Acute gastroenteritis is an infection of the intestinal tract that causes vomiting and diarrhoea. It is commonly caused by a viral infection, though it can sometimes be caused by bacteria.
The biggest concern with this infection is dehydration, especially in young infants. Ensuring adequate hydration and using medications to reduce vomiting and diarrhoea are key to managing the condition.
Signs And Symptoms Of Gastroenteritis
Symptoms and signs of this condition may include the following:
Vomiting usually starts first and may last 1-2 days – this is the forceful expulsion of contents from the mouth
Diarrhoea follows and can last for a few days to a week typically
Abdominal pain
Fever
When Should Parents Be Concerned?
If the vomitus is greenish or has blood streaks (reddish streaks)
If the diarrhoea episodes last for 10 days or more
If your child is curling up in severe pain, or has inconsolable crying
If your child is not eating or drinking well, their urine output may decrease and you may notice no wet diapers for about 6 hours
If your child appears tired
If your child is very young – less than 6 months of age
If any of the above is observed, parents should bring their child to a doctor as soon as possible.
The doctor will check on your child’s hydration status and examine your child’s abdomen. Anti‑vomiting medication may be administered in the clinic or the Children’s Emergency, and additional medication may be prescribed to reduce diarrhoea volume at home. If there are signs of significant dehydration, they may need to be admitted to hospital for hydration through an intravenous drip or a nasogastric tube.
Antibiotics are not usually required for most cases of gastroenteritis.
Treatment and Management options
Apart from those with the concerning signs listed above, most children with gastroenteritis can otherwise be managed at home first.
Encourage your child to take fluids.
This may be in the form of oral electrolyte solutions such as Pedialyte, or Hydralyte. Other solutions may include rice water, broth or barley water.
For young infants who are predominantly on milk feeds, they can continue their usual milk. For formula‑fed infants, continue preparing the formula at the normal dilution as directed by the manufacturer.
Aim to feed your child some fluids every hour.
An average of 10ml/kg/hour of fluids can be given, as a general guide.
For breastfeeding children, consider increasing the frequency of feeding, especially if the duration of each feed is reduced.
Soft solid foods may be continued if tolerated. Avoid items such as fruit juice and spicy or oily foods, which may worsen the diarrhoea. If you child cannot tolerate any feeds and keeps vomiting over the next 3-4 hours, please seek medical attention.
Ensure that there is urine output or urine in the diapers at least every 6 hours. Frequently change soiled diapers, with gentle washing instead of wiping of the bottom. Using barrier creams containing zinc may help prevent or reduce diaper rash caused by diarrhoea.
Summary
Acute gastroenteritis is common in childhood, and good hand and bottle hygiene can help reduce the spread of this infection.
When it does occur, the mainstay of treatment is ensuring good hydration, with small, frequent fluids in the form of oral rehydration salts and milk in young infants; solid foods that are easy to digest can also be given. If there are signs of dehydration or a change in your child’s behaviour, parents should bring their child to the doctor for evaluation as soon as possible. Medications play a supportive role as well, though antibiotics are not usually helpful or required.
Parents should also be cautious if their child has persistent vomiting without developing diarrhoea in the days that follow, as vomiting can be caused by many conditions other than gastroenteritis.
