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Diarrhea, Pediatric

Diarrhea, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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  • One of the most common pediatric complaints; 2nd only to respiratory infections in overall disease frequency for ED visits
  • Leading cause of illness and death in children worldwide
  • Acute infectious enteritis (AIE):
    • Vomiting and diarrhea
    • Children <5 yr in US typically have 2 episodes annually.
    • Responsible for ∼10% of all pediatric ED visits and hospital admissions
  • Acute change in the “normal” bowel pattern that leads to increased number or volume of stools and lasts <7 days; World Health Organization (WHO) defines case as 3 or more loose or watery stools per day.
    • Chronic if the diarrhea persists for >2 wk


  • Acute enteritis:
    • Infectious:
      • Viruses: 70–80% of cases:
        • Rotavirus most common
        • Enteric adenovirus
        • Norovirus (foodborne outbreaks)
      • Bacteria: 10–20%:
        • Escherichia coli, Yersinia, Clostridium difficile
        • Salmonella, Shigella, Campylobacter
        • Vibrio
        • Aeromonas
      • Parasites 5%:
        • Cryptosporidiosis (waterborne)
        • Giardia lamblia
    • Noninfectious:
      • Postinfectious
      • Food allergies and intolerance:
        • Cow's milk protein
        • Soy protein
        • Methyl xanthines
        • Lactose intolerance
      • Chemotherapy/radiation induced
      • Drug induced:
        • Antibiotics, laxatives, antacids
      • Ingestion of heavy metals—copper, zinc
      • Ingestion of plants—hyacinth, daffodils, amanita species
      • Vitamin deficiency: Niacin, folate
      • Vitamin toxicity: Vitamin C
    • Associated with other infections
      • Otitis media, UTI, pneumonia, meningitis, appendicitis.
  • Chronic diarrhea:
    • Dietary factors: Excessive consumption of sorbitol or fructose from fruit juices
    • Enteric infections in immunocompromised
    • Malnutrition
    • Endocrine: Thyrotoxicosis, pheochromocytoma
    • Inflammatory bowel diseases: Crohn's disease, ulcerative colitis
    • Malabsorption syndromes (cystic fibrosis, celiac disease)
    • Irritable bowel syndrome

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Rosen, Peter, et al., editors. "Diarrhea, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307443/all/Diarrhea__Pediatric.
Diarrhea, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307443/all/Diarrhea__Pediatric. Accessed April 24, 2019.
Diarrhea, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307443/all/Diarrhea__Pediatric
Diarrhea, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307443/all/Diarrhea__Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Diarrhea, Pediatric ID - 307443 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307443/all/Diarrhea__Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -