Chronic diarrhea encompasses a large number of possible causes, among which we can cite as the most frequent:
- Protein intolerance
- Deficiencies in disaccharidases
- Celiac disease
- Infections
- IgE-mediated and non-IgE-mediated allergy.
- Enzyme deficiencies, most common Cystic Fibrosis
- Infestations of the intestine
- Immunoglobulin deficiency, Immunodeficiencies
- Lymphocytic or collagenous enteritis
- Inflammatory bowel disease such as Crohn’s disease, Ulcerative Colitis, Indeterminate Colitis
- Incorrect diets
- Bacterial hyperproliferation of the small intestine.
The latter, small intestinal bacterial hyperproliferation, is a common clinical complication, which can be found in various childhood pathologies and conditions. Children will experience diarrhea, flatulence, abdominal pain, malnutrition or growth retardation, having risk factors for this syndrome.
What are the causes?
- Alterations of the distal ileum with colonization of the small intestine by colon bacteria.
- Alteration of intestinal motility, as a cause of small bowel pathologies or other chronic disorders.
- Reduced gastric acid secretion, in some cases due to excessive use of proton pump inhibitors.
- Primary or acquired immunodeficiency.
Currently there are few diagnostic procedures, which have certain limitations and may be falsely positive or negative.
The most indicated tool to diagnose small bowel bacterial hyperproliferation in children is the exhaled air gas study, a non-invasive test and especially useful for those patients who need several tests or have mild symptomatology.
How should it be treated?
When a diagnosis cannot be made with absolute certainty, but the symptoms clearly indicate a case of hyperproliferation, the physician should consider empirical antibiotic treatment, along with probiotics and nutritional therapy.
There are no established guidelines yet on the treatment and prevention of the pathology, but stool examination and exhaled air gas studies may help.
For more information about chronic diarrhea, contact a Digestive Tract specialist.