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Chronic diarrhoea in infants and young children: causes, clinical features and outcome
1Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. drleews@pc.jaring.my
Insights
Chronic diarrhea in Malaysian children has diverse causes, with a specific diagnosis achievable in most cases. Prompt diagnosis leads to effective treatment and positive outcomes for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Clinical Research
- Public Health
Background:
- Chronic diarrhea in children presents a significant clinical challenge.
- Understanding the diverse etiologies is crucial for effective management.
Purpose of the Study:
- To investigate the causes, clinical manifestations, and outcomes of chronic diarrhea in Malaysian children.
- To identify key diagnostic and therapeutic strategies for pediatric chronic diarrhea.
Main Methods:
- Prospective study of children with diarrhea exceeding 14 days duration.
- Management at the University of Malaya Medical Centre from 1996-1997.
- Analysis of etiological factors, treatment interventions, and patient outcomes.
Main Results:
- Twenty-seven children (median age 6 months) were studied with a mean symptom duration of 66.5 days.
- Identified causes included prolonged diarrhea entities, postenteritis conditions, and gastrointestinal infections.
- Dietary changes and parenteral nutrition were required in 16 and 9 cases, respectively.
Conclusions:
- Chronic diarrhea in Malaysian children stems from various causes.
- A specific diagnosis was established in 90% of cases.
- Accurate diagnosis facilitated appropriate therapy, resulting in a 96% positive outcome rate.
Objectives:
To review the causes, clinical features and outcomes of Malaysian children who had chronic diarrhoea.
Methodology:
A prospective study was performed on children with diarrhoea of more than 14 days' duration who were managed at the Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur from 1 January 1996 to 31 December 1997.
Results:
Twenty-seven patients (14 boys and 13 girls) were studied. The median age of onset of diarrhoea was 6 months and the mean duration of symptoms before referral was 66.5 days. The underlying causes of diarrhoea were found to be: (i) prolonged diarrhoea due to well-defined entities (intestinal lymphangiectasia, two cases; congenital glucose-galactose malabsorption, one case; post-small bowel resection, one case; (ii) postenteritis diarrhoea (cow's milk protein intolerance, eight cases; secondary lactose intolerance, four cases; transient monosaccharide intolerance, one case; (iii) gastrointestinal infections (nontyphoid Salmonella gastroenteritis, three cases; trichuriasis, two cases; amoebiasis, one case; adenovirus, one case; (iv) cases in which a firm diagnosis could not be established (three cases). The mean duration of hospital admission was 63 days. Sixteen cases required a change in diet, while nine cases required total parenteral nutrition. One death occurred.
Conclusions:
Chronic childhood diarrhoea in Malaysia had a variety of aetiologies. A specific diagnosis could be established in 90% of cases. Making a diagnosis was important because this led to appropriate therapy and a good outcome in 96% of cases.