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What Causes Fever, Cough, Cold And Loose Stool In An Infant?
Question: Hello,
My son is 14 months old and had lose, frequent stools in the last several days. Today, I saw black XXXXXXX seed looking specks in his stool. When pressed, they are very soft like mucous and dissolve between fingers. My son had a general cold last week and has had no fever for several days now. But the lose stools continue days after his fever and cold subsided. What is up with those black specks? What would be the first thing that comes to your mind?
My son is 14 months old and had lose, frequent stools in the last several days. Today, I saw black XXXXXXX seed looking specks in his stool. When pressed, they are very soft like mucous and dissolve between fingers. My son had a general cold last week and has had no fever for several days now. But the lose stools continue days after his fever and cold subsided. What is up with those black specks? What would be the first thing that comes to your mind?
Brief Answer:
This may be undigested food
Detailed Answer:
Hello
Thanks for asking on this platform
The most common cause of fever,cough,cold and loose stool in this age is some viral infection.
The fever and cold has subsided this also suggests it's viral origin.
In case of bacterial infection the conditions gets deteriorated and fever remains high.So chances of bacterial infection is remote.
The loose motion a are very common during viral illness and it may persist for 7-10 days even after subsidence of cough,cold and fever.
The black colored material coming in stool may be improperly digested food material.
I won't get overly worried if baby is active,accepting feeds well,passing urine and there is no vomiting.
During loose motion,the inner intestinal layer gets flattened (loss of absorptive surfaces called villi)leading to poor absorption.
It may take 7-10 days for complete recovery.
The main aim of management is giving plenty of fluids to avoid dehydration.
Giving probiotics and zinc supplementation helps in early recovery.
I would suggest you to observe the baby closely and if the baby gets lethargic or the oral acceptance gets poor consult your physician.
I hope this helps.
I shall be glad to help you out if you have any more doubts.
regards
This may be undigested food
Detailed Answer:
Hello
Thanks for asking on this platform
The most common cause of fever,cough,cold and loose stool in this age is some viral infection.
The fever and cold has subsided this also suggests it's viral origin.
In case of bacterial infection the conditions gets deteriorated and fever remains high.So chances of bacterial infection is remote.
The loose motion a are very common during viral illness and it may persist for 7-10 days even after subsidence of cough,cold and fever.
The black colored material coming in stool may be improperly digested food material.
I won't get overly worried if baby is active,accepting feeds well,passing urine and there is no vomiting.
During loose motion,the inner intestinal layer gets flattened (loss of absorptive surfaces called villi)leading to poor absorption.
It may take 7-10 days for complete recovery.
The main aim of management is giving plenty of fluids to avoid dehydration.
Giving probiotics and zinc supplementation helps in early recovery.
I would suggest you to observe the baby closely and if the baby gets lethargic or the oral acceptance gets poor consult your physician.
I hope this helps.
I shall be glad to help you out if you have any more doubts.
regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you, Doctor!
Everything you described makes sense. But here is something weird, if you could please help us understand it. The baby's fever started on the 13th of XXXXXXX Then, by the 17th there was no fever. However, his diarrhea started on the 20th of XXXXXXX and was gone by the 23rd of XXXXXXX He looked and acted fine. No fever, no diarrhea. Then, all of a sudden, yesterday - XXXXXXX 25th - he had severe vomiting. Could this vomiting be related to the same viral infection?
We are trying to understand why he vomited. If the timeline doesn't make sense and this is not related to the same viral infection, then what is more likely, food poisoning or overeating? On the day of his vomiting yesterday, he ate a lot of sheep yogurt in one sitting (about 3-4 tbs). He had some beef and squash with it too (another 3 tbs). He acted fine after his meal, played well and fell asleep. An hour later, he woke up and was playing, when all of a sudden (after about 15-20 minutes) he started vomiting. What comes to your mind first, when you read this?
Thank you so much in advance for sharing more of your insight with us. We look forward to hearing from you!
Everything you described makes sense. But here is something weird, if you could please help us understand it. The baby's fever started on the 13th of XXXXXXX Then, by the 17th there was no fever. However, his diarrhea started on the 20th of XXXXXXX and was gone by the 23rd of XXXXXXX He looked and acted fine. No fever, no diarrhea. Then, all of a sudden, yesterday - XXXXXXX 25th - he had severe vomiting. Could this vomiting be related to the same viral infection?
We are trying to understand why he vomited. If the timeline doesn't make sense and this is not related to the same viral infection, then what is more likely, food poisoning or overeating? On the day of his vomiting yesterday, he ate a lot of sheep yogurt in one sitting (about 3-4 tbs). He had some beef and squash with it too (another 3 tbs). He acted fine after his meal, played well and fell asleep. An hour later, he woke up and was playing, when all of a sudden (after about 15-20 minutes) he started vomiting. What comes to your mind first, when you read this?
