Risk Factors
Risk factors for infectious causes of diarrhea include travel to foreign countries, swimming in lakes and ponds, attendance at day care, foster home and school as well as sick contacts at home. Recent antibiotic use can also put individuals at risk for developing diarrhea. Celiac disease and inflammatory bowel disease (IBD) have been associated with certain genes and families with first-degree relatives with these diseases are at greater risk.
Diagnosis
Acute Diarrhea
Diarrhea due to acute infection (acute gastroenteritis) usually does not require tests. In some cases doctors will order blood tests to determine if a child is dehydrated. Collection of stool samples (stool cultures) can be done to identify the specific cause of the diarrhea in some children, especially if they have blood in stools. Stool cultures can take from 2 to 5 days before a result is available. Stool studies can also be done to look for parasites including Giardia. In many cases of acute infectious diarrhea, a precise cause will not be identified despite stool testing.
Chronic Diarrhea
The diagnosis of chronic diarrhea usually requires confirmatory tests. Establishing the exact cause of chronic diarrhea may require several different tests, some of which are listed below:
Blood tests to look for anemia and inflammation, assess for dehydration and nutrition status and screen for possible Celiac disease.
Stool studies to look for possible bacterial, viral or parasitic etiologies.
X-ray studies are not routinely performed but may be useful in some circumstances to evaluate the liver and gastrointestinal tract if other causes are suspected.
Upper endoscopy and/or colonoscopy with biopsy to access for inflammation. An upper endoscopy can help to definitively diagnose Celiac disease. A colonoscopy is invaluable in making the diagnosis of inflammatory bowel disease and figuring out what portion of the colon is involved with the inflammation. It can also help to diagnose diarrhea that follows antibiotic use and to diagnose rare conditions such as lymphocytic colitis.
Lactose breath hydrogen test to diagnose lactose intolerance.
Your physician can assist you in choosing the best treatment after determining the cause of your child’s diarrhea.