Chronic diarrhoe in children
Aymen fathi zemmal
Difinition, types, causes,
investivations, management and
treatment of diarrhea.
Present history: Azam almitairi 5 year old has projectile
of vomiting of eaten food in large amounts, diarrhea
and abdominal pain.
Dizzines and severe dehydration
Since 4 years
Aggreviated after cold water
Since 4 years with diarhea
Birth history: normal vaginal delivery neonatal period: is
preterm 6 months associated with hydroamonia.
Feeding history: both artificial and maternal feeding now
having normal family diet.
Development history: delayed in walking and speaking.
Normal vaginal delivery, preterm 7 months mother got
got all vaccinations according to saudi vaccination programme
Nutritional history Mix of artificial and maternal breast feeding, now having family diet.
Delayed walking and speaking.
Eczema and sodium and pottasium deficiency.
Sodium chloride solution ,IV to prevent dehydration
• Tropical travel
The biggest brother16 years old have same condion, rest of brothers are
having well health, mother and father are relatives.
General examination and abdominal examination.
All patients with chronic diarrhea should go for
sigmoidoscopy and rectal biopsy.
Evaluation(DD):celiac disease, crohn’s disease.
Plan: blood tests.
Stool test for pathogens such C.difficile toxin.
Rigid sigmoidscopy with normal and abnormal biobsy.
Colonscopy to see malignancy or colitis.
Elaboration: always treat causes and handle food.
IV to prevent dehydration.
Antibiotics for infective diarrhea.
In congenital patient should try as possible as can to keep
Increased stool water and this increases stool
frequency and the passage of liquid stool.
osmotic diarrhea. Ex: glucose-galactose malabsortion.
Secretory diarrhea. Ex: after ileac resection.
Inflammatory diarrhea(mucosal destruction).
ex: infective causes and ulcerative colitis and Crohn’s disease.
ex: diabetic patients and hyperthyroid overactivity.