What every parent needs to know about GASTROENTERITIS  

Causes:
This is a condition usually caused by irritation of the stomach and bowel by Infection (for example with viruses, bacteria or other types of germs). Other causes include eating spoiled food, dairy products (for those who are allergic to or intolerant of dairy products), medication (especially antibiotics) and laxatives.  


Symptoms:

One or more of the following symptoms may be seen: 

  • Diarrhoea (frequent passage of watery stools)
  • Abdominal Pain (with or without bloating)
  • Fever (usually low grade)
  • Nausea with or without vomiting

It is important to recognize the signs of dehydration as dehydration is one of the most serious complications of gastroenteritis. These include: 

  • Extreme thirst
  • Dry mouth (little or no saliva)
  • Lack of tears
  • Little or no urination (dry diapers in infants)
  • Lethargy or physical weakness
  •  Sunken eyes


When To Seek Medical Care:  

Dehydration (which is most likely to occur if vomiting and diarrhoea are present at the same time; if the vomiting and/or diarrhoea are recurrent with large volumes of fluid being lost – but not being replaced).  

Vomiting lasting for more than 48 hours.  

Blood in the Vomit or Stool.  

Swollen Abdomen or pain to the lower right side of the abdomen  

Fever higher than 101 degrees Fahrenheit. 

The passage of diarrhoeal stools often occurs for up to one week but may persist into a second week – if diarrhoea is still present after this seek medical attention as this will need investigation.  


Gastroenteritis Treatment:

The main treatment is to replace fluids lost with the Correct Fluids.  

The correct fluids include:

  • Pedialyte
  • Coconut Water
  • Oral Rehydration Fluids
  • Other acceptable fluids if available include Rapolyte, Resol, Rehydrate.  

After each loose stool children younger than 2 years should be given 1–3 Ounces (or 30-90 ccs/mls) of any of the rehydrations solutions.
Older Children should be asked to drink 3-8 ounces (or 90-240 ccs/mls).  

Additional fluids equal to the usual amount taken each day should also be given. Solid foods eventually help to end the diarrhoea – The child's usual diet should be administered (snacks, cookies, candy for instance are Not Recommended at this time or for the duration of the illness).
If vomiting is present, all fluids and food should be administered in small quantities at a time, and given frequently such as every 20 minutes.
Breastfeeding mothers should continue to breastfeed.    

Fluids to Avoid include:

  • Teas
  • Carbonated beverages
  • Fruit Juices
  • Sports drinks
  • Salty broths
  • Soups
  • Plain Water

(These will not correctly replace fluid and electrolytes lost from diarrhoea or vomiting and can actually prolong the diarrhoeal illness.)  

Gatorade has been shown to replace some but not all of the electrolytes lost during vomiting and diarrhoea and as a result should not be used to replace these losses.  

Medicines to stop diarrhoea or vomiting are not given routinely and should not be given unless they are prescribed by your child’s Paediatrician. In some but not all cases, intolerance of dairy products may develop during the course of diarrhoeal illness or for a while after the diarrhoea has stopped – if this occurs, dairy products should be withheld. Lactose free/Soy based formulas may be substituted at this time.  


Prevention: 

Handwashing after a visit to the bathroom/diaper change and especially before eating always!

Eat properly prepared and stored food.

Water for drinking should always be boiled and then cooled before being consumed.

 Avoid the use of bottles with nipples as even sterilization of these has been found to be inadequate in preventing diarrhoeal illness in children. Use of a clean cup and spoon is a better alternative. 

If your child is on antibiotic therapy when diarrhoea occurs call your child's Paediatrician and discuss this with him/her.

If your child has been prescribed laxatives to treat constipation they should be used only as prescribed and especially only for the recommended duration indicated by your child's Paediatrician.

 If despite reading the information given here you are still unsure about what to do, or you are uncomfortable with trying to treat your child at home, please call your child's Paediatrician for clarification or take your child in to the nearest health facility for evaluation and treatment.