Ongoing diarrhea: Diet can help

Ongoing diarrhea: Diet can help

Dr. Stan Cohen, MD

Is a pediatric gastroenterologist at the Children’s Center for Digestive Health Care / GI Care for Kids, whose books on nutrition for parents led him to start Nutrition4Kids with his co-founders.

Some infants and children continue to have diarrhea after an intestinal infection (gastroenteritis). Their fever breaks and the vomiting subsides, but the diarrhea continues for days or even weeks. 

Lactose intolerance can be the cause. The virus or other infective agent has gone, but while it was there, it temporarily destroyed the intestine's ability to digest and absorb lactose, or milk sugar. When it's not absorbed, the lactose will pull more water into the intestine, causing cramping and more  diarrhea. In this situation you should switch infants from a milk-based formula to a soy-based or lactose-reduced formula for up to two to four weeks. If a baby is on any other formula, you needn't concern yourself with this, since the only formulas that are lactose predominant are the milk-based formulas. Older kids should drink a lactose- free milk (and eat limited dairy-particularly, soft cheeses, and ice cream–since they have the most lactose) for the same length of time. That's how long it takes the intestine needs to regrow its villi, those absorbing tips of the surface where lactase enzymes do their work. 

Most infants and  children will improve just by restricting lactose. However, a few will persist with diarrhea, especially if they remain on a restricted diet, consuming  electrolyte solutions, juices, and other liquids that are high in sugar, as parents try to "keep up with the diarrhea." The problem is that these sugary drinks speed the intestinal contents and cause what's called toddlers diarrhea. So it becomes very important to resume a regular diet soon after the illness is over, using a lactose-free drink, as discussed.  

If the Infant or Child Isn't Any Better 

If your child has not responded to these suggestions or the diarrhea seemed to have started without a cause, you are need the aid and counsel of your pediatrician, if you haven't already sought it. Your doctor will begin to consider the less frequent causes of diarrhea. They can be far more difficult to identify. Perhaps the first and most important step  is to have a thorough evaluation by your pediatrician. Your pediatrician should examine your child and the child's bowel movements as well. Most likely, he or she will check for blood and various infections; and a battery of blood tests may need to be done to rule out celiac and the inflammatory bowel diseases (see the blogposts on those topics) and possibly for less common conditions as well, if those initial tests are unrevealing.

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