Diarrea crónica en el ni？o

chronic diarrhea, defined as that lasting more than 4 weeks, is a common complaint in patients who present to the pediatrician's or pediatric gastroenterologist's office. causes of chronic diarrhea vary widely and differ according to the patient's age. in children under 6 months of age congenital anomalies and food allergies prevail; in preschoolers disaccharide intolerance, giardiais, nonspecific diarrhea and tumors are seen; in children of school age inflammatory bowel disease must be considered. celiac disease and infectious etiologies must be ruled out at all ages. the diagnostic approach should be organized, progressive and systematic; based on clinical history, starting with a nutritional evaluation and general workup to rule out infection, malabsorption or maldigestion. some cases may require further and more specific evaluation at the hands of a specialist. treatment should focus on preserving nutritional status, while specific therapies are instituted. chronic diarrhea should be managed initially by the general pediatrician, and referral to a pediatric gastroenterologist at a specialized facility may be needed at times for further management.