Diarrhea is a common symptom of many different problems. It often appears with other symptoms, which may help physicians determine the underlying cause. For example, children with diarrhea due to infection may also experience abdominal pain, abdominal cramping, fever and blood in the stool as a result of damage in the lining of the bowel. Nausea and vomiting may also occur with gastrointestinal infections.

Specific combinations of symptoms and possible causes include:

• Chronic diarrhea. This may be a symptom of lactose or sorbitol intolerance, infection or irritable bowel syndrome (IBS). Symptoms of abdominal bloating and excessive gas after consuming dairy products may indicate lactose intolerance. When diarrhea is accompanied by alternating episodes of constipation, as well as abdominal pain and frequent bowel movements, it may indicate IBS.
  
  
• Chronic bloody diarrhea. This may be a symptom of inflammatory bowel disease (IBD), especially if accompanied by abdominal pain, cramping and unintentional weight loss.
  
  
• Chronic oily or fatty diarrhea (stool often appears bulky, greasy or foul smelling). This may indicate absorption problems or other digestive problems. It may also indicate bile duct or liver diseases, celiac sprue (damage to the small intestine caused by eating gluten) or complications of intestinal surgery.

In some cases, children may pass large volumes of diarrhea. This can lead to dehydration as the body loses significant amounts of water and salt. Dehydration can be life-threatening for very young children and children with weakened immune systems. Infants can become dehydrated after just one or two days of severe diarrhea.

Signs of dehydration in children include:

• Darkened urine
  
  
• Dry mouth or tongue
  
  
• High fever
  
  
• Lack of tears when crying
  
  
• No wet diapers for three hours or more
  
  
• Poor appetite (anorexia)
  
  
• Rapid heartbeat
  
  
• Restlessness, irritability
  
  
• Skin that does not flatten after being pinched and released
  
  
• Sunken abdomen, eyes, cheeks, “soft spot” or fontanel (in babies younger than 18 months)
  
  
• Thirst
  
  
• Weight loss

Some signs that children need immediate medical attention include black stool, presence of blood or pus in stool, temperature of 101.4 degrees Fahrenheit (38.6 degrees Celsius) or higher, diminished responsiveness or a lack of improvement after 24 hours.