Symptoms
Overview
- Diarrhea is the sudden increase in the frequency and looseness of bowel movements (BMs).
- Mild diarrhea is the passage of a few loose or mushy BMs.
- Severe diarrhea is the passage of many watery BMs.
Cause
- Viral gastroenteritis (viral infection of the stomach and intestines).
- Occassionally caused by bacteria (such as Salmonella or Shigella).
Return to School
- Your child can return to day care or school after the stools are formed and the fever is gone. The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.
Related Symptoms
Should I Call?
- Call 911 NOW (your child may need an ambulance) IF:
- Not moving or too weak to stand.
- Call Your Doctor NOW (night or day) IF your child has any ONE of the following:
- Your child looks or acts very sick.
- Signs of dehydration (e.g. no urine in over 8 hours, no tears with crying and very dry mouth).
- Blood in the stool.
- Fever above 105°F (40.6° C).
- Age under 12 weeks with fever above 100.4°F (38.0° C) rectally.
- Abdominal pain present over 2 hours.
- Vomiting clear liquids 3 or more times.
- Age under 1 month with 3 or more large diarrhea stools.
- Passed more than 8 diarrhea stools in the last 8 hours.
- Severe diarrhea while taking a medicine that could cause diarrhea (e.g., antibiotics).
Action: If you are unable to reach your doctor - go to one of our nearby urgent care clinics or to a local hospital Emergency Department.
Use our Facility Search to find an urgent care clinic near you.
- Call Your Doctor WITHIN 24 HOURS (during regular daytime office hours) IF:
- You think your child needs to be seen.
- Mucus or pus in the stool present for over 2 days.
- Loss of bowel control in a toilet trained child occurs 3 or more times.
- Fever present for more than 3 days.
- Close contact with person or animal who has bacterial diarrhea.
- Contact with reptile (snake, lizard, turtle) in previous 14 days.
- Travel to a country at risk for bacterial diarrhea within the past month.
- Call Your Doctor DURING WEEKDAY OFFICE HOURS IF:
- You have other questions or concerns.
- Diarrhea persists over 2 weeks or is a recurrent problem.
- Provide Care at Home to children for:
- Mild diarrhea, probably viral gastroenteritis and you don't think your child needs to be seen.
Care at Home
Mild Diarrhea
- Continue regular diet. Eat more starchy foods. Drink more fluids. Exception: avoid all fruit juices and soft drinks because they make diarrhea worse.
Formula-Fed Infants (less than 1 year old) WITH frequent, watery diarrhea
- Start Oral Rehydration Solutions (ORS)
- ORS (such as Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It is readily available in supermarkets and drug sores. NOTE: formula is fine for average diarrhea.
- Use ORS alone for 4 to 6 hours to prevent dehydration. Offer unlimited amounts.
- If ORS is not available, use formula prepared as usual (unlimited amounts) until you can get some.
- Avoid Jello water and sports drinks or fruit juice.
- Return to Formula
- Go back to formula by 6 hours at the latest (Reason: infant needs the calories.)
Use formula prepared as usual (Reason: it contains adequate water).
- Offer the formula more frequently than you normally do.
- Lactose: Regular formula is fine for most diarrhea. Lactose-free formulas (soy formula) are only needed for watery diarrhea lasting over 3 days.
- Extra ORS: also give 2-4 oz. of ORS for every large watery stool.
- Solids
- Infants over 4 months old: Continue solids (such as rice cereal, strained bananas, mashed potatoes, etc.)
Breastfed Infants WITH frequent, watery diarrhea
- Continue breastfeeding at more frequent intervals. Continue solids as for formula-fed.
- Offer ORS (in addition to breastfeeding) after every large watery diarrhea stool (especially if urine is dark).
Older Children (over 1 year old) WITH frequent, watery diarrhea
- Solids: Starchy foods are absorbed best. Give dried cereals (especially rice cereal), oatmeal, bread, crackers, noodles, mashed potatoes, rice, carrots, applesauce, strained bananas, etc. Pretzels or salty crackers can help meet sodium needs.
- Fluids: If taking solids, offer unlimited fluids--use water or half-strength Gatorade. If child refuses solids, give milk or formula.
- Avoid all fruit juices and soft drinks. Reason: Make diarrhea worse.
- ORS is rarely needed, but for severe diarrhea, also give 4-8 oz. of ORS after every large watery stool.
- Yogurt: If over 12 months, give 2-6 oz of active culture yogurt twice a day. Reason: restores healthy bacteria to GI tract.
Diaper Rash
- Wash buttocks after each stool to prevent a bad diaper rash. Consider applying a protective ointment (e.g. petroleum jelly) around the anus to protect the skin.
Contagiousness
- Your child can return to day care or school after the stools are formed and the fever is gone. The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.
Expected Course
- Viral diarrhea lasts 5-14 days. Severe diarrhea only occurs on the first 1-2 days, but loose stools can persist for 1-2 weeks.
IF your symptoms become worse:
Review Should I Call? recommendations.
Copyright 1994-2008 Barton D. Schmitt, M.D.;
David A. Thompson, M.D., Self-Care Decisions LLC
Last Review Date: 10/1/2008