What is the treatment for diarrhea in an 11-year-old child?

From the Guidelines

For treating diarrhea in an 11-year-old child, the primary focus should be on preventing dehydration with oral rehydration solutions, and antimotility agents like loperamide should be avoided due to potential risks, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1. The child can continue eating a regular diet, focusing on bland foods like bananas, rice, applesauce, toast, and crackers. Key considerations include:

• Preventing dehydration with oral rehydration solutions like Pedialyte or a homemade solution (1 liter of water with 6 teaspoons of sugar and 1/2 teaspoon of salt) 1.
• Encouraging the child to drink small amounts frequently, aiming for at least 1-2 cups after each loose stool.
• Avoiding antimotility agents like loperamide in children under 18 years of age with acute diarrhea, as recommended by the guidelines 1.
• Monitoring for signs of dehydration, such as decreased urination, excessive thirst, dry mouth, and sunken eyes, and seeking medical attention if symptoms persist or worsen.
• Proper handwashing is essential to prevent spread to other family members. Some key points to consider when treating diarrhea in children include:
• The use of reduced osmolarity oral rehydration solution (ORS) as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause 1.
• The potential benefits and risks of antimotility agents like loperamide, which can reduce stool volume but may increase the risk of adverse events, particularly in children under 3 years old 1.
• The importance of advising patients about medications that may increase the risk of complications from diarrhea, such as antidiarrheal and antimicrobial agents 1.

From the FDA Drug Label

Pediatric Use Loperamide hydrochloride is contraindicated in pediatric patients less than 2 years of age due to the risks of respiratory depression and serious cardiac adverse reactions The safety and effectiveness of loperamide hydrochloride in pediatric patients with chronic diarrhea have not been established

The FDA drug label does not answer the question.

From the Research

Diarrhea Treatment for an 11-year-old

• The primary goal of treating diarrhea in children is to prevent dehydration, and oral rehydration therapy (ORT) with a rehydration solution can be used to treat mild to moderate dehydration 2.
• A child with minimal or no dehydration should be encouraged to continue their usual diet plus drink adequate fluids, as many studies have shown that a child's regular diet reduces the duration of diarrhea 2.
• Oral rehydration solutions (ORS) have been shown to be effective in managing acute diarrhea, and the World Health Organization (WHO) recommends the use of ORS to prevent dehydration 3, 4.
• Some studies suggest that modifications to the standard ORS, such as hypo-osmolar or hyperosmolar solutions, rice-based ORS, zinc supplementation, and the use of amino acids, may be beneficial in improving the effectiveness of ORS 3.
• However, other studies have raised concerns about the use of glucose-based ORS, suggesting that it may not appreciably reduce diarrheal stool volume and may even exacerbate a net secretory state 5.
• In cases of severe dehydration, intravenous hydration with isotonic saline solution may be necessary, and nutrition should be ensured after dehydration resolution to support intestinal and immune health 4.
• Symptomatic medications, such as ondansetron, may be used to decrease vomiting or help avoid the need for intravenous fluid, but they may also increase episodes of diarrhea 2, 6.
• Probiotics may be used to shorten the course of diarrhea, and good handwashing practices can help reduce the incidence of acute gastroenteritis 2.