Diagnosis

As with other diseases, the anamnesis is of great importance in diarrheal diseases. Since diarrhea can have many causes, it is very important that parents observe the symptoms and the course of the disease very closely. Of particular interest here are the frequency and nature of the stool and whether the child also suffers from abdominal pain.

Other questions that may give the doctor useful advice and which you should therefore keep in mind are The physical examination of the child, which includes palpation and listening to the abdomen, is part of the basic diagnostic procedure. However, further examinations are usually not necessary and usually bring little benefit in the further course of therapy. It may make sense to give a stool sample, for example, a microscopic examination of the stool for white blood cells can be performed.

If the microscopy is positive, this would indicate a viral cause, triggered by noro- or rotaviruses. Other possible examinations include an ultrasound examination of the abdomen, a lactose intolerance test to diagnose lactose intolerance, and laboratory tests of the blood.

Does your child have a fever and vomits?
Has your child been sick lately?
Do friends, acquaintances or relatives with whom the child has recently come into contact show similar symptoms?
How long has it been since your last stay abroad and what medications is your child taking or has your child taken recently?

If your child suffers from diarrhoea, measuring the body temperature is an important first step.

Especially in combination with vomiting, subfebrile temperatures or even fever indicate an infectious cause. In any case, however, the diarrhea-related high loss of water and electrolytes by the child must be compensated. Depending on the age of the child, there are various recommendations as to which fluids and salts can be used to achieve this compensation as effectively as possible.

Small children in particular should not eat any solid food in the first six hours and should instead drink as much as possible. Ideally, this should be done in small quantities and with as varied a range of drinks as possible. Especially recommended are various teas, which have an anti-inflammatory and bactericidal effect due to the tanning agents they contain.

Classically, mainly chamomile, fennel and diluted black tea are used, in which per 100 ml two level teaspoons of sugar or honey and a pinch of salt can be added. Apart from this, potassium-rich fruit juices, especially banana and apricot juice, and salty broths are very suitable for compensating for the loss of nutrients and electrolytes. A small tip: If your child is already drinking from the cup on its own, the use of a straw can increase the amount drunk in many cases.

After about six hours, your child can be offered solid food again. However, this should be easily digestible and low-fat. Well-tried “recipes” are still valid today: salted gruel, rusk, grated apple or pureed banana are a suitable light food for diarrhea in small children.

With regard to fluid intake during the first six hours after the onset of diarrhoea, there are a number of recipes on the Internet for mixing an electrolyte-sugar mixture that should contain all the necessary nutrients. However, caution is advised. Most of these recipes are based on outdated WHO recommendations and are therefore no longer valid today.

In addition, these recipes carry potential risks. Children are much more sensitive to electrolyte fluctuations than adults. The wrong preparation of these so-called rehydration solutions can therefore have a negative effect on the well-being of your child.

As an alternative to mixing the solutions yourself, they can also be purchased at the pharmacy. As far as the combination of cola and savoury snacks, which used to be common for diarrhoea diseases, is concerned, it is no longer recommended or even advised against today.The reason for this is that Coca-Cola contains more than eight times the solution recommended by the WHO for rehydration in cases of diarrhoea. This gives it a high osmolar activity, which ultimately means that it binds additional water in the intestine.

As a result, cola can even exacerbate diarrhea. Incidentally, the usual hygiene measures should not be neglected in the case of diarrhoea in small children, just as with adults. Above all, frequent hand washing is of utmost importance for each family member to avoid infection.

In most cases, therapy with medication against diarrhea in small children is not necessary, as the disease is self-limiting in most cases. Instead, the focus is on a sufficient supply of fluids and electrolytes. In fact, the diarrhea medication loperamide, which is frequently used in adults, is even unsuitable for use in small children, except in severe cases.

The effect of the drug, which belongs to the class of opioids (synthetically produced opiates), is based on an inhibition of intestinal movement (intestinal motility), which gives the intestine more time to absorb fluid so that the bowel movement becomes firmer. In adults, loperamide only acts locally on the bowel, which means that the drug itself has very few side effects. In children, however, the blood–brain barrier, which prevents most substances from passing into the central nervous system, is much more permeable than in adults.

Loperamide can thus penetrate into the brain and cause symptoms typical of opiates, such as respiratory inhibition and even delirium. For this reason, loperamide is never prescribed to children under the age of two and only in severe cases in children under the age of twelve, and only under strict dosage guidelines. Since diarrhea in intestinal infections is also a protective function that is intended to flush out pathogens, the opioid tends to have a negative effect here and can prolong the duration of the disease.

An antibiotic therapy is usually not advisable either, since a large proportion of diarrheal diseases are caused by viruses against which antibiotics are not effective. However, if an antibiotic is prescribed for viral infections, there is a high probability that the diarrhea will get worse, since the natural intestinal flora is also damaged. If diarrhoea exists in small children, but also in adults, a lack of fluid in the body develops after a certain period of time, as a lot of fluid is excreted in the form of liquid stool.

One of the main goals must therefore be to replace the lost fluid. This is best done with still water or tea. The child should drink at least 2.5 liters of water a day.

Another problem is the loss of electrolytes such as sodium or potassium. These are flushed out of the body with the fluid in the case of diarrhoea and an electrolyte deficiency develops. This can be easily replaced by salt sticks, rusks or a cup of vegetable broth.

Cola should not yet be used for this purpose in small children, as it would further irritate the intestines through the carbonic acid. It is also never wrong to offer a lot of fruit. You can grate bananas or apples in this way.

The pectin contained in the peel helps to bind the free water in the intestine. Ideal is therefore a mash of squashed bananas with grated rusk. You should not touch heavy, deficient food and dairy products at first.

A well-known household remedy is orange tea. For this, a bag of black tea is steeped in about 700ml of boiling water for about 8 minutes. Then add some orange juice, sugar and a spoonful of salt.

This way you have all the above mentioned ingredients in one drink, even if this is not always tasty for small children. As with most diseases, if diarrhea is present, a number of homeopathic medicines are available to relieve the symptoms of the disease or to cure it. The boundaries between useful naturopathy and charlatanism are blurred and often difficult to discern.

Globules in general do not keep their promises according to the current state of science. In fact, homeopathy even contradicts all scientific knowledge, if only with regard to the principle of testing homeopathic remedies. In fact, this is not carried out on sick persons, but only by healthy testers, who then describe the subjectively felt effect of the globules.

In any case, however, there are well-tried herbal products which have been proven to have a positive effect on diarrhoea and are also suitable for small children.These include primarily various teas such as chamomile, fennel and black tea. The latter, however, should be administered in diluted form. Whether, how much and what should be eaten for diarrheal diseases is always a subject of great uncertainty, especially when small children are affected.

The recommendations of the German Federal Center for Health Education, which are also available online, are helpful in this regard. According to their information on the topic of diarrhea in small children, the child should not eat solid food in the first six hours after the beginning of the diarrhea. Instead, it is advised to give the child a variety of drinks.

First and foremost, sugared teas and fruit juices are recommended. As soon as the first six hours have passed, your child can already be offered light, low-fat food. Particularly suitable here is what has long been recommended for diarrhea: salted mucus soups, grated apple, pureed banana and rusk are easily digestible and therefore well suited. Once the diarrhoea has subsided, your child can eat as much normal food as possible the very next day. However, fatty and hard to digest foods should be avoided for the time being.