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Diarrhoea and vomiting in children: Treatment, symptoms, advice and help

About diarrhoea and vomiting in children

Complaints of diarrhoea and vomiting are commonly encountered in children. Diarrhoea is characterised by loose and watery stools, three or more times in a day. Diarrhoea and vomiting are symptoms of various diseases. Both diarrhoea and vomiting are usually benign and self-limiting, resulting in complete recovery in most of the individuals.

Diarrhoea and vomiting in children: Incidence, age and sex

Diarrhoea and vomiting are fairly common conditions encountered in children. Diarrhoea in itself is not a serious condition but it may precipitate life-threatening conditions in children, especially infants.

Signs and symptoms of diarrhoea and vomiting in children: Diagnosis

Diarrhoea in itself is a clinical feature of several diseases including infections and allergy. A child with diarrhoea may have watery or loose stools which may or may not be accompanied with abdominal discomfort. Other associated features may include nausea, vomiting or a sensation of abdominal bloating. The spectrum of clinical features depends upon the underlying cause. For example, diarrhoea and vomiting caused by bacterial infections may also result in fever (high temperature). Diarrhoea and vomiting associated with abdominal pain may point towards acute appendicitis or intestinal obstruction. Vomiting may also be accompanied with headache in cases of meningitis or raised intracranial pressure.

The gastroenterologist would take a detailed history and conduct a comprehensive physical examination before advising any tests. Standard blood tests may reveal increased white blood cell count which is an indication of a bacterial infection. Other diagnostic tests like serum electrolytes or stool test may also be required.

Causes and prevention of diarrhoea and vomiting in children

There are several causes which may result in diarrhoea and vomiting, of which infection of the intestines is the commonest. This infection may be bacterial, viral or parasitic. However gastroenteritis in children is mainly viral in nature. Certain diseases like haemolytic uraemic syndrome, appendicitis, intestinal obstruction or meningitis may also exhibit diarrhoea and vomiting. Some children may experience diarrhoea on intake of milk and milk products. This condition is called lactose intolerance. Furthermore emotional and psychological conditions like stress, anxiety or tension may also cause diarrhoea.

Diarrhoea and vomiting in children: Complications

Furthermore both diarrhoea and vomiting may result in depletion of body fluids called dehydration which may range from mild to severe. Features of mild dehydration include loss of skin elasticity, sunken eyes, dry tongue, irritability or lethargy in the child. The child may become drowsy and exhibit rapid breathing and heart rate in instances of severe dehydration which is a medical emergency. Electrolyte imbalance may be seen which may predispose individuals to seizures. Very rarely, kidney failure may also result from longstanding dehydration.

Diarrhoea and vomiting in children: Treatment

It is essential to evaluate the cause of diarrhoea and vomiting, to manage it effectively. Assessment of dehydration and its severity is of utmost importance in the management of the patient. It is recommended to replenish the dehydrated body with sufficient fluids which can be given orally or by a nasogastric tube or by intravenous route. Moreover, it is better to continue feeding the child as before. Fruit juices and fizzy drinks should be avoided since they irritate the intestinal mucosa and cause increased intestinal disruption. Medications are generally avoided in children with vomiting and diarrhoea. Nevertheless antipyretic drugs may be prescribed if the child has high body temperature.