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Children’s health: acute gastroenteritis CHILDREN’S HEALTH: ACUTE GASTROENTERITIS
Acute gastroenteritis is a highly contagious infection of the digestive tract. It is probably caused by viruses, only a few of which have been identified. There is evidence that the disease may also be caused by some types of Escherichia coli bacteria. These bacteria are normally found in the human intestines, and most types of the bacteria are known to be harmless and even beneficial.
This disease is readily transmitted from person to person. Symptoms may begin within one to four days after being exposed to the germ. The disease is not generally serious except in young babies, who may become dehydrated (a serious loss of body fluids). Acute gastroenteritis has no relationship to true influenza (a disease of the respiratory tract).
Signs and symptoms
Acute gastroenteritis causes sudden vomiting or diarrhea and cramps. The disease may last one to three days or as long as a week. Fever may be high (40°C), low (38.3°C), or absent. Blood in diarrhea is rare. Occasionally, if vomiting is severe, there are small amounts of blood in the vomit, and petechiae (red spots) may appear on the face.
Acute gastroenteritis is more easily identified if there are other cases in the family or neighborhood. It occasionally may be confused with dysentery and food poisoning.
Home care
Treat both vomiting and diarrhea by limiting food intake to clear liquids until the illness subsides. To avoid dehydration, give the child plenty of the following clear liquids: tea, water, flavored gelatin water, and commercial mineral and electrolyte mixtures. Do not give the child milk. Paracetamol is better for relief of fever than aspirin because aspirin occasionally aggravates vomiting in some children.
Precautions
• Practice good hygiene. Be sure to wash your hands before going from the patient to other children in the house. Wash hands carefully before preparing food.
• If a young child develops the disease, watch carefully for signs of dehydration (infrequent urinating, dryness in the mouth, sunken eyes, drowsiness, rapid or slow breathing, sunken soft spot in the scalp). If any symptoms of dehydration appear, call your doctor.
• Do not give anti-diarrheal medications to children, since side effects are common and can be dangerous.
• If there is blood in the stools, high fever, prostration (extreme weakness or collapse), or severe or prolonged diarrhea (more than two to three days), call your doctor. Dysentery may be the cause.
Medical treatment
Your doctor will confirm the diagnosis by knowledge of what illnesses are occurring in the community, by the circumstances of the child's illness, and by absence of other physical findings on examination. Blood count and a stool culture might be required if diagnosis is in doubt. Otherwise, your doctor's treatment will be the same as home treatment. If there is evidence of dehydration in an infant, hospitalization will be necessary in order to give the child intravenous fluids.
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