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Published on: August 4, 2023
The vomiting child--what to do and when to consult
1Department of Gastroenterology, Royal Children's Hospital, Murdoch Childrens Research Institute, and Department of Paediatrics, University of Melbourne, Victoria, Australia. katie.allen@rch.org.au
Insights
Vomiting in children, whether acute or chronic, requires careful evaluation by general practitioners. Prompt assessment ensures proper management and prevents complications like dehydration, with viral gastroenteritis being a common cause.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Vomiting is a frequent, non-specific symptom in pediatric illnesses, necessitating careful clinical assessment.
- General practitioners play a crucial role in determining the need for further investigation and management of pediatric vomiting.
Purpose of the Study:
- To outline differential diagnoses for pediatric vomiting.
- To detail the investigation and management strategies for acute and chronic vomiting in children.
Main Methods:
- Review of common causes of pediatric vomiting.
- Guidelines for diagnostic workup and treatment approaches.
Main Results:
- Viral gastroenteritis is the most frequent cause of acute vomiting.
- Gastro-oesophageal reflux and food allergy are considerations in chronic infant vomiting.
- Referral for specialist assessment may be needed for persistent symptoms in older children.
Conclusions:
- Accurate diagnosis is essential, considering alternatives to viral gastroenteritis.
- Maintaining hydration is critical in managing self-limiting vomiting.
- Regular follow-up is vital to prevent overlooking serious conditions and dehydration complications.
Background:
Vomiting is a common, nonspecific sign of a range of childhood illnesses. It may be acute or chronic and the general practitioner has a key role in identifying whether a child needs further investigation and management.
Objective:
This article outlines the main differential diagnoses, investigation and management of children presenting with acute and chronic vomiting.
Discussion:
Viral gastroenteritis is the most common cause of acute vomiting but should only be made after careful consideration of other causes. Management of hydration status in a child with a self limiting case of vomiting is vital. Regular review in the early phases of an undifferentiated vomiting illness will ensure that more fulminant illnesses are not overlooked and that secondary complications of dehydration do not arise. Chronic regurgitation and gastro-oesophageal reflux in infancy are common presentations that require considered management and may be a presenting symptom of food allergy. Other chronic presentations of nausea and vomiting in the older child may require referral for specialist assessment.
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