Chronic diarrhoea in infants and young children: causes, clinical features and outcome.
OBJECTIVE
To review the causes, clinical features and outcomes of Malaysian children who had chronic diarrhoea.


METHODS
A prospective study was performed on children with diarrhoea of more than 14 days' duration who were managed at the Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur from 1 January 1996 to 31 December 1997.


RESULTS
Twenty-seven patients (14 boys and 13 girls) were studied. The median age of onset of diarrhoea was 6 months and the mean duration of symptoms before referral was 66.5 days. The underlying causes of diarrhoea were found to be: (i) prolonged diarrhoea due to well-defined entities (intestinal lymphangiectasia, two cases; congenital glucose-galactose malabsorption, one case; post-small bowel resection, one case; (ii) postenteritis diarrhoea (cow's milk protein intolerance, eight cases; secondary lactose intolerance, four cases; transient monosaccharide intolerance, one case; (iii) gastrointestinal infections (nontyphoid Salmonella gastroenteritis, three cases; trichuriasis, two cases; amoebiasis, one case; adenovirus, one case; (iv) cases in which a firm diagnosis could not be established (three cases). The mean duration of hospital admission was 63 days. Sixteen cases required a change in diet, while nine cases required total parenteral nutrition. One death occurred.


CONCLUSIONS
Chronic childhood diarrhoea in Malaysia had a variety of aetiologies. A specific diagnosis could be established in 90% of cases. Making a diagnosis was important because this led to appropriate therapy and a good outcome in 96% of cases.
Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. drleews@pc.jaring.my
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Lee
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Boey
D017668:Age of Onset; D002675:Child, Preschool; D002908:Chronic Disease; D003967:Diarrhea / Q000178:diet therapy / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome