What is gastroenteritis?
Gastroenteritis is inflammation of the gastrointestinal tract.  It is usually caused by a bacterial, viral, or parasitic infection. Transmission often occur from eating contaminated food or poor personal hygiene or touching contaminated objects (vomits or poo).

What are the symptoms of gastroenteritis?

1. Diarrhea: Diarrhea is the main symptom of gastroenteritis. The symptoms associated with diarrhea include: increased frequency and volume of bowel movement, watery feces, or loose stools. This can be 3 times or over than 3 times per day, or frequent than usual. The color of feces might be greenish and accompanied by a strong odor, strike of blood or slimy discharge.
2. Fever
3. Vomiting and abdominal pain
4. Activity changed: restlessness, fatigue, sleepiness, or agitation.
5. Dehydration: dry lip and skin, lack of tears, low urine output and dark urine. Infants may have a sunken front fontanel or eyes.

If your child has any of the above symptoms, it does not necessarily mean that it is gastroenteritis, but please go to a pediatric clinic as soon as possible.

Treatments:

Acute gastroenteritis is commonly caused by a virus. Unless a specific bacterial infection is known, antibiotic treatment is not required. The patient is usually given a symptomatic supplement, such as proper hydration for preventing dehydration or electrolyte imbalance.

Precautions and Home care

1. Prevent the spread of pathogens: One of the most important things you can do to stop the spread of infection is to wash your hands. Both children and caregivers should wash hands with soap or hand sanitizer for at least 40-60 seconds, especially before eating, after changing nappies, or using the toilet. Make sure to clean your hands, including your fingers, nails and elbows.
2. Dietary for diarrhea
   1. Breast-milk feeding: Babies who are breast fed should continue to be breast fed after doctor’s evaluation. Breast milk contains large amount of antibodies from mother that helps the baby with gastroenteritis recovered. Baby is eager to feel calm down by breast-milk feeding.
   2. Formula-milk feeding: Formula-milk fed babies should be give lactose-free formula milk or diluted formula milk according to physician’s instruction.
   3. General diet: Oral electrolyte solutions might be given to the children with gastroenteritis upon physician’s instructions. When diarrhea improves, some light food, such as rice soup, white toast, steamed bread, or rice can be taken. Avoid greasy food, beans, dairy products, and high sugar food (juice, soda, and snack) so that the gastrointestinal tract can take its proper rest. Under physician’s instructions, probiotics can be given to children who have normal immune functions. If diarrhea does not improve, then it is recommended to go to a hospital for further medical treatment.
3. Stools with higher acidity during diarrhea may irritate the skin. If the skin is lack of good care. Skin redness or diaper rash may occur. Therefore, the skin on the buttocks needs to receive proper attention.
   1. Change diapers often, clean skin around the anus with warm water and gently wipe it dry with a soft cotton towel. Open diapers, expose skin of bottom and perineum to air is a natural way to let it dry. 
   2. If there is no reddish or damaged on the buttocks, vacillin cream can be applied around anus to isolate irritates from feces.
   3. In case of a diaper rash on the buttocks, apply ointment by the physician’s instructions.
4. How to manage children’s vomiting
   1. When the child vomits, keep the child’s upper body leaning forward and maintain the head in a lower position or the face facing the side. The vomit should be cleaned up immediately so as to prevent aspiration pneumonia.
   2. After vomiting, skin and oral care should be careful. To proper cleaning especially of the face, ear back and neck skin folds. Keep skin dry to prevent eczema happens.
   3. In cases of acute vomiting, the child has to fast 2-4 hours by doctors’ instruction. Drink a small amount of water while vomiting improved. Start your diet pattern gradually.

References

1. Hartman, S., Brown, E., Loomis, E., & Russell, H. A. (2019). Gastroenteritis in children. American Family Physician, 99(3), 159-165.
2. Pediatric Infectious Diseases Society of Taiwan. (2019). Acute gastroenteritis in children. https://www.pids.org.tw/index.php?route=news/news_detail&news_id=112
3. Viateur, K. (2018). Determinants of mother’s preventive practices against children’s acute gastroenteritis: basis for a health education program. Galore International Journal of Health Sciences and Research, 3(2), 13-22.
4. World Health Organization. (2017). Diarrhoeal disease. https://www.who.int/en/news-room/fact-sheets/detail/diarrhoeal-disease