Pediatrics: Diarrhea in Children

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Questions and Answers

What is a characteristic of the stool in Viral diarrhea?

Foul-smelling

Bloody

Offensive

Non foul-smelling (correct)

What is the typical duration of symptoms in Viral diarrhea?

10-14 days

2-4 days

3-8 days (correct)

1-2 days

What is the assessment of dehydration based on?

Mental status and eye examination

Mental status, eye examination, and skin pinch

Tears, mouth and tongue, and thirst

All of the above (correct)

What is the characteristic of Enterohemorrhagic E coli diarrhea?

Watery, offensive, and bloody Signup and view all the answers

What is the treatment plan for severe dehydration?

Plan C Signup and view all the answers

What is the percentage of Giardia and Cryptosporidium in parasitic diarrhea?

10% Signup and view all the answers

What is the key sign in assessing dehydration?

Restless, irritable, or lethargy Signup and view all the answers

What is the primary mechanism of secretory diarrhea?

Intestinal cells actively secreting due to secretagogue Signup and view all the answers

What is the characteristic of Campylobacter diarrhea?

Watery, offensive, and bloody Signup and view all the answers

Which type of diarrhea is commonly associated with blood and mucus in the stool?

Invasive diarrhea Signup and view all the answers

What is a common complication of osmotic diarrhea?

Hypernatremia Signup and view all the answers

What is the primary cause of decreased gut motility in diarrhea?

Decreased gut motility due to bacterial overgrowth Signup and view all the answers

What is the primary mechanism of motility disorders in diarrhea?

Increased gut motility leading to decreased transit time Signup and view all the answers

What is the definition of diarrhea according to the WHO?

Loss of 10ml ⁄ kg ⁄ day of fluid through stool Signup and view all the answers

Which type of diarrhea is commonly associated with lactose intolerance?

Non-infective diarrhea Signup and view all the answers

What is a common complication of invasive diarrhea?

Septicemia Signup and view all the answers

What is the duration of acute diarrhea?

Less than 14 days Signup and view all the answers

What is a common feature of diarrhea in short gut syndrome?

Decreased solute absorption Signup and view all the answers

What is the age incidence of diarrhea?

Between 3 months to 5 years Signup and view all the answers

What is a risk factor for diarrhea?

All of the above Signup and view all the answers

What is the percentage of deaths below 5 years of age due to diarrhea?

25-30% Signup and view all the answers

What is the type of diarrhea that lasts for more than 28 days?

Chronic diarrhea Signup and view all the answers

What is not a characteristic of dysentery diarrhea?

Excessive mucous in stools Signup and view all the answers

What is a behavioral factor that contributes to diarrhea?

Using contaminated feeding formula or water Signup and view all the answers

Study Notes

Definition of Diarrhea

Diarrhea is the loss of more than 10ml/kg/day of fluid through stool.
In breastfed babies, it's an increase in consistency, volume, and frequency of stool relative to their usual habits.
In bottle-fed babies, it's three or more loose stools per day.

Clinical Types of Diarrhea

Acute diarrhea: lasts for less than 14 days.
Persistent diarrhea: begins as acute and lasts for 14-28 days.
Chronic diarrhea: lasts for more than 28 days.
Dysentery diarrhea: diarrhea with visible blood in stools.

Epidemiology and Etiology

Diarrhea constitutes 25-30% of deaths in children below 5 years of age.
The age incidence is between 3 months to 5 years, with a peak at 6-12 months.
It's common in summer and autumn, but less in winter and spring.

Risk Factors for Diarrhea

Host factors:
- Age
- Inadequate breast-feeding
- Malnutrition
- Measles infection
- Vitamin A deficiency
- Milk protein allergy
- The use of oral antibiotics
- Immunosuppression
Behavioral factors:
- Using contaminated feeding formula or water
- Improper sewage disposal
- Poor sanitary conditions
- Day care centers

Pathophysiology of Diarrhea

Secretory diarrhea:
- Intestinal cells actively secrete due to secretagogues (e.g., cholera toxin)
- Rapid development of dehydration
- Electrolyte imbalance
Invasive diarrhea:
- Microbes invade intestinal mucosal cells
- Blood and mucus in stool
- Septicemia
- Intestinal perforation
- Toxic megacolon
- HUS
Osmotic diarrhea:
- Ingested solutes poorly absorbed
- Dehydration
- Hypernatremia
Motility disorders:
- Increased gut motility
- Decreased transit time
- Malnutrition
Decreased surface area:
- Decreased solute absorption and transit time
- Malnutrition (Short gut syndrome)

Differential Diagnosis of Diarrheal Disorders

Infective diarrhea:
- Primary GIT infection (GE)
- Secondary (parenteral diarrhea)
- Watery offensive for 2-4 days, then bloody with campylobacter
Non-infective diarrhea:
- Lactose intolerance
- Enterohemorrhagic E coli
Viral diarrhea:
- Low-grade fever
- Vomiting followed by copious watery diarrhea
- Non-foul-smelling stool
- Symptoms persisting for 3-8 days (intestinal flu)

Assessment of Dehydration

Item No dehydration Some dehydration Severe dehydration
Mental status Well, alert Restless, irritable* Lethargy, unconscious*
Eye Normal Sunken Very sunken, dry cornea
Tears Present Absent Absent
Mouth and tongue Moist Dry Very dry
Thirst (oral intake) Drinks normal Drinks eagerly* Poor or unable to drink*
Skin pinch Goes back quickly Goes back slowly* Goes back very slowly*

Treatment Plan

Plan A, Plan B, and Plan C are used to manage dehydration based on the severity of dehydration.

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Description

This quiz covers the clinical types of diarrhea, its pathophysiology, risk factors, clinical picture, management, dehydration, and rehydration therapy in pediatric patients.