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Managing Dehydration in Children

Gastroenteritis, or "gastro" in short form, is a common infection of stomach and bowel that is usually associated with vomiting and diarrhoea. In most cases it runs its own course over several days. However, it can be a serious condition if the fluid loss is severe enough to cause dehydration; this is more likely to occur in the elderly and the very young. Mostly gastroenteritis is due to viral infections. Around half of the cases caused by rotavirus. Although some other bacteria like Campylobacter may cause gatroenteritis.
Cause of Gastroenteritis

In most cases the precise infective agent is not identified. It is only when symptoms are persisting that stools are sent for microscopy and culture in the laboratory.

Symptoms
The main symptoms of are vomiting, diarrhoea and cramping abdominal pain. Sometimes a fever will also be present. In more severe cases, signs of dehydration may appear; a young child may look floppy and pale and the urine output may be reduced. These signs mean that urgent medical assessment and treatment are required.
Other conditions can mimic gastroenteritis. Food poisoning is caused by bacterial contamination of food and it may cause severe vomiting and diarrhoea. Often several people who have eaten the same food are affected. If diarrhoea is not settling, stools are sent for culture.

Remedy
Usually gastroenteritis settles without specific treatment over a few days, although the diarrhoea may last several days longer. Because of the transient intolerance to sugars that often accompanies gastro, dairy products and fatty foods are best avoided for the first day or two. Dry biscuits, toast, clear soups, and foods like boiled rice and potato may be tried. However, adequate fluid intake is the main concern.

Most of these cases clear without treatment. Early appendicitis and other acute abdominal conditions can also look like gastroenteritis. Persistent pain and localized tenderness should suggest that something more than gastroenteritis may be responsible.
Treatment and Care

In babies replacement of fluid losses is vitally important. Whilst it is preferable to continue with breastfeeding and bottlefeeding, top-ups with oral rehydration fluid are often required. Gastrolyte is one of several excellent oral rehydration fluids available from the chemist. An alternative fluid supplement can be prepared using flat lemonade diluted to one fifth strength with boiled water. Undiluted lemonade, cordials and fruit juices should never be used because they can aggravate diarrhoea and cause dehydration. Medications to stop vomiting and diarrhoea should not be used in children; their absorption is unpredictable and they may make matters worse.

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