Differential Diagnosis for Recurrent Diarrhea in a Toddler
Single Most Likely Diagnosis
- Toddler's diarrhea (or chronic nonspecific diarrhea): This is a common condition in toddlers characterized by recurrent, watery diarrhea without an identifiable cause, often related to a diet high in fruit juices or a rapid transit time through the gut.
Other Likely Diagnoses
- Gastroenteritis (viral or bacterial): Recurrent episodes of diarrhea could be due to repeated infections, common in toddlers due to their exposure to various pathogens at daycare or in the community.
- Lactose intolerance: Some toddlers may develop lactose intolerance after a gastrointestinal infection, leading to recurrent diarrhea when consuming lactose-containing products.
- Food allergy or intolerance: Allergies to foods like milk, eggs, or wheat can cause chronic diarrhea in toddlers.
- Irritable bowel syndrome (IBS): Although less common in toddlers, IBS can present with recurrent abdominal pain and changes in bowel habits, including diarrhea.
Do Not Miss Diagnoses
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis are rare in toddlers but can present with chronic diarrhea, weight loss, and abdominal pain. Missing these diagnoses can lead to significant morbidity.
- Celiac disease: An autoimmune reaction to gluten, which can cause chronic diarrhea, malabsorption, and failure to thrive if not diagnosed and managed with a gluten-free diet.
- Intestinal infection with a parasitic organism (e.g., Giardia): Certain parasites can cause chronic diarrhea and are important to diagnose due to the potential for treatment and prevention of further complications.
- Congenital or acquired immunodeficiency: Conditions affecting the immune system can predispose toddlers to recurrent and severe infections, including those causing diarrhea.
Rare Diagnoses
- Congenital enteropathies (e.g., microvillus inclusion disease, tufting enteropathy): These are rare genetic disorders affecting the small intestine and can cause severe, chronic diarrhea starting in infancy.
- Endocrine disorders (e.g., hyperthyroidism): Although rare, certain endocrine conditions can cause chronic diarrhea among other symptoms.
- Tumors of the gastrointestinal tract: Extremely rare in toddlers, but tumors can cause obstructive symptoms or chronic diarrhea depending on their location and nature.