Vomiting, Diarrhea, and Dehydration

Vomiting and diarrhea are very common problems during childhood. There are many reasons that cause children to have this problem, many of which require minimal medical attention.

The most common cause of vomiting and diarrhea is viral gastroenteritis ("stomach flu"). Symptoms include vomiting and/or diarrhea, abdominal pain, and fever. This is an illness that antibiotics will not help, and unfortunately must "run it's course". The goal of treating children with vomiting and diarrhea is to prevent dehydration. There are many strategies, some of which are discussed below. Simply, it is important to encourage fluids so that the fluid lost is replenished.

Medications

It is very rare that medications are used to stop the above symptoms from occurring. Adults often will use over-the-counter medicines such as Immodium to stop diarrhea. This is not used in children. There are some anti-nausea medicines that are prescription and can be given as suppositories in rare cases.

Strategies for rehydration

Small amounts of fluid frequently is preferred over large amounts of fluid infrequently. By taking small amounts, the body is able to absorb the fluid before it has caused enough GI irritation to trigger vomiting. Popsicles are a good source of fluid because they must be taken slowly.

Rehydration Fluids

Pedialyte or a generic equivalent is the preferred oral rehydration solution (ORS), and is available at most grocery stores. The downside of Pedialyte is taste. It can be quite salty. This is because it contains electrolytes such as Sodium which is very important. Other suitable fluids include sports drinks (such as Gatorade), and clear liquids for children over 1 year of age. If those fluids are used, a source of sodium such as saltine crackers or pretzels can be helpful (if age appropriate). Rehydration with plain water is not recommended because it can lead to electrolyte imbalance and in severe cases, seizures. When reintroducing solid foods, the BRAT (bread, rice, apples, and toast) diet has been recommended for years.

Signs of dehydration

Sunken eyes, decreased urine output, cool extremities, decreased level of alertness, and dry tongue

Other causes of vomiting

Other causes of vomiting include bowel obstruction, bowel twisting, appendicitis, etc. If vomiting is accompanied with severe abdominal pain, bilious (green) vomiting, bloody vomiting or a rigid abdomen it should be discussed with a physician.

Diarrhea

Diarrhea is defined by the volume of the stool as opposed to the consistency (looseness). Diarrhea can be many colors such as yellow, brown, and green. It also may contain mucous. Blood can be a sign of bacterial infection and should be brought to the attention of a doctor.

JDMD 12/26/00