Persistent Diarrhea & Malabsorption :: Nationwide Children's Hospital

Persistent Diarrhea and Malabsorption

Diarrhea occurs commonly in both children and adults. Diarrhea lasting less than seven days is considered acute. The majority of diarrheal episodes fall into this category. Diarrhea lasting more than 7 days is defined as persistent, while diarrhea for more than 30 days is chronic. Malabsorption is the body's inability to use the food that it takes in, often causing diarrhea.

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Diarrhea lasting more than seven days can be caused by a number of different problems, including:

  • Celiac disease (an allergy to protein in wheat, rye and barley)

  • Enzyme deficiencies (like lactose intolerance)

  • Toddler's diarrhea

  • Infection (parasites such as Giardia, Cryptosporidium)

  • Food allergy

  • Pancreatic disorders (like cystic fibrosis, pancreatic insufficiency)

  • Inflammatory bowel disease (Crohn's disease, ulcerative colitis)

  • Too much laxative intake

  • After-infection (after an acute diarrhea episode, diarrhea may continue for weeks)

  • Other medical conditions (such as overactive thyroid)



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"Toddler's diarrhea," one of the most common causes of persistent diarrhea, is caused by a diet low in fat and high in sugar and fluids (usually from fruit juices).

Affected children will oftentimes have multiple loose bowel movements in a day that get progressively more watery througout the day. Stools may contain undigested foods or mucus, and may be very foul-smelling. The child with toddler's diarrhea has normal growth and weight without any bloody stools.

Visit your child's doctor if your child is losing weight, not growing well, has blood in his/her stools or has excessive pain.



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Many antibiotics for common infections such as ear infections and urinary tract infections may cause some diarrhea. The diarrhea usually resolves once the antibiotics are finished. Eating yogurt and other dairy products containing "good bacteria" (Lactobacillus, Acidophilus) may improve the diarrhea.



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Any child who is not growing well, has lost weight or had poor weight gain should be seen by a physician. Also, if your child's stools appear greasy, bloody or mucusy, you should see a physician.



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In addition to obtaining an extensive history and performing a complete physical exam, your child's doctor may order blood work, stool studies and radiology studies.

Sometimes an upper and/or lower endoscopy must be performed. This test is done while the child is asleep under anesthesia or is sedated. A fiber optic tube is passed through the mouth down into the stomach and small intestine. Another fiber optic tube may be inserted into the rectum and is advanced throughout the large intestine. Tiny samples of cells (biopsies) are taken from both the small and large intestine for diagnosis.



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Treatment is dependent on the underlying cause of the diarrhea or malabsorption, and may include medications or the avoidance of certain foods. Contact your child's physician before beginning any anti-diarrhea medicine.



Nationwide Children's Hospital
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