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Management of gastroenteritis
1Department of Child Health, Cardiff Royal Infirmary.
Insights
Childhood gastroenteritis is generally mild, but many children receive inadequate pre-admission treatment. Prolonged diarrhea, a post-enteritis syndrome, affects a significant number of cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Childhood gastroenteritis is a frequent cause for pediatric hospital admissions.
- Recent trends suggest a decrease in disease severity.
Purpose of the Study:
- To assess the severity of childhood gastroenteritis.
- To identify causative organisms and complications.
- To evaluate pre-admission management adequacy.
Main Methods:
- Consecutive admission of 215 infants and children with gastroenteritis.
- Analysis of stool pathogens (viruses, bacteria, protozoa).
- Assessment of morbidity, complications, and prior treatment.
Main Results:
- Pathogens identified in 58% of patients (viruses, bacteria, protozoa).
- Low incidence of acute morbidity and complications.
- Prolonged diarrhea (postenteritis syndrome) observed in 11% of cases.
- Inappropriate pre-admission treatment noted in 36% of patients.
Conclusions:
- Acute childhood gastroenteritis is typically mild.
- Pre-hospital management is frequently inadequate.
- Postenteritis syndrome (prolonged diarrhea) is a notable complication.
Abstract:
Childhood gastroenteritis remains a common reason for admission to British paediatric units, although the severity of the disease appears to be diminishing in recent years. We studied 215 infants and children with gastroenteritis admitted consecutively to four paediatric units in South Wales in order to determine the severity of the disease, the organisms isolated, the frequency of complications, and the adequacy of management before admission. Stool pathogens were isolated in 125 (58%) patients (viruses in 65, bacteria in 30, and protozoa in 19, with multiple infection found in 11). There was a low incidence of morbidity and complications, but prolonged diarrhoea (postenteritis syndrome) was present in 24 (11%) cases and 77 (36%) had received inappropriate treatment before admission. Contemporary gastroenteritis is thus a relatively mild disease in the acute phase, but management before admission to hospital is often inadequate, and prolonged diarrhoea may be a feature in a considerable number of cases.