Infections

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Vomiting and/or Diarrhea

What is gastroenteritis?

Gastroenteritis is an infection of the bowel (intestines) that causes diarrhea and sometimes vomiting. It is common in infants and children. It is more serious in infants and young children than it is in adults. Diarrhea and vomiting can cause the loss of important fluids and minerals the body needs (dehydration). Infants and children lose fluids and minerals quicker than adults. Since water makes up most of an infant's or child's weight, this can lead to serious illness and require hospitalization.

What causes gastroenteritis?

Gastroenteritis is more common in the winter and early spring. Most gastroenteritis is caused by a virus (most commonly rotavirus, norovirus, adenovirus), or one of several kinds of bacteria that get into the intestinal tract (bowels). Bacteria or viruses get to the intestinal tract by putting dirty hands, toys or other objects near or into the mouth or eating contaminated food. It is nearly impossible to keep a child from being exposed to the germs that cause gastroenteritis. Proper hand washing by the whole family is the best way to prevent the spread of disease. When a family member is sick, extra care should be taken to wash hands often.

What are the symptoms of gastroenteritis?

The most common symptoms are: • Diarrhea (frequent, loose, watery stools) lasting 2-3 days, but usually not more than a week • Nausea and vomiting, lasting 1-2 days • Abdominal/stomach pain/cramping • Fever

How is gastroenteritis diagnosed?

Generally, viral gastroenteritis is diagnosed by a physician on the basis of the symptoms and medical examination of the patient. Rotavirus infection can be diagnosed by laboratory testing of a stool specimen. Tests to detect other viruses that cause gastroenteritis are not in routine use. If symptoms are prolonged or severe, stool studies may be sent to look for another cause, eg. bacterial, parasitic, etc.

Monitoring for dehydration

Mild dehydration is common in children with diarrhea. Signs and symptoms of mild dehydration include a slightly dry mouth, increased thirst, and slightly decreased urine output (one wet diaper or void in six hours). Common features of moderate or severe dehydration include markedly decreased urination (less than one wet diaper or void in six to eight hours), lack of tears when crying, dry mouth, sunken eyes and fatigue.

What can I do for the infant or child with gastroenteritis?

Usually diarrhea and vomiting last only a short time, therefore, you can safely care for your child at home.

Medications — Medications such as antibiotics and antidiarrheal agents are generally not necessary and could be harmful for infants or children with diarrhea. Rarely, antibiotics may be used in cases of

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bacterial infection when a specific cause of the diarrhea has been found or is strongly suspected, particularly after recent travel. Inappropriate use of antibiotics will not improve diarrhea. Furthermore, antibiotics can cause side effects and lead to development of antibiotic resistance.

Antidiarrheal agents (including Imodium, Pepto-Bismol, and Kaopectate) are not recommended for infants or children, since the benefits do not outweigh the risks. One risk of using an antidiarrheal agent is that it could mask worsening symptoms and delay treatment.

Probiotics — There are "healthy" bacteria (called probiotics) that may help reduce the duration of diarrhea (by about 12 to 30 hours). Some of these are available in drug stores without a prescription.

Vaccines- There is a vaccine readily available for one of the most common causes of gastroenteritis, Rotavirus. It is indicated for infants between 2 and 8 months of age. The vaccine’s brand names are Rotarix and Rotateq. They are administered orally in 2 or 3 doses, respectively.

Preventing spread — Parents with children who have diarrhea should be cautious to avoid spreading infection to themselves, their family, and friends. Care with hand washing, diapering, and keeping sick children out of school or day care until the diarrhea is gone are a few ways to limit the number of people exposed to the infection.

Hygiene measures — Hand washing is an essential and very effective way to prevent the spread of infection. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available, however, alcohol-based hand rubs do not prevent all types of diarrhea (eg, Norovirus, Clostridium difficile). Hands should be cleaned after changing a diaper or touching any soiled item. They should also be washed before and after preparing food and eating, after going to the bathroom, after handling garbage or dirty laundry, after touching animals or pets, and after blowing the nose or sneezing.

When to seek help for vomiting and diarrhea.

The following is a list of signs and symptoms that are worrisome and require immediate medical attention:

. Bloody diarrhea . Severe, repeated vomiting . Vomit that is bloody, black or bright green . If an infant refuses to eat or drink anything for more than a four to six hours . Signs of moderate to severe dehydration ( no urine output in 8-12 hours, dry mouth, sunken eyes, no tears when crying) . Abdominal pain that comes and goes, or is severe or worsening . Behavior changes, including lethargy or decreased responsiveness

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292