UMEM Educational Pearls

Category: Pediatrics

Title: Chronic nonspecific diarrhea (CNSD)

Posted: 7/5/2009 by Rose Chasm, MD (Updated: 10/21/2021)
Click here to contact Rose Chasm, MD

  • CNSD, also known as toddler's diarrhea
  • the most common cause of chronic diarrhea in childhood
  • possibly a variant of irritable bowel syndrome, family history of IBS is common
  • children are 6-58 months of age, most commonly 11-24 months old)
  • otherwise in good health with normal weight gain, without signs of malabsorption syndrome or enteric infection
  • morning stool is the most formed, with the stools becoming progressively looser through the day that are malodorous with food particles
  • most often due to dietary factors causing altered gastrointestinal motility such as reduced fat intake or excessive fluid intake, especially sucrose-containing fruit juices
  • treatment is based on modification of the contributing dietary factors


Davidson M, Wasserman R. The irritable colon of childhood (chronic nonspecific diarrhea syndrome). J Pediatr. 1996;69:1027-1038

Kneepkens CM, Hoekstra JH. Chronic nonspecific diarrhea of childhood: pathophysiology and management. Pediatr Clin North Am. 1996;43:375-390