Differential Diagnosis for Green Stool with Harder to Settle in a 13-Month-Old
Single Most Likely Diagnosis
- Gastroenteritis: This is the most common cause of green stool in infants, often due to a viral infection. The harder to settle behavior could be related to discomfort or pain associated with the infection.
Other Likely Diagnoses
- Food Intolerance or Allergy: Introduction of new foods can sometimes cause changes in stool color and consistency, along with fussiness in infants.
- Teething: While not directly causing green stool, teething can lead to increased saliva production, which may change stool consistency, and the discomfort can make the child harder to settle.
- Overfeeding or Foremilk Imbalance in Breastfed Babies: Can lead to green, frothy stools due to the high lactose content and may cause discomfort.
Do Not Miss Diagnoses
- Intussusception: Although less common, it's a serious condition where a part of the intestine slides into an adjacent part, potentially causing bowel obstruction. Green stool can be a sign, along with severe abdominal pain and drawing up of the legs.
- Pyloric Stenosis: Typically presents with projectile vomiting, but in some cases, can lead to changes in stool due to decreased feeding and subsequent dehydration.
- Infectious Diarrhea (Bacterial or Parasitic): Certain infections like Salmonella or Giardiasis can cause green stools and significant illness in infants.
Rare Diagnoses
- Cystic Fibrosis: A genetic disorder that can lead to malabsorption and changes in stool, including green color due to undigested fats.
- Biliary Atresia or Other Liver Disorders: Can cause changes in stool color, including green, due to issues with bile production or flow.
- Congenital Sucrase-Isomaltase Deficiency: A rare genetic disorder affecting carbohydrate digestion, potentially leading to abnormal stools.