Toddler diarrhoea

Question 1

Define toddler diarrhoea.

Answer 1

Toddler diarrhoea is now known as chronic non-specific diarrhoea. It is the most common cause of persistent loose stools in preschool children.

Question 2

Explain the aetiology/risk factors for toddler diarrhoea.

Answer 2

In a proportion of children, the diarrhoea may result from undiagnosed coeliac disease of excessive ingestion of fruit juice, especially apple juice. Occasionally the cause is temporary cow’s milk allergy following gastroenteritits. Toddler’s diarrhoea is more common in children who eat a low-fat diet.

Question 3

Summarise the epidemiology of toddler diarrhoea.

Answer 3

Occurs from 6 months to 5 years.

Question 4

What are signs and symptoms of toddler diarrhoea?

Answer 4

Characteristically, the stools are of varying consistency, sometimes well formed, sometimes explosive and loose. The presence of undigested vegetables in the stools is common. Affected children are well and thriving.

There are no positive findings on examination.

Question 5

What are appropriate investigations for toddler diarrhoea?

Answer 5

Lab investigations are usually negative.

Consider a dietary investigation- may reveal a very high intake of fruit juices and which are hyperosmolar and in addition contain sorbitol, a non-absorbable sugar alcohol- for example, pear juice, 2%, apple juice, 0.5%

Question 6

What is the management for toddler diarrhoea?

Answer 6

Reassurance; dietary (increase fat intake, normalize fibre intake; decrease milk, fruit juice, and sugary drink intake); loperamide occasionally may be necessary.

Remember 4 Fs= Fat, Fluid, Fibre, Fruit juice.

Question 7

What are possible complications associated with toddler diarrhoea?

Answer 7

Dehydration and malnutrition.

Question 8

What is the prognosis of toddler diarrhoea?

Answer 8

In many cases the diarrhoea will go, or become less severe, if the child changes certain eating and drinking habits.