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- Deise Granado-Villar, MD, MPH*
- Beatriz Cunill-De Sautu, MD†
- Andrea Granados, MD§
- *Chief Medical Officer, Senior Vice President for Medical & Academic Affairs, Miami Children's Hospital; Clinical Associate Professor of Pediatrics, Affiliate Dean for Miami Children's Hospital, Herbert Wertheim College of Medicine, Florida International University.
- †Director, Pediatric Residency Program, Miami Children's Hospital; Clinical Assistant Professor of Pediatrics, Herbert Wertheim College of Medicine, Florida International University.
- §Chief Resident, Miami Children's Hospital; currently Pediatric Endocrinology Fellow, University of Michigan.
Author Disclosure
Drs Granado-Villar, Cunill-De Sautu, and Granados have disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
- CDC:
- Centers for Disease Control and Prevention
- IV:
- intravenous
- K+:
- potassium
- Na+:
- sodium
- NG:
- nasogastric
- ORS:
- oral rehydration solution
- WHO:
- World Health Organization
Educational Gap
In managing acute diarrhea in children, clinicians need to be aware that management based on “bowel rest” is outdated, and instead reinstitution of an appropriate diet has been associated with decreased stool volume and duration of diarrhea. In general, drug therapy is not indicated in managing diarrhea in children, although zinc supplementation and probiotic use show promise.
Objectives
After reading this article, readers should be able to:
Recognize the electrolyte changes associated with isotonic dehydration.
Effectively manage a child who has isotonic dehydration.
Understand the importance of early feedings on the nutritional status of a child who has gastroenteritis.
Fully understand that antidiarrheal agents are not indicated nor recommended in the treatment of acute gastroenteritis in children.
Recognize the role of vomiting in the clinical presentation of acute gastroenteritis.
Introduction
Acute gastroenteritis is an extremely common illness among infants and children worldwide. According to the Centers for Disease Control and Prevention (CDC), acute diarrhea among children in the United States accounts for more than 1.5 million outpatient visits, 200,000 hospitalizations, and approximately 300 deaths per year. In developing countries, diarrhea is a common cause of mortality among children younger than age 5 years, with an estimated 2 million deaths each year. American children younger than 5 years have an average of two episodes of gastroenteritis per year, leading to 2 million to 3 million office visits and 10% of all pediatric hospital admissions. Furthermore, approximately one third of all hospitalizations for diarrhea in children younger than 5 years are due to rotavirus, with an associated direct cost of $250 million annually. (1)(2)
Definitions
Diarrhea is defined as the passage …
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Jump to section
- Article
- Educational Gap
- Objectives
- Introduction
- Definitions
- Clinical Presentation
- Assessment of Dehydration
- Laboratory Evaluation
- The Evolution of Oral Rehydration Solutions
- Management
- Minimal or No Dehydration
- Mild to Moderate Dehydration
- Severe Dehydration
- Indications for Admission
- Limitations of ORS Therapy
- Pharmacologic Therapy
- References
- Figures & Data
- Info & Metrics
- Comments