Preventing gastroenteritis in your child

VOMITING, diarrhoea and abdominal pains are among the most common symptoms linked to acute gastroenteritis. The condition, which is generally described as benign, is one of the leading causes of paediatric morbidity and mortality, accounting for the deaths of thousands of children across the world annually.

But what causes this condition and what impact does it have on the body?

“Acute gastroenteritis occurs most commonly as a result of infection of the intestines and stomach, along with inflammation, resulting in decreased ability of the organs to perform their function of digestion and absorption of foods and fluids, hence an increase in frequency of watery consistency of stools, as well as vomiting,” Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour, explained.

She said that the condition, which not only results in death, but also disability, accounts for approximately 15 per cent of deaths in children around the world each year.

“Historically, acute gastroenteritis has always been a major concern. Noticeably, however, there are a higher number of cases in developing and underdeveloped countries which have been linked to conditions which facilitate a perfect environment for gastroenteritis- causing bacteria and viruses.”

She said some of these facilitating conditions include poor water quality and inadequate supply, poor nutrition, poor hygiene practices, and overcrowding of individuals with inadequate waste disposal, including human waste.

Noting that gastroenteritis must be considered in any patient who has diarrhoea, vomiting or both, Dr Griffith said that other symptoms of the condition may include fever, abdominal pain, and may be preceded by a runny nose. Blood, Dr Griffith said, may also be present in the stool, especially where bacteria is the causative agent.

“The most common agents that cause gastroenteritis are viruses, for example rotavirus and Norwalk, and have been associated with the epidemics and many deaths, especially in children. Bacteria such as salmonella and shigella have been identified, and parasites and worms have also been implicated,” Dr Griffith shared.

But while the condition has managed to devastate the health systems in many countries and is listed among the conditions that cause great strain on the health system, gastroenteritis, according to Dr Griffith, is generally self-limiting and mild.

“When gastroenteritis is mild it can be managed at home, once there is an adequate replacement of fluids lost with appropriate fluids. However, it can become complicated very easily and even fatal once there is an imbalance between supply and deficit. These cases need urgent medical care.”

Dr Griffith encourages caregivers to observe children well. She noted that there are symptoms which can be used to identify dehydration in children.

“Because children tend to lose water quickly, it is important to identify signs of dehydration. So you want to take note of decreased saliva, tears, urine, sunken eyes, decreased activity and droopiness, and slow return of skin to the regular position when pinched,” Dr Griffith advised.

But this can be addressed with fluids for rehydration.

“Fluids containing an ideal mix of glucose and electrolytes such as oral rehydration salts, are highly recommended by the World Health Organization. But others such as coconut water and commercially prepared electrolyte solutions can be used for breastfed babies. Breastfeeding is also encouraged,” Dr Griffith said.

She said that fluids must be administered frequently and in small graduated amounts, while in severe cases where children are hospitalised fluids may have to be given intravenously. In the event of complicated cases, especially those caused by bacteria, antibiotics may be required to treat the underlying infection.

Also notable Dr Griffith said is the development of the rotavirus vaccine. She said that it has dramatically reduced the severity of the disease caused by the rotavirus. It is available if desired and is given along with the primary series of vaccines up to six months.

Noting that we should always seek to prevent health issues where possible, Dr Griffith encouraged parents to create a safe and clean environment for their children by:

• Ensuring water is used from a clean water supply;

•Using boiling water if cleanliness is questionable;

•Handwashing;

•Proper garbage and waste disposal;

•Trying to prevent overcrowding.