Gastroenteritis

What is Gastroenteritis?

Gastroenteritis is also known to some as the "stomach flu" or "intestinal flu," but it is not really flu at all.  The illness can include vomiting, diarrhea, and dehydration.  The incubation period is usually one to two days after exposure.  The average child has one to two cases per year, but children in daycare can have up to three times as many occurrences.  This overview is mainly related to viral gastroenteritis, which represents over 90% of cases. Most occurrences are brief and will go away without treatment; however, some children can become dehydrated, requiring hospitalization.  A small percentage of children die each year in the U.S. from these diseases.

 

Causes

Gastroenteritis can be caused by several different viruses, bacteria, or parasites. It is spread through improper hand washing and contamination by stools or vomiting.

 

Symptoms

Although not always present, vomiting is usually the first symptom seen with gastroenteritis. It is often associated with low-grade fevers. If there is any blood or dark green color in the vomit, call your physician immediately. Diarrhea usually begins within 48 hours of vomiting, although it is not always present. A wide variety of stools occur with gastroenteritis from a few mild loose or mushy stools to severe, constant, watery, explosive stools. If you ever notice blood or mucus in stools, call our office immediately. A green stool indicates a very rapid passage of contents through the gastrointestinal tract. Keeping your child on nothing but clear fluids for more than two days can cause green watery stools called "starvation stools." Dehydration is a side effect of gastroenteritis that is critical to avoid. Signs of dehydration include:

• No urine output for eight hours
• Dark-colored urine
• Lack of moisture on the inside of the mouth
• Sunken eyes or sunken “soft spots” on your infant’s head
• No tears when crying
• Listless or difficult to arouse child

If any one of these symptoms occurs, call us. Occasionally gastroenteritis will mimic other conditions which can be more serious, or your child may have a more serious bacterial gastroenteritis. If your child has any of the following symptoms, call our office right away.

• Shortness of breath
• Worsening abdominal pain
• Stomach swelling
• Bloody or mucusy stools
• "Currant jelly" appearing stools
• Diarrhea lasting longer than seven days

 

Treatment

There is no medication to make viral gastroenteritis go away. Medications such as Immodium (Lomotil), Pepto Bismol or Kaopectate can actually make your child’s symptoms last longer. Your child’s immune system is the best medication against gastroenteritis. Sometimes your provider may recommend a medicine such as Zofran or a probiotic to help with some of the symptoms. By using the measures below, your child should recover without complication from gastroenteritis within two to seven days.

 

Vomiting and diarrhea cause your child’s body to lose fluids as well as salts called "electrolytes," such as sodium and potassium. You need to replace these salts with the liquids that you are feeding your child. These salts can be found in "oral rehydration solutions (ORS)" such as Pedialyte, Infalyte, and Kayolectrolyte.

 

Normally infants may continue on breast milk or formula.  It is advisable to feed smaller amounts more frequently.  If their symptoms persist, they may need ORS for several hours, returning to breast milk or formula if they stop vomiting for 4-8 hours.  In children over 1 year, they may take water.  If a child can’t keep water down, they can take ORS if they also have watery diarrhea.  If they refuse ORS, they may take 1/3 strength Gatorade or ½ strength Pedialyte.  If you have other questions regarding your child’s intake, please contact our office or after-hours Nurse Advice Line.

 

To treat your child’s diarrhea:
The American Academy of Pediatrics and many universities have done studies on what to feed children with diarrhea. The results were surprising to many people. In general, you can feed your child a regular age appropriate diet once the vomiting has stopped. This includes milk products. This has been found to help provide nutrients which help the lining of intestines to heal. Regular diets usually do not lengthen the time of diarrhea or worsen the symptoms of the illness. Well-tolerated foods are complex carbohydrates such as breads, cereals and rice.