Diarrhoea in children can occur for many reasons but is less common than constipation in children with chronic or terminal illnesses.
Diarrhoea is still a major cause of mortality in under-developed countries.
Adequate management requires taking a thorough history of illness, medications and diet. Many cases can be managed with reassurance, clear fluids and oral rehydration in the short term. Below is a summary of the types of diarrhoea, followed by some approaches to management. In all cases, but particularly pertinent in palliative care, children ought to be treated according to their individual needs and agreed goals of care.
Types of diarrhoea
Assessment of diarrhoea
It will be appropriate to determine goals of care in advanced/critical disease. Formulating a care plan in consultation with the child where appropriate and their caregivers can be an opportunity to discuss ways of managing symptoms, determine the social and psychological impact and can provide the time to offer reassurance to the child and family.
1. Take a full history by determining the following from the parents (and the child if they are old enough):