can be a problem for kids
By Dr. Diana Curran
When a child gets sick with vomiting or diarrhea, the body fluids
they lose can lead to dehydration. Although most children with
diarrhea do not get dehydrated, those that do have a very serious
condition that could lead to death if not treated properly. Parents
can prevent these complications if they recognize the signs of
dehydration early and know how to treat it at home. Diarrhea
that comes on rapidly is also called acute gastroenteritis. It may
be associated with nausea, vomiting, fever, or abdominal pain.
Gastroenteritis is very common. In the United States, children under
3 years old get sick with diarrhea 1.3 to 2.3 times a year on
average. Each year 220,000 children under age 5 years require
hospitalization for treatment of gastroenteritis, and 300 will die
due to dehydration.
Symptoms of gastroenteritis typically last from 24 hours to a
week, and may be associated with other illnesses including colds.
The cause can be viral or bacterial. All forms of diarrhea are
contagious, and children should remain home until the diarrhea
stops. Children under 5 years old in day care or pre-school programs
are more likely to catch these illnesses from other children. In
these settings, especially, we may need to know the cause in order
to prevent spread. The stool culture is the test of choice.
In recent years, our region has experienced outbreaks of both
Campylobacter and Shigella infections. To prevent spread, health
department nurses investigate the cases, like detectives, so they
can find the source and contain it. They also educate the public in
order to notify those at risk to watch for symptoms and get
treatment if necessary.
Treatment is supportive. Over the counter medicine should be
avoided in children. It is best to let the illness run its course.
Pepto-bismol contains an aspirin-like substance that should not be
given to children. Anti-diarrhea medication such as Immodium can
prevent clearing of the infection and prolong the illness, and may
lead to serious intestinal complications in children. Even with
bacterial causes of diarrhea, antibiotics should not be given to
children due to severe complications that can arise from certain
types of bacterial gastroenteritis. The only effective treatment is
supportive rehydration with salt-containing fluid solutions.
Rehydration replaces the important salts lost by the body in
diarrhea such as sodium, potassium, and chloride. This can be
accomplished by giving an oral solution if it contains these salts
and some sugars. Sodas like ginger ale or Sprite have often been
used by parents, but they do not contain enough salts to replace
what is lost, and may worsen diarrhea. Homemade solutions with salt
can have too much salt and may also worsen the condition. Some
parents use Pedialyte solution which is available at drug stores.
However, this can be expensive.
To make it easier for parents, AccessCare recently provided
oral rehydration packets to the Health Department and Hendersonville
Pediatrics to give to their parents. These packets are mixed with
one liter of water to make the perfect balance of salt and sugar to
effectively rehydrate children. AccessCare also provided these
offices with educational pamphlets for parents with all the specific
instructions about how to recognize the signs of dehydration, what
other treatments to try or to avoid, when and how to reintroduce
food and when to call the doctor.
In general, give fluids soon and often, and offer the child
her usual diet right away.
Dr. Diana Curran is medical director of the Henderson County
Department of Public Health.