Chronic diarrhoea in children: a clinical perspective.

Abstract

Chronic diarrhoea in its previously described severe malnourished presentation is not common in Singapore. A retrospective study was made of children with chronic diarrhoea between January to September 1990, at the Department of Paediatrics, National University Hospital. Chronic diarrhoea in our context included all those who presented with diarrhoea of 7 or more days duration. The age range was one month to 11 years, with 23 males and 13 female patients. Approximately half of the patients had associated symptoms like fever. Anthropometric data of these patients revealed none less than the third percentile in height and weight. Clinically the patients were mainly well nourished, mildly dehydrated with no significant pallor or oedema. Perianal erythema though not excoriation was common being present in approximately 50%. Haematological parameters and electrolytes were generally normal. Mild elevation of urea and creatinine levels especially the former was present reflecting the relatively mild dehydration status. Infection was the main cause of the diarrhoea, 55% of stool cultures being positive mainly for Salmonella or rotavirus. Treatment was mainly directed at correcting dehydration. 40% needed antibiotics. Hence, chronic diarrhoea as seen in the National University Hospital is generally not debilitating. An infective cause must first be excluded with usage of antibiotics often necessary in young children.