Gastroenteritis

Causes

Gastroenteritis is usually caused by a virus – or, less commonly, by a bacterium or parasite. These can cause an infection of the bowel, which results in inflammation of the intestinal lining. These processes lead to diarrhoea and vomiting.

Rotavirus is a common cause of viral gastroenteritis in children. It’s becoming less common, however, because there’s now a vaccination against rotavirus that’s part of the National Immunisation Program Schedule.

Gastroenteritis is common in babies and toddlers.

Symptoms

Symptoms include the sudden onset of diarrhoea, accompanied by vomiting, abdominal cramps and sometimes fever. If your child doesn’t get enough fluid, there’s a risk he’ll become dehydrated.

When to see your doctor

Take your child to the doctor if:

• there’s a lot of diarrhoea (8-10 watery poos, or 2-3 very large poos a day)
• your child is vomiting often and can’t seem to keep any fluids down
• your child seems to be dehydrated – if she’s not passing urine, is pale and thin, has sunken eyes, cold hands and feet, drowsiness or significant irritability
• your child develops severe abdominal pain
• there’s blood in your child’s poo
• your child’s vomit is a green colour.

Treatment

Most cases of gastroenteritis in children aren’t serious, but it’s important to make sure that your child receives enough fluid. Fluids need to be given in small amounts, but often.

What your child should drink
The best fluid to use is an oral rehydration fluid, such as Gastrolyte or Hydralyte. These can be bought over the counter from pharmacies. Make sure you make up the liquid according to the instructions on the packet.

If you can’t get Gastrolyte, you can use diluted lemonade or fruit juice. Try using one part of lemonade or juice to four parts of water. An alternative is to mix six level teaspoons of sugar plus ½ a teaspoon of salt in 1000 ml of water. Full-strength lemonade or fruit juice might make the diarrhoea worse and can be harmful.

If you have a young baby who is being breastfed, you should continue to breastfeed but offer extra oral rehydration fluid between feeds. For babies who are bottle-fed, you should give oral rehydration fluid only for the first 24 hours and then reintroduce full-strength formula, but with extra oral rehydration fluids between feeds.

Getting your child to drink
Your child might not be keen to drink. You can try to increase his fluid intake by giving drinks via a syringe or spoon, and letting him suck icy poles. You can get Hydralyte icy poles from pharmacies – they represent about 50 ml of water each.

To get enough fluid into your child, you might need to be patient and just keep trying.

Food
Your child might refuse food to start with. But if she’s hungry, you can give her food at the same time as fluid. It’s generally best to start with bland foods such as plain biscuits, bread, rice, potato or jelly. Other foods can be added gradually.

Additional treatment and complications
If your child’s very dehydrated, he might need fluids to be given intravenously (directly into the vein) or through a tube that goes up his nose and into his tummy. In this case, your child will have to go into hospital.

Medicines to stop diarrhoea don’t help at all and can have significant side effects in children. Similarly, you don’t need to give antibiotics of any kind – the most common cause of gastroenteritis is a virus, which doesn’t respond to antibiotics.

Occasionally your child might develop temporary lactose intolerance after the gastroenteritis has sorted itself out. Symptoms of this include diarrhoea that goes on for more than 1-2 weeks, or buttock excoriation in young babies. You’ll need to see your doctor, who might suggest your child tries a lactose-free diet for a couple of weeks before dairy is reintroduced.

Prevention

Gastroenteritis spreads easily. You can help prevent the spread of gastroenteritis by making sure everyone in the family washes their hands regularly.

Keep your sick child away from other children until she’s had no vomiting or diarrhoea for at least 48 hours.

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