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Gastroenteritis (cont.)

Gastroenteritis Treatment

Treatment of gastroenteritis includes self-care and home remedies that are aimed at keeping the patient well hydrated to avoid dehydration. Medical treatment may be necessary if the patient becomes dehydrated and needs intravenous (IV) fluids to replenish lost fluids. Sometimes antibiotics may be prescribed to treat some infections (for example, C. diff). Antiemetic medications can be used to treat nausea and vomiting. Antidiarrheal medication to decrease the frequency and amount of diarrhea are sometimes recommended depending upon the cause of the diarrhea.

Gastroenteritis Self-Care and Home Remedies

The treatment of gastroenteritis is aimed at maintaining hydration while the vomiting and diarrhea resolve, often spontaneously. Home remedies that address keeping fluid in the body are key to recovery.

Since most causes of gastroenteritis are due to viruses, replacing the fluid lost because of vomiting and diarrhea allows the body to recuperate and fight the infection itself. Dehydration can also intensify the symptoms of nausea and vomiting. The critical step is replacing fluids when the affected individual is nauseous and doesn't want to drink (hydrate). This is especially difficult with infants and children. Small frequent offerings of clear fluids, sometimes only a mouthful at a time, may be enough to replenish the body's fluid stores and prevent an admission to the hospital for intravenous (IV) fluid administration.

In general, clear fluids (anything you can see through), may be tolerated in small amounts. Think of it as adding just an ounce or less to the normal saliva that the patient is already swallowing. However, giving too much fluid at one time may cause increased nausea due to a distended stomach, which causes additional irritation.

Clear fluids do not include carbonated beverages but flat colas or ginger ale with the fizz gone are often well tolerated. Coke syrup may also be helpful in settling the stomach.

Jello and popsicles may be "solid food" alternatives to clear fluids in children who aren't interested in clear fluids.

Dehydration in Children

Oral rehydration therapy using balanced electrolyte solutions such as Pedialyte or Gatorade/Powerade may be all that is needed to replenish the fluid supply in an infant or child. Plain water is not recommended because it can dilute the electrolytes in the body and cause complications such as seizures due to low sodium.

The key to oral rehydration is small frequent feedings. If offered free access to a bottle, infants may drink quickly to quench their thirst and then vomit because of a distended, full stomach. Instead it may be best to limit the amount of fluid given at one time. There are a variety of regimens that are used and they follow a basic format:

  • Offer 1/3 of an ounce (5 to 10 cc) of fluid at one time. Wait 5 to 10 minutes then repeat.
  • If this amount is tolerated without vomiting, increase the amount of fluid to 2/3 of an ounce (10 to 20 cc). Wait and repeat.
  • If tolerated, increase the fluid offered to 1 ounce (30 cc) at a time.
  • If vomiting occurs, go back to the 1/3 of an ounce (5 to 10 cc) and restart.
  • Once the child is tolerating significant fluids by mouth, a more solid diet can be offered.

The important thing to remember is that the goal is to provide fluid to the child and not necessarily calories. In the short term, hydration is more important than nutrition.

For infants and children, fluid status can be monitored by

  • whether they are urinating,
  • if they have saliva in their mouths,
  • tears in their eyes, and
  • sweat in their armpits or groin.

If the child's baseline weight is known, dehydration can be measured by comparing weight.

Medical care should be accessed immediately, if the child is listless, floppy or does not seem to be acting normally.

Dehydration in adults

Although adults and adolescents have a larger electrolyte reserve than children, electrolyte imbalance and dehydration may still occur as fluid is lost through vomiting and diarrhea. Severe symptoms and dehydration usually develop as complications of medication use or chronic diseases such as diabetes or kidney failure; however, symptoms may occur in healthy people.

  • Clear fluids are appropriate for the first 24 hours to maintain adequate hydration.
  • After 24 hours of fluid without vomiting, the diet can be progressed to other foods as tolerated.
Medically Reviewed by a Doctor on 2/11/2016

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