children s health issues
Gastroenteritis in Children
Treatment of Gastroenteritis in Children
Fluids and rehydration solutions Rarely antibiotics for certain infections Usually the only treatment needed for gastroenteritis is getting bed rest and drinking an adequate amount of fluids. Once a child has gastroenteritis, parents should monitor their child’s hydration status. Medications that stop diarrhea or antibiotics might be given but only in certain specific situations under the guidance of a doctor. Children should be encouraged to drink fluids even if just in small, frequent amounts. Infants should continue to breastfeed or drink formula in addition to an oral electrolyte solution ( Treatment —available as powders and liquids in pharmacies and some grocery stores). Juice, soda, carbonated beverages, teas, sports drinks, and beverages containing Children who are vomitingshould be given frequent small amounts of fluid to help prevent dehydration. Parents should offer the child a few sips of a liquid. If the liquid is not vomited, the sips are repeated every 10 or 15 minutes, increasing the amount given to an ounce or two after an hour or so and increased as tolerated. These larger amounts can be given less often, about every hour. Liquids are absorbed very quickly, so if the child vomits more than 10 minutes after drinking, most of the liquid has been absorbed and the liquids should be continued. The amount of liquid to give a child within a 24-hour period depends on the child’s age and weight but generally should be about 1½ to 2½ ounces of liquid for each pound the child weighs. If the child’s vomiting or diarrhea lessens, parents may try feeding a more normal diet the next day. Electrolyte solutions should not be continued alone for longer than 24 hours because of potential problems associated with inadequate nutritional intake. Children who have diarrhea but little vomitingshould get extra fluid to make up for the fluid lost in the diarrhea. But, unlike children with vomiting, they may be given larger amounts of fluid at a time and they are fed their normal diet. However, if the child has significant diarrhea, consumption of dairy products (which contain lactose) should be reduced. Severe gastroenteritis may decrease the child’s ability to absorb lactose, resulting in even more diarrhea. Children who cannot keep down even sips of liquid or who have signs of severe dehydration (such as lethargy, dry mouth, lack of tears, and no urine for 6 hours or more) are in danger and should see a doctor immediately. Children who do not have these signs should see a doctor if symptoms last more than 1 day. If the dehydration is severe, the doctor may give the child fluids by vein (intravenously). Antidiarrheal medications such asloperamideshould not be given to children under 18 years of age. Antibiotics are of no value when a viral infection is the cause of gastroenteritis. Doctors give antibiotics only when gastroenteritis has been caused by specific bacteria that can be treated by antibiotics (such asShigellaorCampylobacter). Sometimes, an antibiotic such asmetronidazoleorvancomycinis given for gastroenteritis caused byClostridioides difficile. Certain medications (such asmetronidazoleandnitazoxanide) may be given for a parasitic infection. Probiotics are organisms such as bacteria that are naturally found in the body and promote the growth of good bacteria. They are also in foods and can be taken as supplements. Probiotics, such aslactobacillus(typically present in yogurt), may slightly shorten the duration of diarrhea (perhaps by a day) if people begin taking them soon after the illness starts. However, probiotics probably do not prevent more serious consequences of gastroenteritis, such as the need for intravenous fluids or for hospitalization. 