Differentials
Nonspecific toddler's diarrhea
SIGNS / SYMPTOMS
Age of patient is limited to early childhood, first 2 years of life
INVESTIGATIONS
None. Stool studies or other laboratory studies are normal.
Irritable bowel syndrome (IBS) with alternating constipation and diarrhea
SIGNS / SYMPTOMS
History of alternating constipation and diarrhea associated with pain and abdominal discomfort.
Abdominal bloating or distention that increases during the day and is not associated with nausea and vomiting.
No significant findings following abdominal examination.
INVESTIGATIONS
CBC normal; presence of anemia suggests non-IBS disease.
Stool studies normal; presence of WBCs or parasites in stool suggests non-IBS disease.
Plain abdominal x-ray, flexible sigmoidoscopy, and colonoscopy all normal.
Infectious diarrhea
SIGNS / SYMPTOMS
Usually accompanied by fever, vomiting, and bloody stools.
INVESTIGATIONS
Stool studies may be positive for RBCs and WBCs.
Fecal culture may grow bacteria.
Ova and parasites may be seen on microscopic examination of stool.
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