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Abstract: A 4-year-old child was brought to the hospital by his parents because he had 3-5 stools per day for the last 1 week without abdominal pain, no abnormal odor, and a slightly poorer appetite than before. The child’s physical examination showed no abdominal abnormalities, no abdominal pressure pain, and the stool test results were basically normal. The child’s stool frequency improved significantly after medication was given.
Basic information】Male, 4 years old
Type of disease】Pediatric diarrhea
Hospital】Shanghai Sixth People’s Hospital
Date of consultation】July 2021
Treatment plan】Medication (Bifidobacterium triplex + Bacillus subtilis bifidus pellets + Clostridium typhimurium tablets + montelukast)
Treatment period】3 days of home treatment
Effect】The number of stools improved significantly and the appetite of the child improved.
I. Initial consultation
The 4-year-old child came to the hospital with his parents. The parents said that the child’s stool was not good in the last week, sometimes 2-3 times a day, sometimes 4-5 times, but not much each time, no abdominal pain, vomiting, slightly dilute stool, but no abnormal odor. In the past 2 days, the child’s appetite was slightly worse than before. Usually, the child has a good appetite and likes to eat all kinds of things, especially snacks, snacks and candies. The child’s abdomen was examined, and there was no abdominal softness or pressure pain, no abnormal masses, and the stool test results were basically normal, so the child’s diarrhea was considered to be caused by improper diet and over-eating.
Second, the treatment process
Because the stool tests were basically normal, the stool report did not show any white blood cells or elevated red blood cells. Since rotavirus and adenovirus are more likely to occur in this season and the test results were negative, we initially ruled out intestinal infection and considered that it was caused by improper diet and over-eating. The parents of the child were advised to eat a lighter and simpler diet with less variety in these 2 days, and to take some oral probiotics to regulate the intestinal tract, such as Bifidobacterium triptans, Bacillus subtilis dibacterium granules, and Clostridium typhimurium live tablets. When the number of stools is particularly high, increase the oral montelukast, which can reduce the number of stools on the one hand, and play the role of gastrointestinal mucosa protection on the other.
III. Treatment effect
Three days after the initial consultation, the parents brought their child to the clinic again for a follow-up consultation, saying that he had started to drink mainly thin porridge and rice, and ate fewer kinds of vegetables every day. At present, the child’s stool has basically returned to once a day and is normal in nature, and his diet is slowly returning. Considering that the clinical treatment of pediatric diarrhea is effective, parents are advised to avoid snacks and refreshments and other foods.
IV. Notes
We are glad that the child’s symptoms have improved after treatment, but because the child’s digestive function and intestinal barrier function are slightly weak, the child’s nutritional intake does not need to be too varied to avoid increasing the intestinal burden. There are also norms for the daily intake of the affected children. Among the total amount of food that is regulated to be consumed, try to increase the amount of healthy and natural foods, and avoid or reduce the consumption of various snacks, snacks, cold drinks and the like. In case of diarrhea and diarrhea, parents can give some probiotics, or anti-diarrheal medicine, and can also send the stool to the hospital for laboratory tests.
V. Personal insight
By understanding the situation of the child in this case, it is clear that the child should have a rich diet in his daily life, but it is not recommended to have too much variety or overeat. In case of diarrhea, it is important to give a simple diet and hydrate promptly. In addition, oral probiotics or antidiarrheal medications can be used as a first step in home treatment, which are very widely indicated. If available, the stool can also be sent for examination in time, so that treatment and examination are not delayed.