Acute diarrhea is defined as the passage of three or more loose or watery stools per day, typically lasting less than 14 days. It is often accompanied by increased stool volume and frequency and can rapidly lead to dehydration in infants.
Acute diarrhea is the 2nd leading cause of death (~525 000 children less than 5 years old/year) and is the leading cause of malnutrition in children less than 5 years old.
Causes
- Rotavirus (40% of hospital admissions in <5 years).
- Other infectious agents (bacterial or parasitic infections), allergies, digestive disorders.
Pathophysiology and Risks
During an episode of acute diarrhea, there is:
- Loss of fluids and electrolytes through the gastrointestinal tract
- Reduced nutrient absorption and caloric utilization
- Potential for rapid dehydration, particularly in infants due to their low fluid reserves
Dehydration is the most critical complication in infants, and is the main cause for medical visit, hospitalization and death as if left unmanaged, it can lead to electrolyte imbalances, metabolic acidosis, and even life-threatening outcomes.
WHO Management Strategy for Infants & Toddlers
- Rehydrate: Oral rehydration solution (ORS) first-line; enteral or intravenous fluids if needed.
- Refeed: Continue breastfeeding & age-appropriate diet; avoid unnecessary dietary restrictions and food dilution.
- Improve stool consistency: Zinc supplementation for 10–14 days.
*Guarino A., et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J. Pediatr. Gastroenterol. Nutr. 59, 132–152 (2014).
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Acute Diarrhea Fact Sheet