Pediatria pre prax 4/2024

Chronic diarrhoea of infants and toddlers

Diarrhoea is a frequent health problem in children, mainly in those younger than 2 years of age, and is responsible for up to 13,2% of international child mortality. Majority of diarrhoea is acute and 3–20% are chronic, lasting for more than 2 (to 4) weeks. In most cases, infectious causes are responsible for chronic diarrhoea. In developed countries and with the decreasing age of the child, mainly in newborns and infants, the risk of congenital and genetic causes is increasing. In older children, allergies and immune mediated aetiologies should be considered. History and a detailed physical examination are key in evaluating a child with chronic diarrhoea. Laboratory work and other diagnostic methods evolve from the considered differential diagnosis and may include endoscopies and genetic testing. Therapy depends on the aetiology of diarrhoea. In intractable diarrhoea of infancy, parenteral nutrition is often required, and small intestine transplantation is not an exception.

Keywords: chronic diarrhoea, infection, congenital and genetic causes, allergies, immune pathologies