Parents frequently seek advice regarding their child’s stool patterns. Personal and cultural beliefs often influence their perception of diarrhea in children. The most common cause of diarrhea in children is viral infection, which is usually self-limiting. Bacterial and parasitic infections can also cause diarrhea, though less frequently.

During diarrheal episodes, it is crucial to maintain adequate hydration, primarily through oral rehydration solutions (ORS). The use of antibiotics is generally not recommended, as they may prolong bacterial shedding and are often unnecessary. However, diarrhea caused by parasites such as amoebae requires targeted pharmacological treatment.

In some cases, diarrhea may become prolonged or chronic, leading to dehydration and malnutrition. Causes of protracted diarrhea include tropical enteropathy (post-enteritis syndrome), food-sensitive enteropathy, unrecognized immunodeficiencies, cystic fibrosis, Shwachman-Diamond syndrome, Crohn’s disease, ulcerative colitis, and blind loop syndrome with bacterial overgrowth.

Diagnostic evaluation typically involves blood tests, genetic analysis, enzyme assays, and both upper and lower endoscopy with biopsy sampling. In severe cases, children may require total parenteral nutrition (TPN) to meet their nutritional needs and reduce the frequency of diarrheal episodes.

Crohn’s disease and ulcerative colitis are the two primary forms of Inflammatory Bowel Disease (IBD). These conditions cause chronic inflammation of the intestinal tract and commonly present with symptoms such as bloody diarrhea, abdominal pain, weight loss, and intestinal strictures.

IBD can involve any part of the gastrointestinal tract—from the mouth to the rectum—and may also produce extra-intestinal manifestations, affecting organs such as the eyes, spine, liver, and skin.

The exact cause of IBD remains unclear, but it is believed to be multifactorial, resulting from complex interactions between genetic susceptibility, environmental factors, and alterations in the gut microbiome.

Diagnosis is established through endoscopic evaluation and histopathological confirmation from biopsies. The complications, clinical course, and management differ between Crohn’s disease and ulcerative colitis.

Treatment typically requires long-term medical management and regular follow-up. In cases resistant to conventional therapy, biologic agents such as Infliximab may be used to control inflammation and induce remission.

Constipation is a common and often chronic problem in children, characterized by hard stools that are difficult or painful to pass. In most cases, it is a behavioral issue rather than the result of an underlying disease or structural abnormality.

Children may intentionally withhold stool passage because they are preoccupied with play, engaged in other activities, or uncomfortable with their surroundings (for example, at school). When stools are withheld for several days, the colon continues to absorb water, making them hard, dry, and bulky. Passing such hard stools can cause painful tears in the rectal or anal lining, leading to spasm of the anal sphincter.

Over time, children begin to associate pain with defecation and continue to withhold stools, worsening the constipation. Chronic stool retention causes the rectum and colon to become distended and less sensitive to the normal urge to pass stool.

Effective management of constipation requires a comprehensive approach involving parental understanding, behavioral modification, and medical therapy. Treatment typically includes stool softeners or laxatives, positive reinforcement, and dietary adjustments to encourage regular bowel habits.

In selected cases, anorectal manometry or rectal pressure studies may be performed to assess bowel motility and rule out conditions such as Hirschsprung’s disease.