A father brings a girl, 11 months old, to the Emergency Department with a 5 month history of diarrhea which is described as frequent soft stools. There is no blood in the stool. The child has not been vomiting and has abdominal pain. Weight gain slowed significantly after about 6 months of age. There are no known sick contacts. The child is fully immunized and is formula fed plus a variety of solids. Family history reveals that the child's mother has type 1 diabetes. On examination the child looks tired. The vital signs are as follows, bp: normal, hr: normal and temp: 37.5°C. Abdomen is mildly distended. Perianal examination is normal. Skin examination is normal. 

What is the most likely diagnosis?

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Author

Dr. Joanna Holland

joanna.holland@iwk.nshealth.ca

Reviewers

Dr. Karen Forbes

Dr. Nicole Johnson

nicole.johnson@ahs.ca