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Chronic diarrhoea in children: A practical algorithm-based approach

Sahana Shankar1,2, Jeremy Rosenbaum2

  • 1Consultant Pediatric Gastroenterologist, Department of Pediatrics, Mazumdar Shaw Medical Centre, Narayana Health, Bangalore, India.

Journal of Paediatrics and Child Health
|July 30, 2020
PubMed

Insights

Chronic diarrhea, often without a clear infection, requires careful evaluation. This review outlines an approach to diagnosing and managing chronic diarrhea based on its causes and stool characteristics.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Diagnostics

Background:

  • Diarrhea is a significant global health issue, causing widespread morbidity and mortality.
  • While most cases are acute and infectious, prolonged diarrhea (over 4 weeks) without an identified cause necessitates further investigation.

Purpose of the Study:

  • To present a systematic approach for evaluating chronic diarrhea.
  • To elucidate diagnostic and management strategies based on pathophysiologic mechanisms and stool characteristics.

Main Methods:

  • Review of normal gut fluid homeostasis and diarrhea pathophysiology.
  • Classification of diarrhea into watery, fatty, and bloody types.
  • Detailed listing of history, physical examination, and investigations for differentiating diarrhea types.

Main Results:

  • An algorithmic approach is devised for the evaluation of different diarrhea types.
  • Key diagnostic investigations and management principles are outlined.
  • Recent advances in diarrhea diagnostics and therapeutics are briefly discussed.

Conclusions:

  • A structured, mechanism-based approach is crucial for diagnosing and managing chronic diarrhea.
  • Differentiating diarrhea by stool characteristics aids in targeted investigation and treatment.
  • This review provides a framework for clinicians managing complex diarrheal conditions.

Keywords:
adolescentalgorithmchildrendiarrhoeapractical

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