Gastroenteritis

Abstract

Diarrheal disease is so common and so often short-lived and apparently benign that neither physicians nor parents may give it the attention it deserves. Unfortunately, this lack of concern plays an important role in the high mortality rate from diarrhea among children in developing countries. It also contributes to the high numbers and costs of hospitalizations for diarrhea in the United States.

This review focuses on acute infectious diarrhea and on persistent diarrhea. These two conditions begin similarly, but persistent diarrhea by definition persists for longer than 14 days. It emphasizes appropriate management, particularly oral rehydration therapy (ORT) and current recommendations regarding feeding during diarrhea, and addresses new information about pathogens that cause both acute and persistent diarrhea. Although ulcerative colitis, Crohn disease, and other causes of chronic diarrhea must be considered in the differential diagnosis of acute or persistent diarrhea, a thorough discussion of chronic diarrhea is beyond the scope of this article. Information from developing countries as well as from the US and other developed countries is included.

Epidemiology

Gastroenteritis, both acute and persistent, may occur as often as 15 times per year in a child, although rates of 3 to 5 episodes annually are seen more commonly in most developing countries.