What is the 'objective' differential factor of diarrhea in infancy?: Normal state versus diarrheal illness in infants with chronic frequent and loose stool.
OBJECTIVE
This study aimed to identify 'objective' differential factors for normal frequent loose stool (NFLS) and diarrheal illness with dehydration and nutritional deficiency (DIDN) among infants with chronic frequent loose stool (CFLS).


METHODS
Data were analyzed from infants under 2 years of age with CFLS who had been transferred from general pediatricians. These 46 patients were divided into 2 groups (NFLS versus DIDN). Nocturnal stool was defined as evacuation between 10 pm and 6 am. Maximal stool amount/day (measured using the mother's hand) was specified as the highest score during the period of CFLS obtained by adding up each evacuation's score (range, 0-2 points).


RESULTS
There were 36 cases of NFLS and 10 of DIDN. A failure to gain weight (P=0.0001), fever (P=0.0079), colic/abdominal pain (P=0.0014), gross blood in stool (except allergic proctocolitis) (P=0.0113), nocturnal stool (P=0.0001), and the score of stool amount (P=0.0001) were found to significantly differentiate the groups. A failure to gain weight was observed in 39% of even NFLS. The frequency, mucus content, and microbiological findings of stools, as well as diaper dermatitis were not found to significantly differentiate the groups.


CONCLUSIONS
NFLS was more common than DIDN in infants with CFLS. The most 'objective' differential factors were nocturnal stool and the score of stool amount (≥7 points/day).
Department of Pediatrics, Keimyung University, School of Medicine, Daegu, Korea.
Jin-Bok
JB
Hwang
Kyung Ji
KJ
Kang
Jung Jeung
JJ
Lee
Ae Suk
AS
Kim
J Pediatr. 2009 Jul;155(1):129-32
19559297
Gastroenterology. 1995 Jun;108(6):1729-38
7768377
Pediatr Clin North Am. 1991 Jun;38(3):667-86
2047145
J Gastroenterol Hepatol. 2005 Feb;20(2):182-6
15683418
Pediatr Allergy Immunol. 2007 Jun;18(4):360-7
17584315
Gut. 1999 Sep;45 Suppl 2:II60-8
10457047
J Korean Med Sci. 2007 Apr;22(2):213-7
17449926
Eur J Clin Microbiol Infect Dis. 2005 Aug;24(8):559-61
16096776
Nestle Nutr Workshop Ser Pediatr Program. 2005;56:73-9; discussion 79-84
16632945
Pediatrics. 2006 Sep;118(3):1279-86
16951027
J Pediatr Gastroenterol Nutr. 1988 Sep-Oct;7(5):637-40
3054038