Chronic nonspecific diarrhea

My son has chronic diarrhea. It is not associated with any allergies. What could be the reasons for it, and what can I do for him? Will he outgrow this?


Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Beth,

I am assuming that you have had discussions with your pediatrician and pediatric allergist in trying to pinpoint a reason for the diarrhea and have been unsuccessful. It must be very frustrating, especially considering the messiness of it all. I have a friend, who is a nurse at my pediatrician's office, whose baby had the same problem, and eventually outgrew it.

From conversations surrounding that experience and from reading, I have become familiar with a syndrome known as 'chronic nonspecific diarrhea'. The "Pediatric Nutrition Handbook", written by the American Academy of Pediatrics, aptly calls it "sloppy stool syndrome".

A child with this syndrome is not sick. They eat well, are growing normally and don't seem to have any food intolerances. It is not health threatening like acute diarrhea because it is not associated with any other dehydrating factors such as fever and excessive sweating, and because they can drink when thirsty and keep the fluid down. Chronic diarrhea is one of the most frequent gastrointestinal complaints brought to pediatricians. It is unknown what causes it. Gradual but complete recovery is expected by 3 to 4 years.

In the meantime, there are some things you can do to help manage it. Continue to offer a balanced diet , going easy on the fruits and fruit juices (limit him to 2 or 3 small portions, at least one with vitamin C). Be sure there is plenty of fat in his diet. It may help by slowing down the activity of the stomach and intestine.

Evidence has shown that a high fat diet helps with this syndrome (one doctor had an 80% success rate). Fat can be up to 50% of his calorie intake. He should be drinking whole milk (I am not clear if he is drinking any milk at all, if not, make sure his dairy products are full fat). Put butter on his vegetables and bread. Meat should contain moderate amounts of fat. Avoid prunes and figs. Keep sugar usage to a minimum since too much can promote fermentation and gas in the large intestine. Do not allow any artificial sweeteners in his diet.

Include 8 ounces of full fat yogurt a day in his diet. The yogurt introduces beneficial bacteria to the colon, and will help take over the diarrhea causing bacteria. Give him plain yogurt that you have sweetened yourself with a little bit of sugar or fruit. It will be less than the amount of sugar found in the store bought variety.

Toilet train him as soon as age appropriate. He probably doesn't like those messy diapers any more than you do. He will learn to hold in his stool until he can make it to the toilet. The longer he can hold in his stool the better chance the fluid has of being absorbed from them, resulting in a more formed stool.

Hopefully some of these tips will help. Good luck.

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