by nerve damage) adds
to the problem.
Small bowel bacterial overgrowth (SBBO)
Abnormal motility in the diabetic colon, as discussed above, frequently occurs with sluggish motility
in the mid-gut or small intestine. Slow motility places individuals at a much higher risk for small
bowel bacterial overgrowth.
Symptoms of SBBO are very similar to the symptoms mentioned for poor sugar digestion: boating,
belching, rumbling gut, and diarrhea or alternating constipation. Some studies have suggested that
nearly half of the problems of diabetic diarrhea are related to SBBO. Furthermore, untreated SBBO
will create problems of poor sugar digestion, weight loss and nutrient depletion.
It is a significant problem, but easy to treat with antibiotics. To learn more, please see our patient
educationalbooklet on SBBO.
Pancreatic insufficiency
Recall the pancreas has two functions: First, for the regulation of blood glucose levels and second,
for producing digestive enzymes which are excreted into the small bowel. In individuals with type I
diabetes, pancreatic digestive enzymes may also be deficient. Reduced pancreatic digestive
enzymes can create problems of fatty stools (steatorrhea) and diarrhea, along with symptoms very
similar to gastroparesis: nausea, fullness, bloating and abdominal pain. In fact, gastroparesis and
pancreatic dysfunction may occur together. Supplementing at each meal with pancreatic enzymes
may help relieve symptoms of diarrhea.



Megaloblastic (Pernicious) Anemia in
Children
What is megaloblastic anemia?
Megaloblastic anemia is a type of anemia characterized by very large red blood cells. In
addition to the cells being large, the inner contents of each cell are not completely developed.
This malformation causes the bone marrow to produce fewer cells, and sometimes the cells
die earlier than the 120-day life expectancy. Instead of being round or disk-shaped, the red
blood cells can be oval.
What causes megaloblastic anemia?
There are many causes of megaloblastic anemia, but the most common source in children
occurs from a vitamin deficiency of folic acid or vitamin B
12
. Other sources of megaloblastic
anemia include the following:
Digestive diseases. Certain diseases of the lower digestive tract can lead to megaloblastic
anemia. These include celiac disease, chronic infectious enteritis, and enteroenteric fistulas.
Pernicious anemia is a type of megaloblastic anemia caused by an inability to absorb vitamin
B
12
due to a lack of intrinsic factor in gastric (stomach) secretions. Intrinsic factor enables the
absorption of vitamin B
12
.
Malabsorption. Inherited congenital folate malabsorption, a genetic problem in which
infants cannot absorb folic acid in their intestines, can lead to megaloblastic anemia. This
requires early intensive treatment to prevent long-term problems, such as intellectual
disability.
Medication-induced folic acid deficiency. Certain medications, specifically ones that
prevent seizures, such as phenytoin, primidone, and phenobarbital, can impair the absorption
of folic acid. The deficiency can usually be treated with a dietary supplement.
Folic acid deficiency. Folic acid is a B vitamin required for the production of normal red
blood cells. Folate, the naturally occurring form, is present in foods, such as green vegetables,
liver, and yeast. Folic acid is produced synthetically and added to many food items, including
breads and cereals.
What are the symptoms of megaloblastic anemia?
The following are the most common symptoms of megaloblastic anemia. However, each
child may experience symptoms differently. Symptoms may include:
Abnormal paleness or lack of color of the skin
Decreased appetite
Irritability
Lack of energy or tiring easily (fatigue)
Diarrhea
Difficulty walking
Numbness or tingling in hands and feet
Smooth and tender tongue
Weak muscles
The symptoms of megaloblastic anemia may resemble other blood conditions or medical
problems. Always consult your child's doctor for a diagnosis.
How is megaloblastic anemia diagnosed?
Megaloblastic anemia may be suspected from general findings from a complete medical
history and physical examination of your child. In addition, several blood tests can be
performed to confirm the diagnosis. If the megaloblastic anemia is thought to be caused by a
problem in the digestive tract, a barium study of the digestive system may be performed, and
occasionally an endoscopy may need to be performed.
Treatment for megaloblastic anemia
Specific treatment for megaloblastic anemia will be determined by your child's doctor based
on:
Your child's age, overall health, and medical history
Extent of the anemia
Cause of anemia
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the anemia
Your opinion or preference
Treatment for megaloblastic anemia due to a folic acid deficiency usually involves your child
taking an oral dietary folic acid supplement for at least two to three months. If the disorder is
caused by an absorption problem in the digestive tract, this may need to be treated first.
Vitamin B12 supplements are best absorbed when given by injection. Animal proteins are the
only food sources of vitamin B12.
Foods that are naturally rich in folate include the following:
Orange juice
Oranges
Romaine lettuce
Spinach
Liver
Rice
Barley
Sprouts
Wheat germ
Soy beans
Green, leafy vegetables
Beans
Peanuts
Broccoli
Asparagus
Peas
Lentils
Chick peas (garbanzo beans)
Foods that are fortified with folic acid include the following:
Breakfast cereals
Breads
Enriched pasta
Enriched rice
Foods that are rich in vitamin B
12
include the following:
Meat
Poultry
Milk
Shellfish and some fish
Eggs
Cheese