Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that frequently affects infants and young children under the age of five. This highly contagious infection is typically mild, but it can cause significant discomfort for a period of about seven to ten days. While the name suggests where the primary symptoms appear, the illness is caused by a group of viruses that circulate throughout the body. Understanding the full range of symptoms is important for parents trying to care for an unwell child.
The Direct Answer: Gastrointestinal Symptoms and HFMD
Hand, Foot, and Mouth Disease is caused by viruses belonging to the enterovirus family, most commonly Coxsackievirus A16 or Enterovirus 71. These viruses naturally travel through and replicate within the gastrointestinal tract, which explains why symptoms related to the digestive system can occur. Therefore, the answer to whether HFMD causes diarrhea is yes, it can, though it is not a defining characteristic of the illness.
Diarrhea occurs in approximately one-third of affected individuals. Gastrointestinal symptoms are reported in a portion of HFMD cases. The diarrhea is generally mild, characterized by loose, watery stools, and may sometimes be accompanied by abdominal discomfort. Vomiting and a general decrease in appetite are also common initial signs that accompany the onset of the infection.
The presence of diarrhea, vomiting, or abdominal pain can begin during the initial phase of the illness, often alongside a fever and sore throat. Because the virus is shed in the stool for several weeks, the gastrointestinal involvement contributes significantly to how easily the infection spreads. Maintaining strict hygiene practices is necessary to limit transmission, especially when these digestive symptoms are present.
Defining the Classic Rash and Sores
The early phase of Hand, Foot, and Mouth Disease often begins with non-specific symptoms that resemble a common cold, such as a fever, sore throat, and a general feeling of being unwell. Within a day or two, however, the characteristic lesions begin to appear, which distinguish this infection from other common childhood viruses. These lesions include painful sores inside the mouth and a distinct rash on the skin.
The oral lesions often appear first and can be the most distressing symptom, as they make eating and drinking painful. They begin as small, red spots that develop into ulcers on the tongue, gums, and the inside of the cheeks. This condition, which is a form of herpangina, can lead to a refusal to swallow or drink, making hydration a primary concern for caregivers.
The rash on the body typically appears shortly after the mouth sores, manifesting as red or pink spots that may progress into small, fluid-filled blisters. This rash is usually not itchy, but the lesions can be tender or painful to the touch. The spots are most frequently located on the palms of the hands and the soles of the feet, which gives the illness its name.
The rash may also be found on other areas of the body, including the buttocks, knees, elbows, and around the genital area. Depending on the individual’s skin tone, the appearance of the spots can range from bright red to white or gray blisters, or they may present only as tiny, subtle bumps. The skin lesions usually resolve without scarring within seven to ten days.
Managing Discomfort and Hydration at Home
The treatment for Hand, Foot, and Mouth Disease is supportive, focusing on managing discomfort and preventing dehydration until the body clears the virus. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be administered to reduce fever and alleviate the pain from mouth sores and a sore throat. It is important to follow dosing instructions precisely based on the child’s age and weight.
Maintaining adequate fluid intake is the most important aspect of home care, especially if the child is experiencing diarrhea or refusing to drink due to oral pain. Offer small, frequent sips of cool liquids like water, milk, or oral rehydration solutions. Cold items such as ice pops or smoothies can be soothing to the throat and mouth.
Dietary modifications can help minimize irritation to the painful mouth ulcers. Caregivers should offer soft, bland foods that require minimal chewing, such as mashed potatoes, yogurt, or pureed soups. Acidic foods and beverages, including fruit juices and citrus fruits, should be avoided, as they can sting the open sores and increase the child’s discomfort.
Recognizing When to Seek Medical Attention
While Hand, Foot, and Mouth Disease is typically a self-limiting condition, certain symptoms indicate that professional medical evaluation is necessary. The most immediate concern is dehydration, which is signaled by a significant decrease in urination, a dry mouth, or a lack of tears when crying. Children who appear unusually weak or lethargic also require prompt attention.
Parents should contact a healthcare provider if a fever persists for more than three days or if the temperature remains high despite fever-reducing medication. Though rare, severe complications involving the nervous system, such as viral meningitis or encephalitis, can occur with HFMD. Warning signs for these conditions include a severe headache, a stiff neck, confusion, or sudden seizures.
If the child is inconsolable, difficult to wake, or experiencing difficulty breathing, it is important to seek emergency medical care immediately. Any unusual symptoms, a worsening condition, or a failure of symptoms to improve after ten days should prompt a call to a doctor for further guidance.