Kids Love Dr. Barton

Gastroenteritis

by Dr. Douglas Barton, M.D., Pediatrician 01/22/2009


It’s the middle of the night and suddenly… What was that sound? You head to the kids’ room and find your daughter in a pool of fluid that vaguely resembles her dinner! It’s a scenario that happens all too often and this season seems particularly bad.

Gastroenteritis, or the “stomach flu,” occurs year round, but seems to be the worst in the dead of winter. It is caused by a wide variety of organisms. Most are unidentified viruses, but rotavirus, salmonella, shigella and e. coli account for some of the havoc. Usually the symptoms are vomiting for 6-24 hours with diarrhea that may be only one or two stools a day for a couple of days, or as many as 10-15 stools lasting one or two weeks. The two biggest concerns with gastroenteritis are dehydration and spreading the illness to someone else.       

There are no magic bullets that make the dreaded vomiting go away. The treatment is to make sure your child does not become dehydrated. Once your child starts throwing up, give him or her 20-30 minutes for the stomach to settle a little, then try a few SMALL sips of water. Keep trying small sips as frequently as every 10-20 minutes. Other clear fluids can be used such as Gatorade or Pedialyte. In older kids, chicken broth, Sprite, tea or apple juice may be helpful. Just remember small volumes frequently. Sometimes, your child’s doctor may be able to prescribe a medicine called Zofran to ease nausea and vomiting. If after 8-12 hours of this treatment, your child continues to vomit every time he or she gets sips, it may be time to receive IV fluids in the emergency room.

Once the vomiting stops, usually, the next step is to prevent dehydration from the diarrhea. In older kids, yogurt may play a role in slowing the stools. Over-the-counter anti-diarrhea medications are not very helpful for diarrhea in children, so I don’t recommend them. There is also some evidence that 20 mg of zinc a day during diarrhea episodes may help; however, I’ve been unable to find a preparation that children can take.

Often, younger children will develop quite the diaper rash from the diarrhea. A combination of Desitin, Neosporin, and Lotrimin AF, all over-the-counter can be very helpful as a diaper cream.          

The question always comes up, “When should I take my child to the ER?” If your child is becoming lethargic, not urinating over the course of 8-10 hours, refusing to drink fluids and/or very irritable, IV fluids may be the only way to make your child feel better. At that point, it’s time for an ER visit.

 

 

 

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