The Clinical Spectrum of Chronic Diarrhea in Children

Diarrhea is a common manifestation of gastrointestinal disease, and its definition has traditionally been based on the frequency, volume, and consistency of stools. However, a consensus statement issued by the American Gastroenterological Association suggests that chronic diarrhea should be defined as a decrease in fecal consistency lasting for two or more weeks. Diarrhoea is one of the most common causes of morbidity and mortality in children worldwide, and the World Health Organization (WHO) defines a case as the passage of three or more loose or watery stools per day. A total of 50 children were included in the study, and the patient selection was based on age, presenting symptoms suggestive of chronic diarrhoea. This two-year study of chronic diarrhoea in children in Karnataka and neighboring states found that cow milk protein intolerance was the most common entity encountered, followed by celiac disease and post infectious diarrhoea. The male preponderance encountered in this series is a reflection of the referral pattern in general, resulting from socio-cultural factors. The incidence of celiac disease is the 2nd most common cause of CD in this study (10%), likely due to referral to our institution by various peripheral hospitals when they could not diagnose after routine investigations. This study found that children of 1 year of age are the most at risk for chronic diarrhoea, with a male to female ratio of 3:2. Cow milk protein intolerance (CMPI) was the most common aetiological factor (62.0%), followed by celiac disease (CMI) and tuberculosis (TB). The referral pattern, prevalence of the disease, skills of the physician and availability of appropriate diagnostic facilities all influence the aetiological spectrum and outcome of chronic diarrhea. The high incidence of celiac diseases may be due to referral to our institution by various peripheral hospitals when they could not diagnose after routine investigations. Regional hospitals and laboratory diagnostics should be well equipped to diagnose these cases. Mortality of CD (2%) was a case of glucose galactose intolerance which has poor outcome