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Gastroenteritis In Children

Worldwide, gastroenteritis is a major reason for childhood deaths, primarily in developing nations where sanitation and health care are poor. Most of these children die from extreme dehydration (abnormally low levels of body water) resulting from a combination of severe diarrhea, vomiting and not drinking enough fluids. Even in the industrialized world, millions of episodes of gastroenteritis occur each year, especially in young children. In the United States, rotavirus infections used to be responsible for more than 3 million cases of gastroenteritis in children each year, with at least 50,000 hospitalizations and 20 to 40 deaths. Fortunately, the rotavirus vaccine that is given to young…

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Articles of Interest

Management of gastroenteritis in children

It is most practical to base treatment of diarrhoea on the clinical type of the illness, which can easily be determined when a child is first examined. Laboratory studies are not needed. Four clinical types of diarrhoea can be recognized, each reflecting the basic underlying pathology and altered physiology:

Diarrhoea and Vomiting Caused by Gastroenteritis

When young children suddenly experience the onset of diarrhoea, with or without vomiting, infective gastroenteritis is by far the most common explanation. A range of enteric viruses, bacteria and protozoal pathogens may be responsible. Viral infections account for most cases in the developed world. Gastroenteritis is very common, with many infants and young children experiencing more than one episode in a year.

Gastroenteritis

Gastroenteritis can be due to bacterial, viral or parasitic pathogens most often transmitted via the fecal-oral route or through contaminated food or water. The most common bacterial pathogen in developed countries is Campylobacter jejuni and other common pathogens include Staphylococcus aureus, Salmonella, Shigella and enterotoxigenic Escherichia coli. While Clostridium difficile is considered the most common cause of antibiotic induced diarrhea in adults it is not in the pediatric population.

Pediatric Diarrhea: History is the Primary Diagnostic Tool

Diagnosing the cause of diarrhea is not always the most important thing we have to do. Often, pediatric patients present to the emergency department very well-appearing after one or two days of some watery diarrhea. Most of the time I don’t do any diagnostic work other than my history and physical exam – blood work and a stool PCR panel don’t change my management in an otherwise well-appearing child. The majority of children will improve without significant intervention other than supportive care and hydration at home. In the acutely ill, dehydrated and sick looking kid with a week of fever and bloody diarrhea, finding out the exact cause can be much more crucial.

Resources

American Family Physician

Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. Evaluation of a child with acute gastroenteritis should include a recent history of fluid intake and output. Significant dehydration is unlikely if parents report no decrease in oral intake or urine output and no vomiting.

Cincinnati Children's

It is more serious in babies and young children than it is in adults because the diarrhea can cause dehydration. Diarrhea and vomiting can cause the loss of important fluids and minerals from the body (dehydration).

DrGreene

Tummy aches are an unpleasant part of childhood. They can be even less pleasant if accompanied by diarrhea or vomiting. Nevertheless, gastroenteritis is a part of everyone''s childhood.

Raising Children

It’s important to make sure that your child has enough to drink. Give your child small amounts to drink often – for example, a few mouthfuls every 15 minutes. This will help to prevent dehydration.

StatPearls

Gastroenteritis in the pediatric population is a very common condition that accounts for around 10 percent of pediatric deaths and is the second cause of death worldwide. The most common cause in infants younger than 24 months old is rotavirus, and after 24 months of age, shigella becomes the most common cause and rotavirus the second most common.