Vomiting and Diarrhoea (V+D) is one of the most common illnesses seen in infants and young children. The vast majority of cases (>80%) are caused by a viral infection (viral gastroenteritis) and settle without any treatment within 48hrs. Most viral gastroenteritis occurs in winter and spring but it can happen any time of the year and nearly all children will have had this bug by the time they are 5 years old. The virus that causes gastroenteritis is very contagious and can passed very easily from person to person.
The biggest risk to a child with V+D if that they aren’t holding in enough fluids and become dehydrated.
Gastroenteritis usually starts suddenly and as well as V + D the patient may have crampy stomach pains, often before a bout of diarrhoea or vomiting, they may also have a temperature.
Vomiting can also be a symptom of other illnesses but these are all much less common than gastroenteritis, these include;
Gastro-oesophageal reflux (common) – Vomiting typically after feeds due to a weak stomach muscle, baby can be cranky but otherwise well, babies usually grow out of this without any treatment.
Appendicitis – child usually has constant tummy pain which gets worse.
Blocked intestine – Tummy pain and vomit is ‘grass green’ colour.
Pyloric stenosis – Very forceful vomiting in baby <3months old.
Urine Infection – Vomiting, tummy pain, high temp and sometimes pain passing urine.
Meningitis (rare) – Vomiting, fever, lethargy, very irritable, spots that don’t fade when pressed.
Treatment of Gastro-enteritis
There is no cure for gastroenteritis and the bug generally passes within 48hours. The illness can go on for a week or more but the main objective is to keep the child hydrated with regular fluids.
The best fluids to rehydrate a child are oral rehydration solution (dioralyte) – it contains the perfect balance of salts and glucose to rehydrate a child. Other drinks i.e. 7up have a sugar content which is too high and they can actually make diarrhoea worse. Start rehydration giving small sips or a spoonful every 10-15mins for the first 4-6 hours. You can also freeze it and make it into ice pops. If you can’t get dioralyte you can dilute 7up to half strength with water.
After 6 hours you can try some soft food or milk – if they vomit up the food keep them on the dioralyte for 24 hours.
After 24 hours you should return to normal diet even if diarrhoea continues, prolonged starvation can actually make diarrhoea last longer. Diarrhoea may last up to 2 weeks. Child should be kept off school till diarrhoea settles as they re infectious.
There is no role for antibiotics in gastroenteritis, we do not give kids medications to stop diarrhoea.
Dehydration – is the main risk in gastroenteritis. The signs that indicate dehydration include, dry lips and tongue, pallor, lethargy, not wetting nappies, fast heartbeat. If your child develops these symptoms they should come to see the doctor.
The above information is general guidance about vomiting and diarrhoea in children, if your child develops any of the features underlined or if they are less than 6 months old I would be advising to come to see the doctor. Needless to say if you are worried about your child with vomiting and diarrhoea we would be happy to see them at any time.