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Himalaya’s Health Digest for You
• Vol LIII • No 4 • Apr–Jun 2014
Concepts and Treatments of
Chronic Diarrhea in Children
Epidemiology
According to WHO, 13.2%
of all deaths in children are
caused by diarrhea and the
worldwide prevalence of
chronic diarrhea ranges from
3% to 20%. An estimated
0.751 million children below 5
years of age die from diarrhea;
and 8 out of 10 of these deaths
occur in the first 2 years
of life. Though worldwide
incidence of diarrhea has
not decreased, mortality
due to diarrhea is decreasing
gradually. These changes are
a result of development of
vaccine (rotavirus), improved
nutritional states, and
appropriate use of medication.
Etiology
The etiologies of chronic
diarrhea are classified as
infectious and noninfectious.
The most frequent infectious
cause of chronic diarrhea is
enteric infection, both in
developing and industrialized
countries. Chronic nonspecific
diarrhea (CNSD) is the
most common cause of
noninfectious chronic diarrhea
occurring in children aged 1 to
3 years. The causes of CNSD
are increased
intestinal motility
and osmotic effects in the
gastrointestinal tract, due
to solutes that are high in
carbohydrate content.
Management of
Chronic Diarrhea
At first, the approach to a
child presenting with chronic
diarrhea should consist of a
careful examination. The type
of diarrhea (osmotic, secretory,
and fatty), the severity of the
condition, and the presence of
associated symptoms should
also be assessed. A dietary
history and the child’s growth
chart should be obtained at
the first visit.
Treatments of chronic diarrhea
are mainly composed of
nutritional rehabilitation,
Diarrhea is the second leading
cause of death in children
< 5 years of age, worldwide.
Chronic diarrhea is defined
as passing watery stools that
lasts for more than 2 weeks.
It is important to consider
children’s age and clinical
manifestations with alarm
signals for providing proper
treatments to children with
chronic diarrhea.
Concept of Chronic
Diarrhea
According to the United
Nations International
Children’s Emergency Fund
(UNICEF) and the World
Health Organization (WHO),
diarrhea is defined as the
passage of more than 3 watery
stools per day. The frequency
and consistency of stool
passage is affected by age,
diet, and medication. Chronic
diarrhea, lasting more than 2
weeks, is sure to bring about
weight loss, dehydration,
and nutritional impairment.
Accurate diagnosis and
proper treatment are very
important because chronic
diarrhea affects physical and
psychological development in
children.
