Chronic Diarrhea In Children

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Chronic Diarrhea In Children
Chronic Diarrhea In Children
Video: Chronic Diarrhea In Children
Video: Chronic Diarrhea in Children for USMLE 2023, February

Chronic diarrhea

One speaks of chronic diarrhea if it lasts more than 14 days. In children, it can hide both relatively harmless causes and serious illnesses. Clarification by the pediatrician is therefore essential.

The symptomatic treatment of diarrhea primarily involves compensating for the loss of fluid and electrolyte. In addition, therapy for chronic diarrhea depends on the underlying cause.


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  • What are the causes of chronic diarrhea in children?
  • How is the diagnosis made?
  • How is chronic diarrhea treated in children?
  • Whom can I ask?
  • How are the costs going to be covered?

What are the causes of chronic diarrhea in children?

Diarrhea that persists for more than 14 days is called chronic diarrhea regardless of the cause. Possible causes are:


An infection with viruses or bacteria (infectious gastroenteritis) leads primarily to acute diarrhea, which gets better after a few days. However, chronic courses are also possible, for example in the event of an infection with rotaviruses or some bacterial pathogens and parasites. In these cases, one speaks of persistent diarrhea. The very young age of the child, malnutrition, insufficient breastfeeding and the inadequate use of antibiotics are risk factors for a chronic course.

Irritable bowel syndrome (nervous bowel, irritable bowel syndrome, irritable colon)

Irritable bowel syndrome is one of the most common digestive problems. The exact causes are not known. Abdominal pain, bloating and flatulence, as well as alternating constipation and diarrhea occur frequently. A change in the texture of the chair is often associated with cramp-like pain. The symptoms improve after a bowel movement. In irritable bowel syndrome, diarrhea typically occurs in the morning shortly after getting up.

Celiac disease

Celiac disease is a so-called resorption disorder in the intestine due to an intolerance to various grain proteins. The symptoms of celiac disease typically occur when toddlers are switched from a milk-based diet to a grain-based diet - i.e. from around the age of 5 and 7 months. The cause is hypersensitivity to the adhesive protein (gluten), which is contained in many types of grain. An immune reaction in the intestine leads to chronic inflammation and, as a result, damage to the intestinal lining, especially in the duodenum. The damaged intestine can no longer properly absorb (resorb) nutrients. The children suffer from failure to thrive, anemia, foul-smelling yellowish diarrhea and gas.For more information, see Infant Nutrition (Introduction to Complementary Food) and Gluten Intolerance.

Chronic Inflammatory Bowel Disease

In the case of inflammatory bowel disease, inflammation occurs within the intestine that is triggered by incorrect reactions of the immune system. Depending on the affected section of the intestine, one speaks of ulcerative colitis or Crohn's disease. Both diseases usually appear for the first time in young adulthood, but can also appear in early childhood. Typical symptoms are recurrent diarrhea, which is often slimy or bloody, together with abdominal pain, feeling sick, fever or stunted growth. Symptoms can also occur outside the intestines, for example in the joints, skin or eyes. More on the topic: Inflammatory bowel disease

Food allergies

The most common triggers of a food allergy in childhood are cow's milk protein, chicken eggs and soy, while older children also have allergies to wheat, nuts, fish or shellfish. The possible symptoms are varied, it can lead to diarrhea, abdominal pain or vomiting, but also rashes, itching, swelling of the lips and mucous membranes, sneezing, runny nose and coughing. Only when these reactions are triggered by the body's own immune system is there a “real” allergy. It is rather rare in babies and toddlers; the symptoms are only triggered by repeated contact with the respective food. More on the topic: food allergy

Food intolerance

In contrast to a food allergy, certain foods are not tolerated in the case of food intolerance without an underlying immune reaction. The cause is, for example, a faulty metabolism. The symptoms are similar to those of an allergy; diarrhea, abdominal pain and vomiting, and skin reactions can occur. These can become noticeable even after a single contact. More on the topic: Food intolerance

Toddler's Diarrhea

"Toddler's diarrhea" usually occurs in late infancy to toddler age (6–36 months) and is a special form of chronic diarrhea. Typically, three or more diarrhea stools occur exclusively during the day with normal growth and the absence of other symptoms. The chairs normalize on their own by the beginning of school age at the latest.

Other causes

Examples of other illnesses that can be associated with repeated or chronic diarrhea:

  • Diseases of the pancreas or gallbladder,
  • Diabetes mellitus,
  • Lipid metabolism disorders,
  • Hyperthyroidism,
  • Immunodeficiency,
  • Autoimmune diseases,
  • Hirschsprung's disease (congenital malformation of the rectum),
  • Cystic fibrosis (cystic fibrosis; hereditary metabolic disorder),
  • Etc.

How is the diagnosis made?

In the case of persistent diarrhea, an exact clarification of possible causes by the pediatrician is necessary. In addition to a detailed discussion with the parents, a detailed examination of the child is necessary. If necessary, further examinations (e.g. blood tests, allergy tests, imaging procedures, etc.) are carried out.

How is chronic diarrhea treated in children?

Symptomatic treatment of diarrhea primarily involves balancing out the loss of fluid and electrolytes. For example, special drinking solutions are used. Further treatment will depend on whether you have dehydration and how severe it is.

In addition, therapy for chronic diarrhea depends on the underlying cause.

Whom can I ask?

The doctor for paediatrics is responsible for diagnosing and treating chronic diarrhea in infancy and childhood.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Health Professions AZ

as well as the online guide to reimbursement of social insurance costs.

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