Gastroenteritis in children

Introduction
Your child has been diagnosed with gastroenteritis, also known as gastric ‘flu (an inflammation of the gastrointestinal tract). This leaflet explains what this is and the treatment your child will need.  

What is gastroenteritis?
Gastroenteritis is a common complaint, which is actually an inflammation of the mucous membranes lining the gastrointestinal tract. The inflammation is usually caused by a virus, but is occasionally due to a bacterial infection. It sometimes turns into an epidemic, which is spread via food, drinking water or inadequate hygiene.  

Symptoms
The symptoms of gastroenteritis can include: diarrhoea (sometimes with blood and/or mucous), vomiting, high temperature, abdominal pain and stomach cramps.  
A high temperature, vomiting and diarrhoea can cause your child to lose too much fluid and salt, and ultimately become dehydrated. Symptoms of dehydration include: no urine production for 12 hours or more, less alert reactions, dry mucous membranes (in the mouth, nose etc), crying without tears or a depressed fontanelle.  

Examination
Your child will be examined by a doctor, who will look for signs of dehydration. Depending on the results of this examination, the doctor will decide on a plan for treatment at home or in hospital. A sample of your child’s faeces and/or blood will also be tested if necessary.  
Treatment primarily involves preventing or curing dehydration. Drugs are not usually needed. Most children will be sent home with a treatment plan after seeing a doctor at the hospital.  

Treatment at home
If the symptoms are fairly mild, you will not need to change your child’s diet. If you are breastfeeding, just carry on as usual. You may need to nurse your baby more frequently. Babies on formula can also be fed as usual without diluting the milk. Older children can continue with their normal diet, but try to avoid fruit juices and fatty foods (such as fried foods, crisps, milky puddings and full-fat milk).  

The best way to treat or cure dehydration is to ensure that your child drinks a lot. When a child has diarrhoea, the body loses a lot of fluid and salt. You can make up for this loss with ORS (Oral Rehydration Salts). These are sachets of a powder that you can dissolve in water, which can be obtained without a prescription.
A child will need about 10ml ORS per kilo of bodyweight after every diarrhoea-soiled nappy. For babies under 12 months old this is roughly a cup, and two cups for children older than a year. Many children will be able to drink the ORS themselves.
If you are breastfeeding, you should nurse your child more frequently and also give ORS in a bottle. Even children that are vomiting absorb ORS easily. It is important to give them small amounts regularly and to continue until the diarrhoea has stopped. This requires a lot of effort and can take several days.  

Treatment on admission
In rare cases, some children may have to be admitted to hospital. This may be advised if the child is not drinking enough of the ORS, for example, or if it is vomiting excessively. A tube will then be inserted into your child’s stomach via its nose to administer the ORS directly. If your child keeps vomiting or is seriously dehydrated, it may become necessary to put it on a drip so that fluid can be administered more effectively.  

Nursing
As gastroenteritis is infectious, your child will be nursed separately in a so-called smetbox. This means that it will be cared for in a side-room, isolated from other children. This is to prevent other children from becoming contaminated. The only visitors allowed will be the parents and brothers and sisters. Special rules apply to anyone entering the room. The nurse will explain them to you but they are also posted next to the door of your child’s room.  

Going home
If your child is admitted to hospital, the aim of the treatment will be to cure the dehydration. As soon as this is achieved and your child is drinking properly, it will be allowed to go home. The child may still have diarrhoea or feel sick. Once the dehydration has been taken care of, there is no need to alter the child’s diet.   The risk of infection will remain until the diarrhoea stops. We would advise everyone coming into contact with your child to wash their hands regularly.  
It is not usually necessary for your child to come back to the Outpatients’ Department for a check-up.  

Questions
If you have any more questions after reading this leaflet, please ask the doctor or nurse treating your child.  
The plan below has been made with your doctor:

Fluid
Extra fluid	...... ml ORS spread over ± 4 hours
Basic fluid intake at home	...... ml ORS/fluid per day
Additional fluid every time your child has a bout of diarrhoea	...... ml ORS/fluid
Additional fluid every time yourchild vomits	...... ml ORS/fluid
Continue breastfeeding.
Start suitable food (according to age) after dehydration has been cured.
Get in touch with your family doctor or the hospital (Tel: 070 - 312 41 41) if you notice the following signs of dehydration: no urine production for 12 hours or more less alert reactions dry mucous membranes crying without tears depressed fontanelle

Edition: June 2010/158