Gastroenteritis in children: A debilitating infection

Acute gastroenteritis is an infection of the gut (stomach and intestines) that causes diarrhea and vomiting. It can be caused by viral infections such as Rotavirus, Adenovirus (commonly in children less than five years) or by bacterial infection.

The following information will help you to forget all your concerns regarding gastroenteritis and make it less likely at the first instance itself.

How does gastroenteritis spread?

Viruses easily spread from an infected person to another by close contact. This usually happens when an infected person, after having a bowel movement (passing the stool) doesn’t wash his/her hands and comes in contact with the unaffected person; the virus present on the infected person's hands pass on to a healthy person. This can usually happen in schools or hospitals.

What are the symptoms of gastroenteritis?

The main symptom of gastroenteritis include diarrhea (loose watery stools three to four times in 24 hours), often with vomiting as well. Blood or mucus may appear in the stools. Sometimes diarrhea is associated with high fever and crampy abdominal pains which may ease for a while whenever stools are passed.

What are the symptoms of dehydration (lack of fluid) in the body?

Symptoms of dehydration in children include passing little urine, dry mouth, dry tongue and lips, fewer tears, sunken eyes, weakness, irritability or lethargy. Symptoms of severe dehydration include drowsiness, pale or mottled skin, cold hands or feet and fast (but often shallow) breathing.

Mild dehydration is common and it can easily and quickly be reversed by drinking lots of fluids. Severe dehydration is a medical emergency and requires immediate medical attention.

Who are at risk for severe dehydration?

Infants below 6 months or under 1 year age; 1 year old babies with low birth weight and who have not gained weight; infants with severe vomiting and diarrhea; breast-fed babies who suddenly stopped feeding during their illness; those babies and infants who have passed more than five or six stools or vomited three to four times in 24 hours are at increased risk of severe dehydration.

How is gastroenteritis diagnosed?

If the symptoms are mild, they usually get better within a few days with or without treatment by drinking plenty of fluids. Tests are usually not recommended. However, in some cases, you have to seek medical advice, particularly when the symptoms are quite abnormal – If your child passes blood in stools, and when motions and vomiting are quite frequent. Your physician may recommend fecal culture if he/she suspects food poisoning.

What is the treatment for gastroenteritis in children?

The symptoms of gastroenteritis often subside within a day or two owing to the child’s immune system’s ability to wear off the infection. During this time, children are usually treated at home. However, when complications develop or symptoms become severe, with vomiting and motions, you should seek medical advice immediately.

To prevent dehydration, oral rehydration fluids (ORS) are given. The child should continue normal diet and should be encouraged to take extra fluids. Apart from ORS, home-made salt and sugar mixtures, prepared under careful conditions should be given to the child.

Are there any medications to treat gastroenteritis?

You should not give any medications without under medical supervision as it is unsafe owing to possible serious complications.Your doctor may prescribe probiotics. They reduce the pathogenic bacteria in the gut and thus reduce the duration and severity of diarrhea. Antibiotic treatment is given when the severity of the infection is high.

Are there any complications due to gastroenteritis?

Though the complications of gastroenteritis are quite uncommon in India, they are, sometimes, more likely in very young infants and children. If a child suffers from ongoing illness or his/her immune system is not completely functional, gastroenteritis may cause severe complications.

The most possible complications include fluid and electrolyte imbalance, secondary lactose intolerance and the spread of the infection to other parts of the body.

How to prevent the spread of infection to others?

Gastroenteritis can easily be passed from person to person. If your child has gastroenteritis, you may also get it if you don’t wash hands after changing diapers, before preparing, serving and eating food. The best way to protect is to wash hands with soap and water and dry them properly after washing. If your child has gastroenteritis, don’t send him/her to school until 48 hours after the last episode of vomiting or diarrhea.

Is there any vaccine available for gastroenteritis?

As mentioned earlier, rotavirus is the most common cause of gastroenteritis in children. There is an effective vaccine against rotavirus. In India, babies are routinely vaccinated with Rota virus as per the recommendations by IAP (Indian Academy of Pediatrics).

Bottom Line

The best way to combat gastroenteritis is to follow good personal hygiene. You should remember that the mode of infection is not always contamination. The other precautions that are essential to follow include proper storage, preparation and cooking of food.

In addition, wash your hands with soap and water several times a day. Breast-feeding is also protective. Breast-fed babies are much less likely to develop gastroenteritis compared to bottle-fed babies.

By Dr. Srikanth Kona

MD (Pediatrics), Fellowship (Neonatology/ Perinatology & Developmental Pediatrics) Consultant Neonatologist & Pediatrician Continental Hospitals, Gachibowli, Hyderabad

www.continentalhospitals.com

040 – 67000000