"Gastroenteritis" (GE) means inflammation of the gastrointestinal tract, or your stomach and your bowel if you prefer. This can be due to different organisms, mainly bacterial (unusual), parasitic (this is more common in developing countries than in the UK) or viral (very common, particularly in the winter months). It presents with vomiting and/or diarrhoea, and may or may not be accompanied by a raised temperature.
Viral gastroenteritis is by far the commonest type of GE you will encounter in the winter months among children in the UK. Children may sometimes have a preceding viral upper respiratory tract infection and may initially only present with vomiting, with diarrhoea following suit. The child may complain of crampy abdominal pain, of headache and of feeling generally awful. The acute phase of the illness may last 2-4 days, but the diarrhoea may persist for much longer (up to 10-14 days), even once the child is feeling better, and is drinking and eating reasonably. This is to be expected, as the lining of the bowel may take a little while to recover from the insult of the bug that infected it.
Usually viral GE is self limiting and does not need hospital admission. The mainstay of treatment is oral rehydration with Dioralyte (rehydrating salts that you can buy over the counter). If the child is vomiting it is wise to give him/her small amounts of fluid frequently, such as 5mls of Dioralyte every 5 minutes with a medicine syringe (if you let your thirsty child have a huge swig she will undoubtedly vomit). This is quite laborious and children often do not like the flavour of Dioralyte (although it comes in blackcurrant and citrus), but it is worth the effort: often the vomiting settles down and most of the fluid is tolerated. Do not panic if your child continues to vomit a little during this period, as long as you feel that most of the fluid is staying down.
If your child is not vomiting but only has profuse diarrhoea then encourage her to drink as much as possible and aim to give her an extra drink every tome she passes a loose motion.
Although we aim to keep children with GE away from hospital as much as possible (they are very contagious), if despite your best efforts with giving Dioralyte little and often, your child is still vomiting profusely then you should bring him to see your doctor or to A&E to assess his state of hydration. It may be that intravenous fluids are needed at this point.
But what are the danger signs that you need to be aware of?
Although most diarrhoea and vomiting will be due to GE, there are some more sinister causes that exist.
If your child's vomitus is green, you must go to the A&E department immediately - this may be the sign of an obstructed or twisted gut. You may also see that your child's belly is very swollen. Equally if the stool is bloody, or it looks like it contains red jelly, you must seek medical help very swiftly as this may be a sign of severe infection or of the gut telescoping upon itself (intussusception).
If your child is becoming increasingly listless or irritable, her eyes are sunken, her lips are dry, she has not peed for a very long time and she feels cool to touch, she may be becoming significantly dehydrated and may need medical attention.
Prevention is always better than cure...
During an episode of GE the corner stone of prevention is strict hand washing and isolation. This must be observed if the rest of the family is to avoid becoming unwell. Every time the child vomits or has a loose or explosive stool, little infected droplets are aerosolised and may infect others. It is very easy to transmit GE on hands as well as other items such as glasses, towels, cutlery, so again it is important not to be sharing these.
As ever, if you do have concerns do not hesitate to consult your doctor.
