22 Feb STOMACH FLU, What to Do?

“Stomach flu” (or gastroenteritis) is an incredibly frustrating illness to deal with as a parent. It is very contagious and can cause major and dramatic symptoms immediately, but for some children, it can cause ongoing lingering symptoms for a few weeks afterwards.

What is gastroenteritis?

Gastroenteritis means inflammation of the gastrointestinal system. In most cases, this is an acute illness that lasts only a few days. Gastroenteritis is primarily (but not always) caused by viruses such as Adenovirus, Norovirus, and Rotavirus.

Symptoms

Symptoms can vary from person to person, even within the same family and even with the same viral cause. They can include:

• Abdominal pain
• Nausea
• Vomiting
• Diarrhea
• A combination of vomiting and diarrhea (sometimes vomiting comes first, and other times they can occur together)
• Depending on the specific viral cause, you can also see fever, rashes, sore throats, congestion and cough, pink eye, and more.

What to do

Treatment of acute gastrointestinal illnesses is primarily supportive. Your biggest goals are to focus on hydration, manage symptoms, and watch for worsening symptoms. In rare cases where fluid losses are hard to keep up with, children may need to be treated in the hospital with IV fluids. For the most part, however, here are some things you can try at home.

Vomiting

For some children, anti-nausea medications like Zofran may be appropriate. These require a prescription, however, and should not be used without oversight by your pediatrician. For a more natural remedy, though, a recent study showed that ginger may be an effective way to decrease vomiting episodes in kids >1 year old with mild illness. Try adding a small amount of grated fresh ginger, or ginger paste, to warm water with honey (only in kids greater than 1 year).

Diarrhea

Anti-diarrheal medications are not recommended for children because of the lack of clear data showing that they work. They also commonly cause side effects, such as drowsiness, slowing gut motility, nausea, and more. Unfortunately, the best way to manage diarrhea is to support your child through it – and wait it out. With that said, if diarrhea is bloody, for longer than 7-10 days, or your child seems dehydrated then it is worth touching base with your pediatrician.

Dehydration

This is one of the most critical elements to manage during a stomach bug. Remember, focusing on fluid intake is more important than focusing on solid food intake. Clear liquids are a good first step because they are easier to digest. The only exception here is breastmilk. For infants on formula, oral rehydration solutions are a reasonable option but switch back to formula within 24 hours. Pedialyte, coconut water, or half-strength apple juice if your child doesn’t like Pedialyte.

Focus on maintaining fluid intake, and if your child wants food, using bland carbs such as plain pasta, applesauce, rice, or mashed potatoes (without gravy) can help an irritated tummy.

Diaper rash

Frequent stools result in skin breakdown and can cause a lot of pain for your baby. As a basic tip: change the diaper frequently and avoid wipes if you can (wash with soap and water).  And always use a nice thick layer of diaper ointment.

Timeline

In general, although symptoms can feel endless, gastroenteritis is a short-lived illness. The exact length may depend on the specific viral cause, but usually vomiting improves within 1-4 days. Diarrhea may linger for longer, but most healthy adults and children will recover fully within 5-10 days. Most children recover their appetite and their weight quite quickly. But for some, we do see a lingering lactose intolerance for several weeks afterward, so do not be surprised if you notice an intermittent recurrence of symptoms or even just complaints of abdominal pain after having dairy.

Transmission

Unfortunately, gastroenteritis is often very contagious. Some basic things you can do to prevent transmission within your household are:

• Effective, frequent hand washing with soap and water for at least 20 seconds
• Wiping down frequently touched surfaces such as doorknobs, counters, toilet seats, and toys
• Take precautions with food preparation

If your child is not improving within a few days, or if they seem to be getting worse, call your pediatrician. Concerning symptoms include:

• Bloody or green vomit or diarrhea
• Ongoing vomiting for more than 24 hours
• Inability to keep down fluids
• Dehydration
• Change in mental status (change in alertness, severe discomfort, excessive fatigue, fussiness)
• Infants under the age of six months