Gastroenteritis is Common in Children-Ask Dr. Paul Library

DEAR DR.PAUL: My 18 month old baby was recently diagnosed with gastroenteritis caused by Rotavirus. He is fine now, should I be concerned about this infection? Will it come back?

DR.PAUL ANSWERS: Many parents have shared your experience, and fortunately this type of infection usually goes away on its own. Gastroenteritis is an infection of the gastrointestinal system; In other words, of the stomach and/or the intestines. Sometimes it is referred to as the stomach flu or "gastro". The symptoms usually include diarrhea and/or vomiting. One or the other, or both at the same time. In some cases, there can be associated fever, abdominal pain or cramps.

What causes gastroenteritis? In most cases it is caused by viruses such as the Rotavirus which tends to infect younger children. Some of the viruses cause symptoms of gastroenteritis only while others can cause cold symptoms as well. Less commonly, several different types of bacteria can also cause gastroenteritis. Importantly, food poisoning is a form of gastroenteritis which can occur if a child eats or drinks contaminated(spoiled) food water. This is why in order to prevent food poisoning, it is important to cook foods well and to make sure that they are properly refrigerated.

Regardless of the cause, the infection usually goes away in its own as long as the child is drinking enough to keep from getting dehydrated. However through experiences we have found that there is a right way and a wrong way to achieve this. In the past most children would be fed a very bland diet, and this for prolonged periods. This approach actually made matters worse. We came to recognize a condition called "Protracted Diarrhea of Childhood". These children had diarrhea that simply would not go away and needed to be admitted to hospital for weeks of intravenous therapy. They started off with a simple diarrhea which would just seem to get worse. We now understand that this protracted diarrhea was due to the fact that these children were being given low calorie diets. Because the intestinal lining did not get enough nutrition it became damaged and started to a leak or secrete liquid into the intestine causing large amounts of diarrhea. This is why we presently recommend that aside form the appropriate oral rehydration solutions, a resumption of a normal diet should start as soon as possible.

What about vomiting? If a child has just vomited, parents should wait for half an hour and then begin giving fluids starting with one tablespoon. If the child keeps it down, five minutes later, one and a half tablespoons is given and so on, progressively increasing the amount each time. Should the child vomit again take a break for about 30 minutes and start the cycle over again. If the child cannot keep any fluids down, medical attention should be sought as intravenous fluids may be necessary. Happily, most children will be able to keep down enough fluids and the vomiting as well as any other associated 'gastroenteritis" symptoms go away on their own.

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