gastroenteritis
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Etiology
Epidemiology
- Rotavirus
- major cause in children 3 to 15 months old
- most children have been exposed to the virus by age 2
- adults who are in close contact with infected children
- November to April
- Adenovirus serotypes 40 & 41
- children younger than 2 years old
- infections occur all year round
- Caliciviruses cause infection in persons of all ages
- norovirus
- Norwalk virus cause epidemic outbreaks
- sapovirus (Sapporo virus)
- norovirus
- Astrovirus infects primarily infants, young children, & the elderly
- most active during the winter months
Clinical manifestations
- vomiting
- watery diarrhea
- abdominal pain
- dehydration
- fever
- headache
- generally 1-2 days in duration, but may last up to 10 days
Complications
- postinfectious irritable bowel syndrome 14.5%, most IBS-D
- postinfectious functional dyspepsia 12.7%[6]
Management
- see diarrhea, gastritis
- dilute apple juice for initial hydration followed by fluids of child's choice[3]
- ondansetron (Zofran) may stop vomiting & prevent dehydration in children & adolescents[2]
- fiber may be of benefit
- Isomil DF (IDF) infant formula
- probiotics for children presenting to the emergency department not helpful[4][5]
More general terms
More specific terms
Additional terms
References
- ↑ Journal Watch 21(23):185, 2001
- ↑ 2.0 2.1 The NNT: Ondansetron (Zofran) for Pediatric and Adolescent Gastroenteritis http://www.thennt.com/nnt/ondansetron-for-pediatric-gastroenteritis/
Fedorowicz Z, Jagannath VA, Carter B. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD005506 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21901699
Carter B, Fedorowicz Z Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework. BMJ Open 2012;2:e000622 http://bmjopen.bmj.com/content/2/4/e000622.long - ↑ 3.0 3.1 Freedman SB et al Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis. A Randomized Clinical Trial. JAMA. Published online April 30, 2016 http://jama.jamanetwork.com/article.aspx?articleid=2518402
- ↑ 4.0 4.1 Schnadower D, Tarr PI, Casper TC et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children. N Engl J Med 2018 Nov 22; 379:2002. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30462938 https://www.nejm.org/doi/10.1056/NEJMoa1802598
Freedman SB, Williamson-Urquhart S, Farion KJ et al. Multicenter trial of a combination probiotic for children with gastroenteritis. N Engl J Med 2018 Nov 22; 379:2015. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30462939 https://www.nejm.org/doi/10.1056/NEJMoa1802597
LaMont JT. Probiotics for children with gastroenteritis. N Engl J Med 2018 Nov 22; 379:2076. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30462932 https://www.nejm.org/doi/10.1056/NEJMe1814089 - ↑ 5.0 5.1 Orciari Herman A. Fairchild DG, Di Francesco L Physician's First Watch, June 9, 2020 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society (subscription needed) http://www.jwatch.org Szymanski H, Szajewska H. Lack of efficacy of Lactobacillus reuteri DSM 17938 for the treatment of acute gastroenteritis: A randomized controlled trial. Pediatr Infect Dis J 2019 Apr 25; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/28060791 https://journals.lww.com/pidj/Abstract/2019/10000/Lack_of_Efficacy_of_Lactobacillus_reuteri_DSM.1.aspx
- ↑ 6.0 6.1 Porcari S, Ingrosso MR, Maida M et al. Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: Systematic review and meta-analysis. Gut 2024 Aug 8; 73:1431-1440 PMID: https://www.ncbi.nlm.nih.gov/pubmed/39013599 https://gut.bmj.com/content/73/9/1431
- ↑ Viral Gastroenteritis ("Stomach Flu") https://www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis