Chronic diarrhea in children.

Definitions Chronic diarrhea is a common complaint in pediatric medicine and can pose a complex situation for practitioners and families. This complaint is both a symptom and a sign. (1) Although patients or their parents often assess the presence of diarrhea by reporting stool consistency and frequency, one can more scientifically define diarrhea as stool volume >10 g/kg per day in infants and toddlers, and >200 g/day in older children. (2) However, diarrhea should not be defined solely by stool weight. Some adolescents and adults may have up to 300 g of formed stool per day without any complaints. (3) The duration of symptoms necessary to define diarrhea as “chronic” also is not definitive. Most authors agree that 14 days of symptoms meets criteria, although others use a cutoff of 4 weeks. (4) An additional term, “persistent” diarrhea, acknowledges diarrhea lasting more than 14 days but implies a more abrupt onset compared with chronic diarrhea. Regardless of the specific term or number of days of symptoms, it should be understood that this definition should allow for the usual resolution of most causes of acute diarrhea.