What Are the Most Common Causes of Chronic Diarrhea in Children?

This entry was reviewed by: Huo Kaiming (Chief Physician), Department of Pediatrics, Hainan Agricultural General Hospital

Basic Information

Visiting department

Pediatrics

Multiple groups

Children

Common causes

Infections, nutrient allergies, enzyme defects, immunodeficiency, drug factors, congenital malformations, etc.

Common symptoms

Increased stool frequency, 3 times a day, changes in stool characteristics, such as watery stool, mucus or pus and blood

The cause is complex,

1.

Fecal examination

High-power microscope (400 times) white blood cells> 15, a small amount of red blood cells can be clinically diagnosed bacillary dysentery; white blood cells 15 to diagnose enteritis. Microscopic examination can also see worm eggs, smears can find amoeba trophozoites, Vibrio cholerae.

2. Duodenal fluid examination

Analyze pH, trypsin, chymotrypsin, enterokinase, and serum trypsinogen to determine protein digestion and absorption capacity, determine lipase and bile salt concentrations in duodenal juice to understand fat digestion and absorption, and perform bacterial culture And parasite eggs

3. Serum immunological examination

Various antigen-antibody immunological tests are helpful for the etiological diagnosis of various infectious diarrhea, such as the confirmation of Feida response to typhoid and paratyphoid.

4. Imaging examination

(1) X-ray examination Under X-ray, dynamic observation of esophagus, stomach, duodenum, small intestine, large intestine to anus, movement function, shape, ulcer, and presence or absence of lesions of the entire digestive tract Very important diagnostic value.

(2) Ultrasound examination of the abdominal B-ultrasound provides morphological diagnosis basis for gastrointestinal, hepatobiliary morphology, and space-occupying lesions.

(3) Magnetic resonance imaging (MRI) MRI is of great significance in the differential diagnosis of liver tumors, especially liver malignancies and cystic lesions. Can also be used for the diagnosis of inflammatory bowel disease and necrotizing enterocolitis, lymphoma and intestinal wall hematoma after trauma.

(4) CT examination plays an important role in the differential diagnosis of abdominal diseases in children. It is mainly used for the diagnosis and differential diagnosis of abdominal mass, abdominal abscess, trauma, liver, pancreas and other diseases.

5. Fiber gastroscopy, fiber colonoscopy and laparoscopy

Upper gastrointestinal endoscopy includes three types: fiber endoscope, electronic endoscope and passive enteroscopy. These endoscopes have clear images, can take pictures, videos, biopsies, and are easy to treat. They have been widely used in pediatric clinics. Laparoscopy can be performed under direct vision or biopsy to confirm the diagnosis.

6. Pathological examination

Histopathological examination is decisive for the diagnosis of diarrhea. The histological examination provided pathological diagnosis for the confirmed diagnosis of the disease.

7. Breath test

Because the method is simple, non-invasive, and suitable for children of all ages, it can be widely used in the clinical diagnosis of gastrointestinal diseases and has become one of the effective methods for the diagnosis of gastrointestinal diseases.

(1) Hydrogen breath test Hydrogen breath test: used to diagnose lactose malabsorption. Sucrose hydrogen breath test: used to diagnose primary sucrose-isomaltose deficiency. Hydrogen breath test for diagnosing intestinal bacterial overgrowth: It can be used to diagnose intestinal bacterial overgrowth.

(2) Carbon dioxide breathing test Detection of fat absorption : The 14C labeled glyceryl trioleate breathing test is a simple and reliable method for detecting fat absorption. Detection of carbohydrate absorption : The application of a natural 13C-lactose-containing breathing test can diagnose lactose malabsorption. diagnosis of small intestinal bacterial overgrowth: 14C-glycine acid test can be used to diagnose small intestinal bacterial overgrowth. urea breath test: used to detect Helicobacter pylori. In addition to being used for diagnosis, it can also be used for follow-up inspection after antibacterial treatment. This test can accurately reflect the negative conversion, recurrence and reinfection of Helicobacter pylori, so it can be used as an important method for determining the efficacy and screening effective drugs.

A diagnosis can be made based on medical history, clinical manifestations, and relevant examination results.

Due to persistent, chronic diarrhea

Actively identify the cause and adopt a comprehensive treatment plan, most of which can alleviate the condition and gradually recover. However, if there is a serious infection or refractory diarrhea, the mortality rate is high. Today, most diarrhea die from persistent and refractory diarrhea.

1. Reasonable feeding, advocate breastfeeding, and add supplementary food in time to prevent malnutrition.

2. Pay attention to diet hygiene to prevent infectious diseases of the digestive tract.

3. Master the principles of treatment for children with (acute) diarrhea, use medication rationally, and prevent the disease from prolonging.

4. Avoid long-term abuse of broad-spectrum antibiotics and prevent diarrhea caused by intractable intestinal flora imbalance.

5. Enhance physical fitness and improve autoimmunity. Get plenty of rest and get more exercise.