J Korean Med Assoc.  2012 Jun;55(6):546-550. 10.5124/jkma.2012.55.6.546.

Chronic nonspecific diarrhea of children

• Jang JY

• KMID: 2015653
• DOI: http://doi.org/10.5124/jkma.2012.55.6.546

Abstract

Chronic nonspecific diarrhea (CNSD) or toddler's diarrhea is the most frequent cause of chronic diarrhea in young children of developed countries. The pathogenesis of CNSD remains unclear. It has been associated with drinking large amounts of fluids and fruit juices that contain large amounts of fructose and sorbitol. Reduction in the intake of fat and fiber can also be the cause of CNSD. Children with CNSD do not show signs of malnutrition or growth retardation. They experience watery stools four to more than ten times daily. Stools are foul smelling, occasionally with undigested food remnants because of the short transit time. The patients do not normally suffer from their ailment; however, diarrhea may cause parents to be extremely worried. Pediatricians and primary physicians have to diagnose CNSD with clinical symptoms and exclusion of specific illness. Proper dietary manipulation improves the condition of most patients.

Keyword

Child; Chronic diarrhea; Nonspecific diarrhea; Toddler's diarrhea

MeSH Terms

Child
Developed Countries
Diarrhea
Drinking
Fructose
Fruit
Humans
Malnutrition
Parents
Smell
Sorbitol
Fructose
Sorbitol

Reference

1. Huffman S. Toddler's diarrhea. J Pediatr Health Care. 1999. 13:32–33.

2. Powell CV, Jenkins HR. Toddler diarrhoea: is it a useful diagnostic label? Arch Dis Child. 2012. 97:84–86.

3. Wyllie R, Hyams JS. Pediatric gastrointestinal and liver disease. 2006. 3rd ed. Philadelpia: Saunders.

4. Hwang JB. Clinical approaches for diarrheal disorders in infancy and early childhood. 1999. Daegu: Choongwae Publishing.

5. Weaver LT. Bowel habit from birth to old age. J Pediatr Gastroenterol Nutr. 1988. 7:637–640.

6. Hamdi I, Dodge JA. Toddler diarrhoea: observations on the effects of aspirin and loperamide. J Pediatr Gastroenterol Nutr. 1985. 4:362–365.

7. Kneepkens CM, Hoekstra JH. Chronic nonspecific diarrhea of childhood: pathophysiology and management. Pediatr Clin North Am. 1996. 43:375–390.

8. Hyams JS. Diet and gastrointestinal disease. Curr Opin Pediatr. 2002. 14:567–569.

9. Tripp JH, Muller DP, Harries JT. Mucosal (Na+-K+)-ATPase and adenylate cyclase activities in children with toddler diarrhea and the postenteritis syndrome. Pediatr Res. 1980. 14:1382–1386.

10. Fenton TR, Harries JT, Milla PJ. Disordered small intestinal motility: a rational basis for toddlers' diarrhoea. Gut. 1983. 24:897–903.

11. Moore SR. Update on prolonged and persistent diarrhea in children. Curr Opin Gastroenterol. 2011. 27:19–23.

12. Hoekstra JH. Toddler diarrhoea: more a nutritional disorder than a disease. Arch Dis Child. 1998. 79:2–5.

13. Hyams JS, Leichtner AM. Apple juice: an unappreciated cause of chronic diarrhea. Am J Dis Child. 1985. 139:503–505.