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Review
. 2020 Jul;56(7):1029-1038.
doi: 10.1111/jpc.14986.

Chronic diarrhoea in children: A practical algorithm-based approach

Sahana Shankar  1   2 , Jeremy Rosenbaum  2
Affiliations
Review

Chronic diarrhoea in children: A practical algorithm-based approach

Sahana Shankar et al. J Paediatr Child Health. 2020 Jul.

Abstract

Diarrhoea is a leading cause of morbidity and mortality world-wide. Most diarrhoeal episodes are acute and infectious in origin. Diarrhoea lasting for longer than 4 weeks with no discernible infectious aetiology warrants thorough evaluation. The aim of this review is to elucidate an approach to evaluation of diarrhoea based on its pathophysiologic mechanisms with focus on aetiology, investigation and management of chronic diarrhoea. It includes a brief description of normal fluid homeostasis in the gut and pathophysiology of diarrhoea. Further, diarrhoea is classified as 'watery', 'fatty' and 'bloody' based on stool characteristics. Relevant history, physical examination findings, first and second-line investigations which help in differentiating the different types of diarrhoea are listed and an algorithmic approach to individual types of diarrhoea has been devised. Principles of management and recent advances in diagnostics and therapeutics of diarrhoea are briefly discussed.

Keywords: adolescent; algorithm; children; diarrhoea; practical.

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References

    1. Liu L, Oza S, Hogan D et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: An updated systematic analysis. Lancet 2015; 385: 430-40.
    1. Troeger C, Blacker BF, Khalil IA et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect. Dis. 2018; 18: 1211-28.
    1. Schnadower D, Finkelstein Y, Freedman SB. Ondansetron and probiotics in the management of pediatric acute gastroenteritis in developed countries. Curr. Opin. Gastroenterol. 2015; 31: 1-6.
    1. Dey A, Wang H, Menzies R, Macartney K. Changes in hospitalisations for acute gastroenteritis in Australia after the national rotavirus vaccination program. Med. J. Aust. 2012; 197: 453-7.
    1. Pendleton A, Galic M, Clarke C et al. Impact of rotavirus vaccination in Australian children below 5 years of age: A database study. Hum. Vaccin. Immunother. 2013; 9: 1617-25.

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