Acute Gastroenteritis

Sometimes referred to as a “stomach virus,” acute gastroenteritis occurs when a virus temporarily disrupts the stomach and intestines, causing vomiting and/or diarrhea. 
Symptoms of viral gastroenteritis include vomiting, diarrhea (usually green or yellow watery stools), fever, and irritability. Typically, the illness will start with vomiting and then progress to diarrhea. 

Acute gastroenteritis can usually be managed at home, and does not necessarily require a visit to the doctor. The most important part of managing gastroenteritis is to prevent dehydration, which can happen if your child loses too much water and salt from vomiting or diarrhea. Occasionally, a child can become so dehydrated that she will need to be hospitalized for intravenous fluids. The younger the child, the more susceptible she is to dehydration. 

Signs and symptoms of dehydration include the following:
Less playful than usual
More fussy or sleepy than usual
Decreased urine output 
Dry mouth
Decreased tears or drool
Sunken soft spot or eyes

Viral gastroenteritis is contagious, and is usually transmitted from direct hand to mouth contact following exposure to contaminated fecal material. Routine hand washing after using the toilet or changing diapers and before handling food is the best way to prevent acute gastroenteritis. Fortunately, there is now a vaccine for Rotavirus, one of the most common viruses causing acute gastroenteritis in small children

If your child has only mild diarrhea and does not seem dehydrated, continue to feed her normal diet (including formula or milk). Avoid beverages that contain a large amount of sugar like apple juice. These beverages actually make diarrhea worse, because the sugar is poorly absorbed and draws more water into the intestine. 

If the diarrhea becomes worse or is accompanied by vomiting, you may introduce an electrolyte solution such as Pedialyte to replace lost fluids and electrolytes. You may also use a sports drink like Gatorade, but dilute it to half strength with water so it’s not too sweet.

If your child seems to be vomiting everything, follow the following protocol: 
oGive nothing by mouth for 2 hrs after the last vomiting episode
oThen give 1 tablespoon of clear liquid every 10 minutes for an hour
oIf still no vomiting, increase to 2 tablespoons every 15 minutes for an hour
oIf still no vomiting, increase to 1 ounce every 15 minutes for an hour
oIf still no vomiting, increase to 2 ounces every 20 minutes for an hour
oContinue to gradually increase liquid intake over 12-24 hours , then slowly begin 
          to introduce bland solid foods

Unfortunately, there are no medications that work to treat viral gastroenteritis. We do not use over-the-counter antidiarrheal medications for children; it is better to allow the virus to pass out of the body through the stool. In severe cases we will sometimes prescribe a medicine to decrease nausea and vomiting. 

Usually, acute gastroenteritis resolves within 7-10 days. Please call us for any of the following:
vomiting blood or green material
diarrhea has blood or mucous
hard or distended abdomen
severe abdominal pain
signs and symptoms of dehydration (see above)
no urine output in 12 hrs
vomiting for more than 48 hrs
diarrhea lasting longer than 2 weeks
severe irritability or lethargy

Call us at (301) 625-2800
Please call us with any questions

Silver Spring Pediatrics
Drs. DeConcini, Schooler, Zang, Wang, Yee & Marcus