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Last Updated 1/2010
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Acute Gastroenteritis – AGE (Vomiting & Diarrhea)
What is Acute Gastroenteritis (AGE)?
A viral infection of the stomach and intestines that can cause:
- Nausea
- Vomiting
- Diarrhea (increase in the frequency and looseness of bowel movements)
- Fever
- Abdominal pain or discomfort
AGE can vary in severity: anywhere from only vomiting that lasts 6-12 hours, to fever and vomiting for 2-3 days with diarrhea continuing for up to a week.
What medicines stop or cure AGE?
AGE is caused by a virus. Medications do not cure AGE. Using anti-nausea, anti-vomiting, or anti-diarrhea medicines right at the start of AGE can actually prolong or worsen your child’s symptoms.
Your physician may advise use of medicines for certain circumstances, such as for persistent vomiting or prolonged diarrhea.
How can AGE be prevented?
Washing hands after changing diapers or using the toilet is the most important way to prevent its spread.
What complications can occur?
- Dehydration: No urine output in 8 hours
- Crying produces no tears
- Mouth is dry
- Feint or dizzy when standing
- Difficult to awaken or confused
What treatment can be done for AGE?
Most AGE can be handled at home by changing your child’s diet (food and fluid intake).
Vomiting and diarrhea are the body’s way of getting rid of the virus. Then the GI system needs to rest in order to heal and replenish its digestive enzymes.
First step: Clear Liquids only for 8-24 hours:
NO formula or milk and no medicines by mouth.
If your child has a fever over 100.4 F rectal, use acetaminophen suppositories.
Don’t give just plain water, use:
Infants:
- Pedialyte, Resol, Ricelyte, etc
- Gatorade or other sports drinks are OK, but not nearly as good.
- Jello water as last choice: (not red – it looks like blood in the diarrhea!)
- Breast fed infants may continue nursing – but refer to directions under Second Step
Children older than 1 year:
- Above list is best, but you can also use flat (no fizz) sodas.
Do not give as much clear liquid as your child wants!!
The volume alone can irritate the stomach and induce vomiting.
Wait at least a half hour after vomiting - Start with 1-3 teaspoons every 10 minutes, and double the amount each hour. If your child vomits again during this, rest the stomach completely for 1-2 hours and then start over more slowly.
Second step: advance diet – this can be started about 4-6 hours after the last episode of vomiting.
Most children with AGE should not be on clear liquids only for more than 24 hours.
Infants on breast milk only: nurse on only one side for 5-10 minutes each time and slowly increase back to regular pattern of nursing over the next 24 hours. Offer pedialyte (1-2 oz) between nursings.
Infants on formula only: Begin smaller than normal amounts of ½ strength lactose free formula or ½ strength soy formula and slowly go back to mixing it normally over the next 24 hours.
Infants and older children on food also: Continue clear liquids and start small amounts of white starchy foods: rice cereal (made with water, not milk or formula), pretzels, saltine crackers, honey or jelly on white bread (if over 1 year of age), broth soups, rice mashed potatoes (no milk, butter, or margarine).
Then advance the diet as tolerated to include applesauce, strained pears, bananas, cooked carrots.
- Then advance the diet as tolerated to include lean meats, boiled eggs, yogurt.
- Avoid milk and milk products (except yogurt), fresh fruits and vegetables, beans, spices, greasy or high fat foods until one day after the diarrhea is resolved.
Common mistakes:
- Many parents get so afraid of dehydration that they try to push too much clear liquids too fast or too soon after vomiting. Vomiting alone rarely causes dehydration. Often, children will have vomiting for just a few hours and then need to sleep for a few hours before trying to rehydrate.
- Using boiled skim milk or any concentrated solution can cause serious complications for babies with diarrhea because they contain too much salt.
- Plain water, Kool-Aid type drinks, popsicles, and sodas should not be used as the only clear liquids because they contain little or no salt.
- Do not give clear liquids alone for more than 24 hours. There are not enough calories in clear liquids.
- Do not use a diluted formula for more than 24 hours. There is too much water and not enough calories in diluted formula.
Call the office or go to the ER immediately if:
- Your child is dehydrated (see above under complications)
- Your child is less than 12 weeks old with a fever over 100.4 F rectal.
- Your child has a fever greater than 105 F
- There is blood in the diarrhea or vomit.
- Abdominal pain lasts continuously for more than 4 hours
- Diarrhea is severe:
Baby under one month old: more than 3 large, watery diarrhea stools in 8 hours;
Baby under one year old: more than 8 large, watery diarrhea stools in 8 hours.
- The diarrhea is watery AND your child vomits the clear liquids three or more times.
- If poisoning with a plant, bad food, medicine, or other chemical is a possibility.
- Your child starts acting very sick.
Your child needs an appointment within 24 hours if:
Please call the office at 778-6762 for help in deciding if and/or when your child needs to be seen. |
