Vomiting and diarrhea in children

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What is it about ?

In children, vomiting and diarrhea are most often caused by a virus, but sometimes by bacteria (for example E. Coli) or a parasite (for example Giardia).

In children, we speak of diarrhea from 3 watery stools in 24 hours. An episode of diarrhea usually lasts between 4 and 7 days.

In Belgium, toddlers are vaccinated against rotavirus. Rotavirus is therefore no longer the primary cause of ‘stomach flu’ (gastroenteritis) in children, but has been replaced by norovirus and ordinary viruses of the respiratory tract, such as adenovirus. Viral contamination usually passes through hand-to-mouth contact, and sometimes through sneezing or spitting up.

Eating undercooked food or food stored out of the fridge can cause bacterial gastroenteritis.

Bacterial or parasitic gastroenteritis can be contracted by drinking contaminated water or traveling to a country where hygienic conditions are poor.

Other causes can still cause diarrhea and vomiting in children, such as an ear infection. (otitis) moderatee, an infection of the lungs (pneumonia), infection of the renal pelvis (pyelonephritis) or severe generalized infection (sepsis). Likewise, a change in diet, food allergy, certain medications and various bowel disorders can cause diarrhea.

What is their frequency?

Vomiting and diarrhea in children are common and usually occur in small outbreaks.
In developing countries (low and middle income countries), millions of children die from gastroenteritis each year due to poor medical care.

How to recognize them?

Most often the child suddenly feels bad, loses his appetite and begins to vomit and / or have diarrhea. Sometimes he complains of stomach aches and fever.

How is the diagnosis made?

The doctor will ask you questions about the symptoms and their appearance:

  • Have you noticed any blood or mucus in the stool?
  • Is the child very thirsty?

He also examines the child to make sure there is no other underlying disease. He will also look for possible signs of dehydration:

  • Is the child drowsy, confused, difficult to wake up?
  • Is his heart beating fast? Is his breathing fast?
  • Is he urinating correctly?
  • Does he have dry mucous membranes, does he have tears, does he have sunken eyes?
  • Is the soft space on a baby’s head (the fontanel) normal or hollow?
  • Has the child lost weight?
  • Are his hands and feet warm to the touch? Are they well irrigated? Is the skin supple? (If you pinch the skin of someone who is dehydrated, you find that it takes a little time for them to return to their normal shape).

What can you do ?

The top priority is to avoid lack of water (dehydration). Encourage your child to drink small amounts regularly. Optionally, use oral rehydration solution (ORS) to speed up rehydration. Be sure to ensure good hand hygiene to reduce the risk of contamination for those around you (and for yourself!).

What can your doctor do?

The main task of the doctor is to assess whether the child is dehydrated, to determine the degree of dehydration and to decide whether the treatment can be continued at home.

Medicines have little influence on the disease. It is up to the immune system to eliminate the virus.

Probiotics (for example Saccharomyces boulardii) can reduce the duration of diarrhea by up to a day, but have no proven effect on the risk of dehydration or hospitalization. They are therefore not recommended.

Loperamide, a drug that slows down digestive transit, is not recommended.

Medicines that act against nausea and vomiting (domperidone and metoclopramide) are not recommended.

The general practitioner can refer the child to the hospital in the following cases:

  • The child is less than 6 months old: it is safer to hospitalize him, because he can become dehydrated very quickly;
  • The diarrhea and vomiting are severe and the general condition of the child is poor;
  • Dehydration is moderate or severe;
  • The diarrhea has lasted for more than 5 days and is accompanied by poor general condition and weight loss;
  • The child has painful cramps in the stomach, with sudden stop of the diarrhea, which makes think of a turning “in glove finger” of part of the intestine (intussusception);
  • The diarrhea is accompanied by blood in the stool.

Once at the hospital, the child will have a blood test and he will receive rehydration treatment with a nasal tube or an infusion. If necessary, and certainly in the event of bloody diarrhea in a child under 6 months of age, the stool will also be cultured for analysis. If a bacteria or parasite is causing the diarrhea, the doctor will prescribe antibiotics or antiparasitics.

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Source

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