Gastroenteritis is an illness caused by an infectious agent (pathogen or ‘germ’) in the bowel. These agents can be viral, bacterial and parasitic in origin.
Gastroenteritis causes diarrhoea (sudden increase in bowel motions, which are loose and watery), vomiting, fever, abdominal pain and cramping.
Diarrhoea can also be associated with upper respiratory (coughs and colds) and urinary tract infections, antibiotic therapy and laxative use.
Gastroenteritis is usually self-limiting (clears by itself ) in 1 to 5 days, although sometimes it can take longer to resolve. The vomit and faeces of an affected person are infectious.
The spread of gastroenteritis is from the faeces to the mouth (we place the infectious agent into our mouth after being in contact or contaminated by infected faeces).
The contamination can be spread from infected goods or water, and from person- to-person contact, especially where there is close contact, such as in childcare centres.
Antibiotics, anti-diarrhoea or anti-vomiting medications are rarely needed and may be harmful to the sick child, although some types of bacterial or parasitic infections may be treated. Paracetamol may be given for an elevated temperature, or abdominal pain and cramping.
How to avoid dehydration
The goals of treating gastroenteritis are to correct any dehydration (fluid loss) and body salts disturbances (electrolyte imbalances) that are caused by the diarrhoea and vomiting.
The signs (symptoms) of dehydration are dry mouth and tongue, increased thirst and fewer than normal wet nappies.
Severe dehydration includes tiredness or lethargy (rag doll appearance), sunken eyes with no tears on crying, cold hands and feet, and loss of skin tone (skin will not seem as elastic as usual when pinched between the fingers).
Your child may need extra fluids in the initial stages of illness by way of a naso-gastric tube or intravenously (drip). If the illness is not too severe the older child may manage to drink some gastrolyte (oral rehydration salts fluid) by mouth.
For infants, breast-feeding should be continued throughout the illness with more frequent feeds and extra water offered.
If vomiting is a problem, small amounts of fluids are offered more frequently. Other fluids such as fruit juices, soft drinks and lucozade or similar should be avoided as they contain high sugar or carbohydrates and may even increase the diarrhoea and/or vomiting.
If these fluids must be given, they should be very well diluted to at least one-quarter strength (1:4 – one part fluid to four parts water).
Early re-introduction of usual diet
For infants, it is generally thought that formula and milks other than breastmilk should be started only after dehydration has been corrected. Sometimes, a lactose-free formula is given only if milk or regular formula is not tolerated.
For older children, a regular diet is also offered as soon as dehydration has been corrected.
A faeces specimen should be sent to pathology and examined for all children with diarrhoea persisting for more than a few days. The examination and culture of specimens can prove a bacterial infection, which may (rarely) require antibiotics. The presence of viruses (eg. rotavirus) and parasites (eg. giardia and cryptosporidium) can also be detected.
Diarrhoea is spread from person to person via the oral-faecal route: kissing, sharing contaminated eating and drinking utensils, poor handwashing after using the toilet, or indirectly, by touching contaminated surfaces, dirty nappies or children’s toys.
The aim of prevention is to stop the infected vomit and faeces from contaminating others.
Here are some important points:
- good handwashing technique is extremely important – wash hands carefully for at least 10 seconds with soap and running water
- wash hands after using the toilet yourself; changing a nappy; helping a child to use the toilet; before preparing, serving or eating food; between handling raw and ready to eat foods; after playing with animals; smoking or using tissues and handkerchiefs
- avoid eating or drinking contaminated food and water
- keep the sick child’s hands as clean as possible. Wash them after using the toilet, vomiting, having a nappy change and before eating snacks and meals
- disinfect toys, bathrooms and food preparation surfaces daily
- keep the sick child away from daycare or school until the gastroenteritis has resolved. Keep thechild away from other children and friends unti they are well.
Please ask your doctor or nurse if you require further information.
Lady Cilento Children’s Hospital
Level 3, 501 Stanley Street, South Brisbane
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.