Gastroenteritis

Gastroenteritis is a term to describe inflammation in the stomach and/or small intestine. The causes are numerous, but in children the most common cause is viral infections.

These viruses are usually ingested and disrupt the normal digestive processes. The lining of the gut is unable to absorb nutrients as it usually does, leaving an excess of fluid and undigested food. This presents as diarrhoea (frequent, loose stool) more often than vomiting, although both can be present at the same time. Additional symptoms include fever, nausea, reduced appetite and lethargy. The most important symptom to look out for and prevent is dehydration. In smaller children this can happen very quickly because of their smaller body volume. Early signs of dehydration include irritability, increased thirst, dry lips, no tears when crying and dark yellow urine.

The mainstay of treatment is hydration. For younger children this can be maintained with breastfeeding/formula feeding and in older children, oral rehydration solution (ORS). This is better than plain water because is replenishes electrolytes (sodium, chloride, potassium, bicarbonate). The salt & sugar allow water to enter the body’s cells easily. Additional treatment like zinc (taken orally) helps with repairing the lining of the stomach and intestines. A good barrier cream (that contains zinc) will help prevent or treat nappy rashes that invariably occur. An anti-spasmodic can be given to alleviate stomach cramps and paracetamol will help with fever. 

Red flags to note, that will warrant a visit to a doctor include: an inability to keep all food and fluids down, blood in the stools and reduced level of consciousness. In these cases, intravenous fluids and antibiotics might be warranted.

Prevention strategies

• Regular hand washing
• Sterilising bottles/teats/pacifiers
• Rotavirus vaccine
  

Homemade ORS recipe

• 1 litre of boiled water which is then cooled to room temperature
• 8 teaspoons of sugar
• ¼ teaspoon of salt

Please note that this solution is not very palatable, so give it slowly and you can add a bit of juice to help. 

Plain foods such as bread, oats, rice and broth are advised during the course of the illness. Normal appetite will return, and any weight lost will be regained. If ever you are concerned or unsure of anything, rather visit your doctor. 

Myth busting

• Anti-diarrhoeal and antiemetic (anti vomiting) medication are not recommended for children. They simply mask the symptoms but don’t actually treat the cause, thus can give a false impression of the illness resolving.
• Milk products should be avoided because they contain lactose that is difficult to digest when the stomach and intestinal linings are inflamed, However, this does not include breast milk or formula which are ideal for keeping smaller babies hydrated.