Abstract I describe two children with chronic diarrhea who had multiple admissions and numerous nondiagnostic procedures before the correct diagnosis of factitious diarrhea caused by laxative ingestion or diet manipulation by a parent was discovered. Report of Cases.—Case 1.—This was the fifth hospitalization because of vomiting and diarrhea for this 23-month-old female infant. Her mother had four previous miscarriages because of prematurity. The mother and father had separated before the birth of this child, and the child and mother lived alone. By history, the child had unexplained fever and had passed ten to 15 watery stools each day since infancy. The patient was pale and irritable, and her weight and height had fallen from the 50th to the fifth percentile. During this hospitalization, the child had watery, pink-tinged stools that averaged 250 g/day. An extensive evaluation disclosed that the following studies yielded normal findings: complete blood cell (CBC) count, References 1. Read N, Kreus G, Read M, et al: Chronic diarrhea of unknown origin . Gastroenterology 1980;78:264-271. 2. Bockus H, Willard J, Bank J: Melanosis coli: The etiologic significance of the anthracene laxatives: A report of four cases . JAMA 1933;101:1-6.Crossref 3. Morris A, Turnberg L: Surreptitious laxative abuse . Gastroenterology 1977;77:780-786. 4. Burkitt D, Walker A, Painter N: Effect of dietary fibre on stools and transit times and its role in the causation of disease . Lancet 1972; 2:1408-1411.Crossref 5. Lloyd D, Borda I: Food-induced heart burn: Effect of osmolality . Gastroenterology 1981; 80:740-741. 6. Cohen S, Mathis R, Walker W: Chronic nonspecific diarrhea: Role of dietary management in control . Pediatr Res 1978;12:432.Crossref 7. Lloyd-Still J: Chronic diarrhea of childhood and the misuse of elimination diets . J Pediatr 1979;95:10-13.Crossref 8. Fleisher D, Ament M: Diarrhea, red diapers, and child abuse . Clin Pediatr 1977;17:820-824.Crossref 9. Ackerman N, Strobel C: Polle syndrome: Chronic diarrhea in Munchausen's child . Gastroenterology 1981;81:1140-1142.
American Journal of Diseases of Children – American Medical Association
Published: Nov 1, 1982
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