Gastroenteritis Health Article

Symptoms

Gastroenteritis symptoms include nausea and vomiting, watery diarrhea, and abdominal pain and cramps. These symptoms are sometimes accompanied by bloating, low fever, chills, headache, and overall tiredness or weakness. Gastroenteritis symptoms typically last two to three days, but some viruses may last up to a week.

Infants, young children, the elderly, and anyone with an underlying disease are more vulnerable to complications of gastroenteritis. The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-threatening problems such as heart beat abnormalities (arrhythmia). The risk of dehydration increases as symptoms become prolonged. Untreated, severe dehydration can be life threatening. Dehydration should be suspected if symptoms of a dry mouth, increased or excessive thirst, or decreased urination are experienced.

When to call the doctor

If symptoms do not resolve within one week, an infection or disorder more serious than gastroenteritis may be involved. Prompt medical attention is required if the child has any of these symptoms:

• a high fever of 102°F (38.9°C) or above
• blood or mucus in the diarrhea
• blood in the vomit
• bloody stools or black stools
• confusion
• severe abdominal pain or swelling
• inability to keep liquids down

If a child has the following symptoms, the parent should contact the child's pediatrician:

• diarrhea or vomiting that wakes the child during the night
• persistent or severe diarrhea or vomiting
• dehydration symptoms, including dry mouth, increased or excessive thirst, few or no tears when crying, decreased urination, dark yellow urine, irritability, low energy, lightheadedness or fainting, severe weakness, and sunken abdomen, eyes, and cheeks
• no improvement in symptoms after 36 hours

Diagnosis

A usual bout of gastroenteritis should not require a visit to the doctor. However, medical treatment is essential if symptoms worsen or if the child has any symptoms of dehydration.

A physician makes the diagnosis of gastroenteritis based on the presence of symptoms and after performing a medical examination. Unless there is an outbreak affecting several people or complications are encountered in a particular case, identifying the specific cause of the illness is not a priority. However, if identification of the infectious agent is required, a stool sample will be collected and analyzed for the presence of rotavirus, disease-causing (pathogenic) bacteria, or parasites.

When symptoms continue even after treatment or to rule out the presence of other illnesses with similar symptoms, the diagnostic evaluation may include blood tests, a hydrogen breath test, or an x ray of the bowel, called a barium enema. Endoscopic tests such as a colonoscopy or sigmoidoscopy may be performed. An endoscopic test is an internal examination of the colon using a flexible instrument (sigmoidoscope or colonoscope) inserted through the anus. When symptoms persist, a nutritional assessment, performed by a registered dietitian, may be included in the child's diagnostic evaluation.

Treatment

Gastroenteritis is a self-limiting illness that will resolve by itself. Acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) should be used sparingly for relief of discomfort. Parents should ask the child's doctor for specific guidelines. Should pathogenic bacteria or parasites be identified in the patient's stool sample, medications such as antibiotics will be prescribed. Over-the-counter antidiarrheal medications such as Imodium should not be given to the child unless advised by the child's doctor, as these drugs may make it more difficult for the child's body to eliminate the virus.

An adequate intake of liquids and oral rehydrating solutions may be enough to treat mild dehydration. More severe dehydration requires medical treatment with intravenous (IV) fluids and may require hospitalization. IV therapy can be followed with oral rehydration as the patient's condition improves. Once normal hydration is achieved and symptoms have cleared, the patient can resume a regular diet.