Thank you so much in advance for sharing more of your insight with us. We look forward to hearing from you!
Brief Answer:
Most likely due to overeating or indigestion
Detailed Answer:
Thanks for follow up
I have gone through the details and to me also it appears to be due to indigestion or overeating.
We can not correlate it with previous illness of diarrhea and fever because of long asymptomatic period in between.
Also I have noticed that he remained well before and after vomiting.
I won't get worried for single episode of vomiting if there is no associated fever,loose stool;child is active and accepting feeds well.
Regards
Most likely due to overeating or indigestion
Detailed Answer:
Thanks for follow up
I have gone through the details and to me also it appears to be due to indigestion or overeating.
We can not correlate it with previous illness of diarrhea and fever because of long asymptomatic period in between.
Also I have noticed that he remained well before and after vomiting.
I won't get worried for single episode of vomiting if there is no associated fever,loose stool;child is active and accepting feeds well.
Regards
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thank you again, Dr. Kumar!
Your response makes perfect sense to us. One last follow up question for you is this. Could indigestion, especially if it's once a week, be caused by silent acid reflux? In other words, could overproduction of acid in our son's stomach cause him to not be able to digest certain foods? Below is a little bit of background behind my question.
Our son has multiple food intolerances (FPIES). He has a chronic issue with microscopic blood in stool almost all of his life. It's usually always related to ingesting some sort of food that doesn't work for him. In the last month or so, he has vomited undigested food at least once a week. This was even before his viral infection. What I have noticed is that every time he has a vomiting episode, there is a lot of acid reflux for a couple of days afterwards.
In your opinion, could it be that his food indigestion related to his food intolerances is the result of overproduction of acid in his stomach? Or is it the other way around, that when he vomits, acid reflux gets initiated? I have a theory with him that both his indigestion/intolerances with foods as well as his blood in stool are all related to overproduction of acids in his stomach. For example, if he has orange juice through breastmilk, he'll have massive blood in stool. But acidic foods are not the only thing that he reacts to. He has reacted to oatmeal and lentils with blood in stool in the past.
The issue is, on normal days (no vomiting), there are no signs of acid reflux with him - no wet burps, no spit ups. Could it be that acid builds up for him to the point that he is unable to digest his foods and they come back up into his throat and he vomits?
Could my theory with my son be correct, based on the details I described? You seem to be a very astute and experienced doctor. We appreciate your help in advance and look forward to hearing from you!
Your response makes perfect sense to us. One last follow up question for you is this. Could indigestion, especially if it's once a week, be caused by silent acid reflux? In other words, could overproduction of acid in our son's stomach cause him to not be able to digest certain foods? Below is a little bit of background behind my question.
Our son has multiple food intolerances (FPIES). He has a chronic issue with microscopic blood in stool almost all of his life. It's usually always related to ingesting some sort of food that doesn't work for him. In the last month or so, he has vomited undigested food at least once a week. This was even before his viral infection. What I have noticed is that every time he has a vomiting episode, there is a lot of acid reflux for a couple of days afterwards.
In your opinion, could it be that his food indigestion related to his food intolerances is the result of overproduction of acid in his stomach? Or is it the other way around, that when he vomits, acid reflux gets initiated? I have a theory with him that both his indigestion/intolerances with foods as well as his blood in stool are all related to overproduction of acids in his stomach. For example, if he has orange juice through breastmilk, he'll have massive blood in stool. But acidic foods are not the only thing that he reacts to. He has reacted to oatmeal and lentils with blood in stool in the past.
The issue is, on normal days (no vomiting), there are no signs of acid reflux with him - no wet burps, no spit ups. Could it be that acid builds up for him to the point that he is unable to digest his foods and they come back up into his throat and he vomits?
Could my theory with my son be correct, based on the details I described? You seem to be a very astute and experienced doctor. We appreciate your help in advance and look forward to hearing from you!
Brief Answer:
Apart from reflux other causes should also sought for
Detailed Answer:
Hello
I have read query thoroughly and concluded that reflux due to erosion could be a cause of bleeding and/or vomiting but other causes like celiac disease should also be ruled out.
I would like to know if there is any associated pain,if child is thriving normal or there is any history of poor weight gain.
Blood in stool with reflux or vomiting can be due to some erosion in the stomach.Here you have not mentioned the hsitory of pain which should be there in case of reflux with erosion/ulcer.
