Gastroenteritis in Children under 5 years of age

Author: Richard Freeman / Editor: Claire Onyon / Reviewer: Thomas MacMahon, Richard Freeman, Amanda King / Codes: / Published: 09/07/2021 / Reviewed: 11/10/2024

This module describes the natural history and aetiology of paediatric gastroenteritis.

After completing this session you will be able to:

• Describe the natural history and aetiology of paediatric gastroenteritis
• Assess the child’s level of dehydration and exclude common differential diagnoses
• Manage cases where the child is not dehydrated, clinically dehydrated and clinically shocked
• Suspect and manage cases of hypernatraemic dehydration
• Consider the use of antibiotics and ondansetron in certain situations
• Provide appropriate advice to ensure children remain hydrated and limit the spread of infection within the community

References

1. National Institute for Health and Clinical Excellence (NICE), Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management. Clinical guideline [CG84]. 2009.
2. Guarino A, Ashkenazi S, et al., European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014 Jul;59(1):132-52.
3. Van Damme P, Giaquinto C, et al., Multicenter prospective study of the burden of rotavirus acute gastroenteritis in Europe, 2004-2005: the REVEAL study. J Infect Dis. 2007 May 1;195 Suppl 1:S4-S16.
4. Armon K, Stephenson T, et al., Determining the common medical presenting problems to an accident and emergency department. Arch Dis Child. 2001 May;84(5):390-2.
5. Pediatric ROTavirus European CommitTee (PROTECT). The paediatric burden of rotavirus disease in Europe. Epidemiol Infect. 2006 Oct;134(5):908-16.
6. Karafillakis E, Hassounah S, Atchison C. Effectiveness and impact of rotavirus vaccines in Europe, 2006-2014. Vaccine. 2015 Apr 27;33(18):2097-107.
7. Gleizes O, Desselberger U, et al., Nosocomial rotavirus infection in European countries: a review of the epidemiology, severity and economic burden of hospital-acquired rotavirus disease. Pediatr Infect Dis J. 2006 Jan;25(1 Suppl):S12-21.
8. Ogilvie I, Khoury H, et al., Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review. BMC Infect Dis. 2012 Mar 19;12:62.
9. Bhattacharya SK, Bhattacharya MK, Manna B, Dutta D, et al. Risk factors for development of dehydration in young children with acute watery diarrhoea: a case-control study. Acta Paediatr. 1995 Feb;84(2):160-4.
10. Fuchs SC, Victora CG, Martines J. Case-control study of risk of dehydrating diarrhoea in infants in vulnerable period after full weaning. BMJ. 1996;313(7054):391-394. doi:10.1136/bmj.313.7054.391
11. Victora CG, Fuchs SC, et al. Breast-feeding, nutritional status, and other prognostic factors for dehydration among young children with diarrhoea in Brazil. Bull World Health Organ. 1992;70(4):467-75.
12. Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? JAMA. 2004 Jun 9;291(22):2746-54.
13. Hartling, L, et al., Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database Syst Rev, 2006(3): p. CD004390.
14. Freedman, SB, et al., Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis. PLoS One, 2015. 10(6): p. e0128754.
15. Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Gastroenteritis. 2015 November 2017];
16. Allen SJ, Martinez EG, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev, 2010(11): p. CD003048.
17. Fedorowicz Z, Jagannath VA, Carter B. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents. Cochrane Database Syst Rev. 2011 Sep 7;2011(9):CD005506.
18. Shane AL, Mody RK, et al., 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical Infectious Diseases, Volume 65, Issue 12, 15 December 2017, Pages e45e80.