Chapter 5.1 Child presenting with diarrhoea

History

A careful feeding history is essential in the management of a child with diarrhoea.  Inquiries should also be made about:

  • Frequency of stools
  • Number of days
  • Blood in stools
  • Report of cholera outbreak in the area
  • Recent antibiotic or other drug treatment
  • Attacks of crying with pallor in an infant.

Examination

Look for:

signs of some dehydration or severe dehydration:

  • Restlessness or irritability
  • Lethargy or reduced level of consciousness
  • Sunken eyes
  • Skin pinch returns slowly or very slowly
  • Thirsty/drinks eagerly, or drinking poorly or not able to drink
  • Blood in stool
  • Signs of severe malnutrition
  • Abdominal mass
  • Abdominal distension

There is no need for routine stool microscopy or culture in children with non-bloody diarrhoea.