Acute Gastroenteritis

Causes – it is an infection caused by a variety of viruses that results in vomiting or diarrhea. It is often called the “stomach flu,” although it is not caused by the influenza viruses. In general, the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days, depending on which virus caused the illness.

Transmission – The viruses that cause gastroenteritis are spread through close contact with infected persons. Individuals may also become infected by eating or drinking contaminated foods/beverages. Children can return to school when they are fever-free and vomit-free for 24 hours. Also, they need to be having less than 4 stools each day.

Treatment – The most important part of treating viral gastroenteritis is preventing severe loss of fluids (dehydration). This treatment should begin at home.

  • Keep Hydrated – The best fluid to treat/prevent dehydration is an oral re-hydration solution (ORS) like Pedialyte. ORS is available at pharmacies without a prescription. Though ultimately, the best fluid is going to be the one that your child will take. Alternatives to ORS are soup broth, diluted juices or even diluted milk. Many children will vomit if offered a large quantity of any fluid when they are dehydrated. So, the trick is to offer small amounts (1 tsp or 5 ml every 3-5 min). Over an hour, this will offer a lot of fluid without overwhelming the stomach. If your child vomits during this period, just keep going. If the vomiting persists despite oral re-hydration, then your child will need to go to an emergency room for intravenous fluid (IV).
  • Count wet diapers or frequency of urination – The goal is to offer enough fluid so that the child urinates 3-4 x in a 24 hr period. The child does not need to produce a large quantity of urine, so the diapers don’t have to be saturated. Urine just has to exist.
  • Skin care – the anus and buttocks can become quite irritated if exposed to very acidic stool. Clean the buttocks and anus after bowel movements with water. Alternatively, soak the child in a bathtub of warm water with baking soda (1/4 cup) sprinkled in. Apply a thick barrier ointment to the skin such as Desitin Original.
  • Medications (including antibiotics which have no effect on viruses) and other treatments should be avoided unless specifically recommended. There is absolutely no role for Imodium or Pepto-Bismol because the body needs to expel the virus. Rarely, we will recommend Zofran, a medication used to halt vomiting for a short period of time to allow oral re-hydration.

Call our office when:

  • child has not urinated in over 8 hours
  • bloody diarrhea
  • vomiting blood, something that looks like coffee grounds, or vomit that is lime green color
  • difficulty rousing your child to drink
  • other concerns

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