Lake Shore Pediatrics - Pediatric Topics - What's Up Doc?

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What's Up Doc? – Gastroenteritis
Dr. Diane Fondriest says many parents ask when they should be concerned about diarrhea and / or vomiting in children. Here are Dr. Fondriest's responses to the most frequently asked questions (FAQ's) on gastroenteritis.

Q: Exactly what is gastroenteritis?
A: Gastroenteritis is an inflammation of the mucous membrane of both the stomach and intestine. In general, the condition is associated with some fever, abdominal cramps, nausea, vomiting and diarrhea, where one or another symptom may be predominant. Gastroenteritis is caused by a virus or bacteria and can effect a person at any age, even small infants. It can be highly infectious so frequent hand washing is the best way to prevent its spread.

Q: When should I be concerned about my child's diarrhea or vomiting?
A: When an infant or child experiences persistent symptoms of frequent vomiting or frequent diarrhea, with episodes every 1/2 hour to an hour, over a 6 to 12 hour period, a call to the doctor's office is in order. We tell our patients to watch for signs of dehydration which include decreased urination, sticky rather than wet mouths, no tears and general listlessness. A parent should call immediately if their child has blood in their stool or diarrhea, or if they are vomiting green bile.

Q: How is gastroenteritis treated?
A: Most gastroenteritis is caused by a virus, and unfortunately, there is no magic medicine for its cure. The virus will run its course in three to five days, but there is a course therapy we recommend to allow the bowel to rest and heal. For all children, we suggest clear liquids for the first 12 to 24 hours to start. These liquids include Pedialyte or Gatorade, both of which are electrolyte solutions that help maintain body salts and sugars to prevent dehydration. Moms who are nursing can continue to do so. From there, diluted formulas can be added over the next day. Isomil DF (Diarrhea Formula) at half strength is recommended for children less than 1 year old, at full strength after 1 day. Older children can start with diluted milk. During this time, solids can be added including bananas, rice, apples and toast (BRAT diet). The important thing is to keep trying bland food in small amounts with some frequency. The body needs food as an energy source to help heal itself.

Q: What if the gastroenteritis is bacterial?
A: If a child's stool or diarrhea contains blood, we will culture a specimen to determine the particular bacteria that is causing the gastroenteritis. Salmonella and Shigella are two such bacteria. Depending on the cause, antibiotic therapy may be indicated. In cases of severe dehydration, we may need to admit a child for I.V. rehydration.