Viral Gastroenteritis in Children
Viral gastroenteritis is often called stomach flu. But it is not really related to the flu or influenza. It is irritation of the stomach and intestines due to infection with a virus. Most children with viral gastroenteritis get better in a few days without a healthcare provider’s treatment. Because a child with gastroenteritis may have trouble keeping fluids down, he or she is at risk for fluid loss (dehydration) and should be watched closely.
Symptoms of viral gastroenteritis
Symptoms of gastroenteritis include loose, watery stools (diarrhea), sometimes with nausea and vomiting. The child may have cramps or pain in the stomach area. A fever or headache may also be present. Symptoms usually last for about 2 days, but may take as long as 7 days to go away.
How is viral gastroenteritis spread?
Viral gastroenteritis is highly contagious. The viruses that cause the infection are often passed from person to person by unwashed hands. Children can get the viruses from food, eating utensils, or toys. People who have had the infection can be contagious even after they feel better. And some people are infected but never have symptoms. Because of this, outbreaks of gastroenteritis are common in childcare and other group settings.
Most cases of viral gastroenteritis get better without treatment. (Antibiotics are not helpful against viral infections.) The goal of treatment is to make your child comfortable and to prevent dehydration. These tips can help:
Be sure your child gets plenty of rest.
To prevent dehydration:
Give your child plenty of liquids such as water. You can also give your child an oral rehydration solution, which you can buy at the grocery store or pharmacy. Ask your child's healthcare provider which types of solutions are best for your child. Have your child take small sips of fluid at first to avoid nausea. Don’t dilute juice or give other drinks with sugar in them (such as sports drinks) as this may worsen the diarrhea.
If your older child seems dehydrated, give 1 to 2 teaspoons of an oral rehydration solution. Do this every 10 minutes until vomiting stops and your child is able to keep down larger amounts of liquid.
If your baby is bottle fed, you can give an oral rehydration solution for 4 to 6 hours and then resume formula. You may need to feed your baby more often to ensure he or she gets enough fluids. You can also give an oral rehydration solution if your baby is urinating less often or the urine is dark in color.
If your baby is breastfeeding, you may need to feed your baby more often. You can also give an oral rehydration solution if your baby is urinating less often or the urine is dark in color.
When your child is able to eat again:
Feed your child regular foods. Returning to a regular diet quickly has been shown to reduce the length of symptoms of gastroenteritis.
Ask your child’s healthcare provider if there are any foods to avoid while your child is recovering from gastroenteritis.
Don’t give your child any medicines unless they have been recommended by your child's healthcare provider.
Some children may develop a short-term (temporary) intolerance to dairy products after a diarrheal illness. If dairy items seem to make your child's symptoms worse, you may need to avoid them temporarily.
Preventing viral gastroenteritis
These steps may help lessen the chances that you or your child will get or pass on viral gastroenteritis:
Wash your hands with warm water and soap often, especially after going to the bathroom, diapering your child, and before preparing, serving, or eating food.
Have your child wash his or her hands frequently.
Keep food preparation areas clean.
Wash soiled clothing promptly.
Use diapers with waterproof outer covers or use plastic pants.
Prevent contact between your child and those who are sick.
Keep your sick child home from school or childcare.
Ask your child’s healthcare provider if your child should receive the rotavirus vaccine. This vaccine protects infants and young children against rotavirus infection, one cause of viral gastroenteritis.
When to call the healthcare provider
Call your child’s healthcare provider right away if your child:
Has a fever (see fever and children section below)
Has had a seizure caused by the fever
Has been vomiting and having diarrhea for more than 6 hours
Has blood in vomit or bloody diarrhea
Has severe stomach pain
Can’t keep even small amounts of liquid down
Shows signs of dehydration, such as very dark or very little urine, excessive thirst, dry mouth, or dizziness
Is a baby and does not urinate for 8 hours or more
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
February 16, 2018
UptoDate: Patient Information: Diarrhea in Children (The Basics), UptoDate: Patient Information: Viral Gastroenteritis (The Basics)
Bass, Pat F. III, MD, MPH,Image Reviewed by Staywell medical art team.,Lentnek, Arnold, MD,Turley, Ray, BSN, MSN