Poopies 2: Revenge of the Turds

In the past, I have talked a little about the importance of a good bowel movement, and avoiding constipation. Let’s go in the opposite direction…diarrhea. As it works out, we are in the peak season for diarrhea, and there are a lot of bugs that can cause diarrhea, especially in children.

Rotavirus is the most common cause of diarrhea worldwide. Symptoms include stomach pain, fever of 101-102, vomiting and diarrhea. The whole illness can last about 5 days, and the diarrhea smells just plain terrible.

It really should be called “road-a-virus”, because if you happen to be in a car when it strikes you, you won’t have time to get to a bathroom. You’ll emergently need to pull over on the side of the road…hopefully by some corn patch (with lots of high corn). That’s how fast it can hit you.

The big concern with rotavirus is its complication of rapidly dehydrating little ones. There is no antibiotic to cure the virus. The best and only treatment is to maintain a clear diet, with lots of fluids, and then to slowly advance the diet to a very bland one (cereal, apple sauce, bananas, and toast).

The virus is highly infectious and can be easily transmitted from one individual to another. The best way to prevent any spread is to make sure that there is good hand washing and there is no sharing of eating utensils, or even toys.

Like I said, rotavirus is primarily a kid’s disease, but occasionally it can hit an adult pretty hard, too. When I first started my pediatric residency, I was exposed to “Eric”, this 3-year-old, 2 foot tall, screaming, red haired “angel” who had rotavirus, and I suffered severely from “road-a-virus”, for about 110 miles. In adults, it doesn’t last as long, but it still remains very important to keep hydrated, so as not to lose too much fluid.

My son has had bad diarrhea for 2 days. He says it burns whenever he goes. What else can I do for him?

With multiple bowel movements, the bowel acids irritates the skin lining of the outer rectum, and can cause a mild “burn”. Each ongoing poopie can irritate it over and over again. The best thing to improve this is to carefully wash his rear end, dry it completely, and then apply a thin film of Vaseline on the outer rectum and skin (after each bowel movement). The Vaseline will help protect the skin from the acids of the stool.

My doctor said my child had rotavirus, but didn’t do any test to check it. I know there is a test. So, why didn’t he?

It’s not going to change anything, especially the treatment. Even if your child has or does not have rotavirus, it’s still important to maintain a good fluid intake in your child, and prevent spread to you or any of your other kids. If your son’s diarrhea continues past 5 days with no improvement, it may be necessary to test his stool for specific bugs.

I heard that you should not give milk or formula to a child has had a bout of diarrhea, because it can make it worse. Is that true?

Yes, sometimes it is. There can be a mild insult to the inside of the bowels, more specifically a decrease in an enzyme, which helps breakdown milk products, called “lactase”. The bowels need a few weeks to repair themselves and increase their production of lactase.

How can I prevent this in my children?

Early prevention of can be achieved with oral rotavirus protection (3 doses) if given prior to 8 months of age. After that, WASH YOUR HANDS!

We all will get it sooner or later…drink and stay hydrated, and you’ll do a lot better!