Other cause can be intolerance to gluten or prolamine containing foods like wheat/rye/barley called celiac disease.But you have mentioned that he has intolerance to orange juice/lentils also.
I would suggest you to go for thorough investigations like upper GI endoscopy,Technetium scan,celiac serology and stool test after consulting a physician to find out the exact cause.
Please feel free to ask further queries if you have any.
Wishing for your child's good health.
Regards
Apart from reflux other causes should also sought for
Detailed Answer:
Hello
I have read query thoroughly and concluded that reflux due to erosion could be a cause of bleeding and/or vomiting but other causes like celiac disease should also be ruled out.
I would like to know if there is any associated pain,if child is thriving normal or there is any history of poor weight gain.
Blood in stool with reflux or vomiting can be due to some erosion in the stomach.Here you have not mentioned the hsitory of pain which should be there in case of reflux with erosion/ulcer.
Other cause can be intolerance to gluten or prolamine containing foods like wheat/rye/barley called celiac disease.But you have mentioned that he has intolerance to orange juice/lentils also.
I would suggest you to go for thorough investigations like upper GI endoscopy,Technetium scan,celiac serology and stool test after consulting a physician to find out the exact cause.
Please feel free to ask further queries if you have any.
Wishing for your child's good health.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. XXXXXXX
This is very helpful, as all your previous responses.
You are absolutely right about the pain/irritability observation. He doesn't seem to be in pain, but when he has heartburn, he gets a little unhappy for a few minutes.
We've done some of the tests your recommended. He was diagnosed with multiple food intolerances as a result. Now we also see acid reflux as another issue on top of the food intolerances.
Based on this, I have one more follow-up question.
If his chronic blood in stool is a sign of food intolerances rather than acid reflux, and most of the time it is in very microscopic amounts, could there be a long term damage to his gut, colon or any other organs from such constant bleeding?
The truth is, despite our best efforts, we are unable to keep his stools blood free for long periods of time. There is usually some food that irritates him for one reason or another. For example, he could be tolerating something well for a long time but then in combination with something else or too much of it, and he gets blood in stool.
My big worry is that as he is growing older and hopefully outrgowing some of his intolerances, the damage to his gut from acid reflux and to his colon/intestines from this constant bleeding could be too much and could create permanent problems.
Do you agree with this? One GI specialist we talked to told us that there was no such thing as permanent damage and that the lining of the gut and intestines would re-build themselves, when he has outgrown his food intolerances.
What is your take on this, given your education and experience about human body?
Thank you! Look forward to hearing from you!
This is very helpful, as all your previous responses.
You are absolutely right about the pain/irritability observation. He doesn't seem to be in pain, but when he has heartburn, he gets a little unhappy for a few minutes.
We've done some of the tests your recommended. He was diagnosed with multiple food intolerances as a result. Now we also see acid reflux as another issue on top of the food intolerances.
Based on this, I have one more follow-up question.
If his chronic blood in stool is a sign of food intolerances rather than acid reflux, and most of the time it is in very microscopic amounts, could there be a long term damage to his gut, colon or any other organs from such constant bleeding?
The truth is, despite our best efforts, we are unable to keep his stools blood free for long periods of time. There is usually some food that irritates him for one reason or another. For example, he could be tolerating something well for a long time but then in combination with something else or too much of it, and he gets blood in stool.
My big worry is that as he is growing older and hopefully outrgowing some of his intolerances, the damage to his gut from acid reflux and to his colon/intestines from this constant bleeding could be too much and could create permanent problems.
Do you agree with this? One GI specialist we talked to told us that there was no such thing as permanent damage and that the lining of the gut and intestines would re-build themselves, when he has outgrown his food intolerances.
What is your take on this, given your education and experience about human body?
Thank you! Look forward to hearing from you!
Brief Answer:
I agree with your doctor
Detailed Answer:
Hi
Thanks again for follow up
I agree with your doctor.Constant exposure to the food to which child is intolerant leads to erosion to the intestine and prevents complete recovery.But if the inciting food items are being removed from the child's diet or the system gets adapted to it(as the child grows up),the intestinal cells start regenerating causing healing of erosion and complete recovery.
So try to avoid the foods causing intolerance.This will help in rapid recovery and proper growth of the child.
Regards
I agree with your doctor
Detailed Answer:
Hi
Thanks again for follow up
I agree with your doctor.Constant exposure to the food to which child is intolerant leads to erosion to the intestine and prevents complete recovery.But if the inciting food items are being removed from the child's diet or the system gets adapted to it(as the child grows up),the intestinal cells start regenerating causing healing of erosion and complete recovery.
So try to avoid the foods causing intolerance.This will help in rapid recovery and proper growth of the child.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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