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Gastroenteritis in childrenThis factsheet is for parents of children with gastroenteritis. There is a separate BUPA factsheet for adults, Gastroenteritis in adults. Gastroenteritis is an inflammation or irritation of the stomach and intestines. In the UK, gastroenteritis is one of the most common childhood illnesses. Most infants and toddlers have at least one or two bouts of it a year. In most cases, gastroenteritis clears up without the need for specific medical treatment. In babies and young children, it can be more dangerous because they become dehydrated more easily. What is gastroenteritis?The stomach and intestines are known collectively as the gastrointestinal tract - or gut. Gastroenteritis is an infection of the gut. Children can get infected from eating or drinking food that is contaminated with bacteria, viruses or parasites, or from other infected people (see "Causes" below). Some of these germs can damage the cells lining the inner surface of the gut and interfere with its normal functions. Certain bacteria or viruses may also produce toxins that irritate the gut and cause it to produce excess amounts of fluid. This can lead to the various symptoms of gastroenteritis such as diarrhoea. Symptoms of gastroenteritisThe time between catching the infection and the start of symptoms - the incubation period - depends on the cause of gastroenteritis. Depending on the type of bacteria, virus or parasite, it can range from a few hours to a couple of weeks. Depending on the cause, your child may have some or all of the following symptoms including:
Most children recover within a week. However, with severe infections, which are uncommon in the UK, the illness may persist for many weeks. DehydrationThe main risk of gastroenteritis in children, particularly babies and young children, is that they become dehydrated. This can occur very quickly in babies because they do not need to lose a lot of fluid to lose a significant percentage of total body fluid. The symptoms of mild to moderate dehydration may include:
With more severe dehydration symptoms include:
Causes of gastroenteritisVirusesViruses are a major cause of gastroenteritis, particularly in children under five, accounting for eight in 10 cases of gastroenteritis. BacteriaThe commonest cause of bacterial gastroenteritis is food poisoning. Escherichia coli (E. coli) is an example. Some E. coli strains are particularly harmful, including E. coli 0157, which produces a toxin that can also damage the kidneys, cause red blood cells to break down and cause inflammation in small blood vessels. These infections can be fatal and children can be particularly vulnerable. For more information on food poisoning, please see the separate BUPA factsheet, Food hygiene. ParasitesParasites rarely cause gastroenteritis in the UK. Other causesThere are a number of other conditions that can cause vomiting or diarrhoea in children. Cow's milk intolerance (in infants) or allergy to foods, such as milk or eggs, can cause nausea and vomiting. For more information on food allergies, please see the separate BUPA factsheet, Food allergy. In babies, diarrhoea can also be caused by other infections such as a chest infection or urinary tract infection. However, very occasionally it may be due to other conditions, such as encephalitis, diabetes, appendicitis or a blockage of the gut. If you and your child have recently travelled to a country where malaria is present, this could also be a potential cause. Most cases of gastroenteritis are due to bacteria and viruses however. How is gastroenteritis spread?The infections are transmitted:
TreatmentHome treatmentThe most important part of treatment is to replace the fluids your child has lost, to prevent dehydration. If your child is very young, seek medical advice, because babies and children are at high risk of becoming dehydrated.
If you are breastfeeding your child, you should continue, and give oral re-hydration on top if needed. MedicinesChildren under 12 shouldn't be given medicines to stop diarrhoea (anti-diarrhoeals) or vomiting (antiemetics). They do not stop the excessive production of fluids that cause diarrhoea, so it will collect in the gut and come out later. These medicines may also cause side-effects such as drowsiness and skin reactions. If your child is in pain, give a painkiller that you would normally give him or her for a headache. When to contact a doctorYou should seek medical advice if your child is becoming dehydrated, or if there is a possibility that their illness is not a simple gut infection. You are likely to know best if your child seems unwell, for example he or she is not responding normally, or seems abnormally drowsy. You should also contact your doctor if:
Most cases of gastroenteritis are caused by viruses, which are not treatable with antibiotics. In general therefore, doctors in the UK do not prescribe antibiotics for a typical case of gastroenteritis. However, if your doctor suspects that your child has a bacterial infection, he or she may ask for a stool sample to send for laboratory testing. The results will help to determine which antibiotic to treat your child with. Hospital treatmentIf your child has lost so much fluid that he or she is very dehydrated, hospital treatment may be needed to replace fluids intravenously. PreventionMost children will get gastroenteritis at some time, no matter how high the standards of hygiene at home. To help prevent gastroenteritis encourage children to always wash their hands after going to the toilet and before handling food. For more information about food handling, please see the separate BUPA factsheet, Food hygiene. If your child has gastroenteritis, help to prevent spreading the infection to other family members by:
Should my child stay off school/nursery?Your child should stay off school/nursery for at least 24 hours after their symptoms of diarrhoea and vomiting have stopped. Further time off may be necessary if your child is infected with Salmonella - ask your doctor for advice. Further information
References
Reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP. partner/principal general practitioner at Rowcroft Medical Centre. Published by BUPA's health information team, healthinfo@bupa.com, February 2006.
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