Acute Gastroenteritis in Children

Background: Gastroenteritis (GE) is inflammation of the mucous membranes of the gastrointestinal tract, and is characterised by vomiting and/or diarrhoea. The most common causes are viruses, but bacterial, protozoal and helminthic GE occur, particularly in developing countries. Vomiting and diarrhoea can be nonspecific symptoms in children, and the diagnosis of viral GE should be made after careful exclusion of other causes.

Objective: This article outlines the assessment and management of children with acute GE.

Discussion: The most important complication of GE is dehydration. The amount of weight loss as a percentage of normal body weight provides the best estimate of degree of dehydration. Clinical signs are not present until the child has lost at least 4% of their body weight. The best signs for identifying dehydration include decreased peripheral perfusion, abnormal skin turgor, and an abnormal respiratory pattern. Fluid replacement is the mainstay of management and most infants and children can be rehydrated safely with oral rehydration solution. Antiemetics and antidiarrhoeals are not indicated in children with acute GE.