ACUTE GASTROENTERITIS

(A.G.E.)

Acute gastroenteritis is the medical term for a “stomach virus”. It is characterized by any or all of the following symptoms: nausea, vomiting, cramps, diarrhea, fever, lack of appetite.

In younger children and infants, nausea and cramping may be hard to judge. Such children usually exhibit irritability (fussiness), lack of appetite (anorexia), and gas as signals of their discomfort. These symptoms are brought about mainly by inability to properly digest their food.

The treatment consists mainly of trying to relieve these symptoms since we are still unable “to make viruses go away”. A light diet will usually relieve most of the symptoms. The foods and drinks chosen are based on ease of digestion and lack of irritation (not on how soft they are or whether they are liquid or solid). The diet varies with the age of the child (see below). It is also necessary to offer smaller feedings. Children may not understand why the special diet and smaller amounts are given and, thus, it is important as parents to be understanding but firm on this issue. Eating a normal diet with acute gastroenteritis is like trying to walk on a sprained ankle. It won’t get better until you rest it.

The usual case of A.G.E. lasts 1-3 days, but occasionally as long as 7-10 days. The diet should be maintained throughout the illness.

What to watch for while treating A.G.E.:
In general, you are watching for improvement in the child’s symptoms. You should evaluate the child on a daily basis and, if not improved, you should call the office to decide on changes in the diet or the need to be seen.

• Diarrhea: 5-6 watery stools per day. Initially, the stools will decrease in amount, then frequency, but will often remain loose. Next, they should return to normal frequency and firmness.

Improvement: This should be seen in mood, comfort and appetite.

NOTE: Diarrhea may persist up to 3 days. If more than 1 stool/hour, for 8-10 hours, or more than 10 stools per day, you should check with physician regarding evaluation of your child.

Unusual symptoms that should result in calling your doctor immediately:

• Dehydration: the infant or child should urinate at lease every 4-6 hours, have a moist tongue and mouth, and tears when crying. This is the most frequent problem to watch for and you should call as soon as possible if your child appears to be dehydrating.
• Severe cramps or irritability that cannot be relieved.
• Inability of the child to stand up straight and move without discomfort.
• Persistence of pain in the same area.
• Blood in the stool.
• Any signs of unusual behavior such as hallucinations, being disoriented or unresponsive.

DIET

(Always give frequent small amounts)

LESS THAN SIX MONTHS OF AGE:

Day 1: Pedialyte or Ricelyte (frequent small amounts)
Day 2: ½ strength or full strength Isomil or Prosobee
Day 3: Full strength Isomil or Prosobee
Day 4: Retry normal diet but continue soybean formula for 1-2 weeks.

SIX MONTHS TO ONE YEAR

Day 1: Pedialyte or Ricelyte (frequent small amounts)
Day 2: ½ strength or full strength Isomil or Prosobee
Day 3: Full strength Isomil or Prosobee
May add: decaffeinated pop/rice/applesauce/bananas/potato/yogurt/small feedings.
Full strength soybean formula for 1-2 weeks.

OVER ONE YEAR

Day 1: Pedialyte, Ricelyte, Gatorade (frequent small amounts)
Day 2: ½ strength or full strength Isomil or Prosobee
May add: decaffeinated pop/rice/applesauce/bananas/potato/crackers/pretzels/yogurt
-small feedings.
Day 3: Lean meat or chicken/egg. Other foods as above.

AVOID: oats, peas, teas, juice, fresh fruit, fatty foods and large meals.

***SPECIAL NOTE FOR BREATFEEDING MOTHERS**: Breastfed infants are less likely to get ill, but they still can get sick. Unfortunately, breast milk and milk formulas both are difficult to digest with A.G.E. This is due to lactose, which is in all mammalian milk (human, cow, goat, etc). This sugar is the first item in which we lose the ability to digest whenever we have A.G.E. Diarrhea in an infant on breast milk usually is more green-brown, has a foul odor and is more explosive. Breastfeeding mothers should call the office regarding diet changes.

**Why not give plain water: In treating A.G.E., the goal is to rest the stomach and intestines while maintaining fluid and mineral requirements. Water alone cannot supply the minerals and, thus, can actually make the child worse.