VOMITING AND DIARRHEA
Vomiting
and diarrhea are most often caused by viral infections of the GI tract. Other illnesses that may cause these symptoms
include respiratory infections, otitis media, strep throat, and urinary tract
infections. In rare instances a more
serious condition, such as bowel obstruction, appendicitis, meningitis,
poisoning, or head injury, may cause vomiting with or without diarrhea. Bilious (green) vomiting, bloody vomiting, or
bloody diarrhea need urgent evaluation.
Treatment of Vomiting and Diarrhea
In most
cases, vomiting will cease within 24 to 48 hours. Diarrhea will often persist for over a week,
and it may be over 2 weeks before the stools return to normal. Over-the-counter remedies for vomiting and
diarrhea are generally not indicated for use in children. They do not cure the underlying causes, and
may in fact mask the symptoms of more serious illness. Antibiotics or other prescription medications
are only used in the few cases that are caused by bacterial or parasitic infections.
Most
physicians now agree that proper fluid intake and continued solid feeding
through episodes of vomiting and diarrhea is the best way to manage the
symptoms. Your child’s intestines
actually need the nutrition provided by a well balanced food intake to heal
damaged tissue; otherwise the diarrhea may be prolonged. The following guidelines will help put you on
the road to recovery:
·
You
may decide to give no fluids or food for the first 2 hours to allow the stomach
and intestines to rest.
·
Start
re-feeding by offering small quantities of clear fluids. This means one teaspoon every 15 minutes for
a child under age 5; children over 5 may have small sips. If your child vomits the first attempt, wait
15 minutes and try again. Do not wait an
additional 2 hours with every episode of vomiting.
·
The
most correct fluid to use for dehydration caused by vomiting or the early
phases of diarrhea is a commercial electrolyte solution such as Pedialyte or Gerber LiquiLytes. If your child is only mildly dehydrated they
may not like the taste of these solutions.
If you offer your child sugary fluids like fruit juice or sports drinks,
be sure to dilute them with water, because too much sugar will actually worsen
diarrhea. Remember, the more dehydrated
an infant or child becomes, the more important it is to re-hydrate them with
electrolyte solutions.
·
You
may continue breast feeding through vomiting or diarrhea. Formula is also fine and does not need to be
diluted. For children over a year of
age, cow’s milk in moderate amounts is acceptable.
·
After
4 to 6 hours of clear liquids you may try to begin solid foods. For babies, this includes formula and any of
the baby foods he was previously eating.
Foods to choose initially for toddlers and older children include
bananas, rice, applesauce, wheat, bread, lean meats, yogurt, fruits,
vegetables, potatoes, and cereal. Avoid
fatty foods. After 24 to 48 hours it is
fine to resume a regular diet.
·
If
you believe vomiting has been caused by the ingestion of a poison, then call
the
Reasons to Call the Office
The main
concern associated with vomiting and diarrhea is dehydration. Early signs of dehydration include decreased
tears and decreased moisture in and around the mouth. Worsening signs of dehydration include dry
lips and tongue, inability to make tears, and decreased urine output. These signs should prompt an office visit. Late signs of dehydration, in addition to
decreased urine output, may include sunken eyes and cold or grey colored
skin. These signs warrant immediate
medical assessment. Other reasons to
call the office include: