Gastroenteritis and Oral Rehydration
Gastroenteritis and Oral Rehydration
Leah Harrington
Suzan Schneeweiss
Introduction
Gastroenteritis: diarrheal disease of rapid onset
May be accompanied by nausea, vomiting, fever, or abdominal pain
Common cause of abdominal pain presenting to the emergency department
Vomiting alone does not constitute gastroenteritis
Be cautious in labeling the child with vomiting in the absence of diarrhea as “gastroenteritis”; need thorough assessment to rule out other diagnoses
Infrequently requires antibiotics
Pathogens
Common Viral Etiologies
Rotavirus: age 3-15 months; fever, vomiting precedes nonbloody diarrhea; duration 5-7 days
Norwalk, adenovirus, torovirus
History
Fluid intake: volume, type (hypertonic, hypotonic, ORS), frequency
Stool output: frequency, consistency, presence of blood or mucus
Emesis: frequency, volume, bilious vs nonbilious, hematemesis
Fever, appetite, weight loss
Sick contacts including daycare
Travel
Underlying illness: cardiac disease, diabetes, renal disease, cystic fibrosis
Examination
Determine if underlying cause of disease
First signs of dehydration may not be evident until reach 3-4% dehydration, more signs at 5%, and signs of severe dehydration at 9%
Difficult to distinguish signs of mild and moderate dehydration on basis of clinical signs; updated recommendations group these patients together (i.e., 3-9%)
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