What is gastroenteritis (commonly called gastro)?
Gastro/gastroenteritis/stomach flu is an infection of the gut. Many children have more than one episode in a year, most commonly before the age of 5 years.
The severity can range from a mild tummy upset for a day or two with some mild diarrhoea, to severe diarrhoea and vomiting for several days or longer. Many viruses, bacteria and other microbes (germs) can cause gastroenteritis.
Viruses are the most common cause of gastroenteritis and the rotavirus is the most common one. Once your child has had a rotavirus infection, his/her body usually becomes immune to it. Viruses are easily spread from one infected child to another by close contact. Surfaces or objects such as toys touched by the infected child can also allow spread of the virus. The virus can also be passed on if the infected person is involved in food preparation. Outbreaks of a virus causing gastroenteritis can often occur in places such as schools, day care centres, etc. Infected food and water can also cause gastroenteritis.
Gastroenteritis symptoms
– The main symptom is diarrhoea, often with nausea and vomiting.
– Diarrhoea means loose or watery stools, usually more than three times in 24 hours.
– Tummy (abdominal) pains are common. A high temperature, a headache and aching limbs can occur.
In most children, the symptoms are mild and they tend to get better within a few days. If vomiting occurs, it often lasts only a day or so, but may last longer. Diarrhoea often lasts for between 5 to 7 days, and often continues after the vomiting stops. Slightly loose stools may persist for a week or so before a normal pattern returns.
When should you seek medical attention?
Diarrhoea and vomiting may cause dehydration (loss of body fluid). Mild dehydration is common and is usually easily and quickly reversed by drinking more liquids.
The symptoms of dehydration in children include:
● passing little urine;
● dry mouth, a dry tongue and lips;
● fewer tears when crying;
● sunken eyes, weakness, being irritable or lethargic.
The symptoms of severe dehydration in children include:
● drowsiness;
● pale or mottled skin;
● cold hands or feet;
● fast or shallow breathing.
This is a medical emergency and needs immediate medical attention.
Dehydration is more likely to occur in:
● children under the age of 1 year and particularly those under six months old;
● an infant that has stopped breast-feeding during their illness;
● any child who does not drink much when they have gastroenteritis;
● any child with severe diarrhoea and vomiting.
Diagnosing gastroenteritis
Most parents recognize gastroenteritis in their children because of typical symptoms.
Your doctor may ask you questions, such as whether your child has been in contact with someone with similar symptoms. The doctor will examine your child for signs of dehydration, check his/her temperature and heart rate. He/she will also examine your child’s abdomen to look for any painful spots.
Investigations may be needed. In certain cases, the doctor may ask you to collect a stool sample. Blood tests are ordered if the child is significantly dehydrated.
Treatment for children
Symptoms of gastroenteritis often settle down within a few days or so as your child’s immune system clears the infection. Children can usually be treated at home. Occasionally, admission to hospital is needed if symptoms are severe, or if complications develop.
Fluids
You should encourage your child to take plenty of fluids. The aim is to prevent dehydration. The fluid lost in their vomit and/or diarrhoea needs to be replaced. Your child should continue with their normal diet and usual drinks. In addition, they should also be encouraged to drink extra fluids. However, avoid fruit juices and sweet drinks as these can make the diarrhoea worse.
Babies under 6 months old are at increased risk of dehydration. You should seek medical advice if they develop gastroenteritis. Breast or bottle feeds should be encouraged as normal. You may find that your baby’s demand for feeds increases. You may also be advised to give extra fluids (either water or rehydration drinks) in between feeds.
Rehydration drinks (Pedialyte) provide a perfect balance of water, salts, and sugar.
If your child vomits, wait 5-10 minutes and then start giving drinks again, but more slowly (for example, a spoonful every 2-3 minutes). Use of a syringe can help in younger children who may not be able to take sips.
Sometimes a child may need to be admitted to hospital for treatment if they are dehydrated. Treatment in hospital usually involves giving rehydration solution with intravenous fluids (fluids given directly into a vein).
Encourage your child to eat as normally as possible once any dehydration has been treated.
Breast-fed babies should continue to breast feed. This will usually be in addition to extra rehydration drinks.
● Bottle-fed babies should be fed with their normal full-strength feeds if they will take it.
● Older children: offer them some food every now and then. However, if he or she does not want to eat, that is fine. Drinking is most important, and food can wait until the appetite returns.
Medication
You should not give medicines to stop diarrhoea in children. They are unsafe to give to children due to possible serious complications. However, you can give paracetamol or ibuprofen to ease a high temperature.
Sometimes an antibiotic or other treatment is needed, depending on the cause of the infection. This should only be used on a doctor’s advice.
Preventing spread of infection
Gastroenteritis can very easily be passed on from person to person. Therefore, you and your child need to take measures to try to reduce this likelihood.
If your baby has gastroenteritis, be especially careful to wash your hands after changing nappies and before preparing, serving, or eating food. Use liquid soap in warm running water, or alcohol based hand gels. Dry your hands properly after washing.
Older children
The following is recommended when older children have gastroenteritis:
– Regularly clean the toilets used with disinfectant. Also, clean the flush handle, toilet seat, sink taps, bathroom surfaces and door handles at least daily with hot water and detergent.
If a potty has to be used, wear gloves when you handle it, dispose of the contents in a toilet, then wash the potty with hot water and detergent and leave it to dry.
Make sure your child washes their hands after going to the toilet.
Don’t let your child share towels.
They should stay away from school, nursery, etc, for at least 48 hours after the last episode of diarrhoea or vomiting. They should also avoid contact with other children, where possible, during this time.
Can gastroenteritis be prevented?
The answer is yes, just by using the few simple measures listed below:
Always wash your hands, and teach children to wash theirs
after going to the toilet (and after changing nappies);
before touching food;
after gardening;
after playing with pets (healthy animals can carry certain harmful bacteria).
The simple measure of washing hands regularly and properly makes a big difference to lower the risk of developing gastroenteritis.
Breast-feeding is protective. Breast-fed babies are much less likely to develop gastroenteritis compared to bottle-fed babies.
Immunization
Rotavirus is the most common cause of gastroenteritis in children. There is an effective vaccine against rotavirus. It is given orally to children, two doses before 6 months of age.This is available in Guyana and parents are encouraged to immunize their children and save the children and themselves a lot of agony by doing so.
