Diarrhoea persistent causes in children

Overview

Persistent diarrhoea in children is when a child has loose, watery stools that last for more than 7 days. It is different from a short tummy bug, which usually improves within a week.

Yes, persistent diarrhoea is common in children, especially in those under 5 years old. It can affect any child, but it is more frequent in areas with poor sanitation.

It mainly affects young children, particularly those in daycare or who have recently travelled. Children with weakened immune systems or chronic illnesses are also more likely to have persistent diarrhoea.

Symptoms

Common symptoms

• Loose, watery bowel movements that happen more often than usual
• Stomach cramps or bloating
• Feeling tired or weak
• Loss of appetite

Symptoms in children

• Fussiness or crying more than usual
• Vomiting
• Fever (temperature over 38°C)
• Signs of dehydration such as fewer wet nappies, dry mouth, or sunken eyes

Causes

Main causes

• Infections (gastroenteritis) caused by viruses like rotavirus, or bacteria such as salmonella or E. coli
• Parasites like giardia, common after drinking contaminated water
• Food intolerances, especially to lactose (milk sugar) or certain food additives
• Irritable bowel syndrome, which can cause long-term diarrhoea in older children
• Coeliac disease (an immune reaction to gluten) or other chronic bowel conditions

Risk factors

• Attending daycare or school where infections spread easily
• Poor handwashing or hygiene
• Recent travel to areas with unsafe water or food
• Weakened immune system due to illness or medication
• Family history of allergies or bowel conditions

When to see a doctor

See a doctor urgently if:

• If your child shows any signs of dehydration: dry mouth, no tears, sunken eyes, fewer wet nappies
• If there is blood or mucus in the stool
• If your child has severe stomach pain or a very high fever
• If your child is lethargic or difficult to wake

Book a routine appointment if:

• If diarrhoea lasts longer than 7 days without improvement
• If your child is not gaining weight or is losing weight
• If diarrhoea keeps coming back (recurrent episodes)
• If you notice your child is always tired or has a poor appetite

Diagnosis

Your doctor will ask about your child's symptoms, how long the diarrhoea has lasted, and whether there have been any recent travel or illnesses. They will also do a physical exam to check for signs of dehydration.

Tests that may be done

• Stool sample test to check for infections or parasites
• Blood tests to look for signs of infection, inflammation, or coeliac disease
• Breath test for lactose intolerance (if dairy is a suspected cause)
• Sometimes a referral to a children's stomach specialist (paediatric gastroenterologist) for further tests

What to expect at your appointment

Your doctor may recommend keeping a diary of your child's bowel movements and diet. Most tests are simple and not painful. If a specific cause is found, treatment will be tailored to that cause.

Treatment

Treatment focuses on preventing dehydration and addressing the underlying cause. Many children improve with simple self-care measures, but sometimes medical treatment is needed.

Self-care at home

• Give your child plenty of fluids – oral rehydration solution (ORS) is best. You can buy it at a pharmacy or make your own if instructed by a health worker.
• Continue breastfeeding or formula feeding for infants.
• Offer small, frequent meals of bland foods like rice, bananas, plain toast, or boiled potatoes.
• Avoid sugary drinks, fruit juice, and fizzy drinks as they can make diarrhoea worse.
• Wash your hands and your child's hands often to stop the spread of infection.

Medical treatments

If diarrhoea is caused by a bacterial or parasitic infection, your doctor may prescribe antibiotics. Medicines that slow down bowel movements (antidiarrhoeals) are not recommended for children and can be harmful. Probiotics (helpful bacteria) may sometimes be suggested to help restore gut health, but always ask your doctor first. In cases of food intolerance, avoiding the trigger food (like lactose or gluten) is the main treatment.

When is surgery considered?

Surgery is rarely needed for persistent diarrhoea in children. It might be considered only if there is a rare complication like a blockage or severe inflammation in the intestines, but this is not common.

Living with this condition

While your child has diarrhoea, focus on keeping them well hydrated. Check their nappies or bathroom visits regularly. Offer small, frequent meals and gentle foods. Rest is important, but your child can still play quietly if they have energy.

Lifestyle tips

• Encourage frequent handwashing, especially after using the toilet and before meals.
• Keep your child home from daycare or school until they have had no diarrhoea for 48 hours (if infection is suspected).
• Clean surfaces and toys regularly to stop the infection from spreading.

Diet and exercise

Offer soft, easy-to-digest foods like porridge, applesauce, or mashed potatoes. Avoid fatty, spicy, or very sugary foods. Once the diarrhoea stops, slowly return to a normal diet. Light exercise like gentle play is fine, but avoid vigorous activity if your child feels weak.

Mental health and emotional wellbeing

Persistent diarrhoea can be stressful for both the child and the family. Children may feel embarrassed or frustrated, especially if they have accidents. Parents may worry about dehydration or underlying conditions. It is important to talk about these feelings and seek help if stress becomes overwhelming.

Prevention

Many cases of persistent diarrhoea can be prevented with good hygiene. Teach your child to wash hands thoroughly with soap and water after the toilet and before eating. Make sure drinking water is clean, and food is properly cooked. When travelling, avoid tap water and raw foods that might be unsafe.

Vaccines

There is a rotavirus vaccine given to babies as part of the routine childhood vaccination schedule in many countries, including the UK. It protects against the most common cause of severe diarrhoea in young children.

Screening programmes

There is no routine screening for persistent diarrhoea. However, if your child has a family history of coeliac disease or other bowel conditions, your doctor may recommend blood tests even before symptoms appear.

Complications

If left untreated

• Dehydration, which can be serious and may require hospital treatment with fluids through a drip
• Electrolyte imbalances (low salts in the blood) that can affect the heart and muscles
• Malnutrition or weight loss if diarrhoea lasts a long time
• Sores on the skin around the bottom (nappy rash) from frequent loose stools

Long-term outlook

The outlook for children with persistent diarrhoea is generally very good. Most children recover fully with the right care at home or simple medical treatment. Even when there is an underlying condition like coeliac disease or a food intolerance, following a proper diet allows children to grow and thrive normally. With support from healthcare providers, families can manage the condition well.

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