Gastroenteritis

=Gastroenteritis=

What it is
Gastroenteritis is a bowel infection which causes diarrhoea and sometimes vomiting. The vomiting may settle quickly, but the diarrhoea may last up to 10 days. Bouts of gastro can cause dehydration which can be dangerous for very young babies. It is commonly caused by Viruses (~70%) usually by rotaviruses or bacteria (~15%) //Campylobacter jejuni, Salmonella spp, (Atypical) enteropathogenic Escherichia coli//, but also protozoa and helminths.

Symptoms
Vomiting, diarrhoea, stomach pain, fever //may not be present until// //loss of 5% bodyweight// - Increased thirst - Dry mouth and tongue - Not passing urine (dry nappies) - Sunken eyes - Skin fold remains for a few seconds after pinching - Cold hands and feet (decreased peripheral circulation) - Deep breathing (acidotic) - Irritable/restless - More sleepy than usual
 * Signs of dehydration:**

How to Treat
Children without dehydration can be managed at home using clear fluids such as: - Oral rehydration products, which avoid risk of electrolyte imbalance, but are not always well-accepted and are more expensive - Sugar solution (sucrose) -1 teaspoon of sugar to 1 cup of water - Fruit juice (natural) - 1 tablespoon to 4 tablespoons of water - Cordials (not low calorie) - half a cup of cordial to eight (8) cups of water - Lemonade - (not low calorie) 1 tablespoon to 6 tablespoons of warm water (to remove the bubbles) //A useful guide is that the diluted fluid should 'just' taste sweet//

Starvation is not a treatment of gastroenteritis. The amounts of carbohydrates present in rehydration fluids do not provide a significant source of energy. If solid feeds need to be withdrawn, this should be for no longer than 24 hours. Ideally, breast- or bottle-feeding of infants should be continued through the illness and if necessary, supplemented with oral rehydration fluid.

- your child is less than six months old - you notice blood in the bowel motion - your child shows any signs of dehydration - they vomit often and are unable to keep fluids down - they are not drinking - your child has ongoing or severe stomach pain
 * Take your child to the doctor or emergency department if:**

//Rough guidelines for referral of children:// - <1 year old: refer if duration >1 day - <3 years old: refer if duration >2 days - >3 years old: refer if duration >3 days

Other advice
Do not give medicines to reduce the vomiting or diarrhoea (antiemetics may be associated with significant dystonic reactions)

It is not required to restrict foods that contain lactose - a small proportion of children will have frothy stools and redness/flaking around the anus and this may indicate a temporary lactose intolerance, however for the majority it will not aggravate the diarrhoea.

- Make sure everyone in the family washes their hands regularly warm water and soap, especially after they use the toilet and before they eat - Wash your hands before you feed and after you change your child’s nappies - Keep your child away from other children as much as possible until the diarrhoea has stopped. - Two new oral vaccines recently been registered in Australia (Rotarix and Rotateq), both conferring >90% protection against hospitalisation from severe rotavirus gastroenteritis
 * Preventing the spread of gastroenteritis:**

Additional Resources
[|Self-care Card - Vomiting and Diarrhoea] [|WCH 2008 Paed Gastro Guidelines] [|Westmead 2008 - Gastroenteritis] [|Better Health - Gastroenteritis in children] [|Acute infectious diarrhoea and dehydration in children]