From the Guidelines
For acute gastroenteritis, the recommended diet is oral rehydration solution (ORS) as the first-line therapy for mild to moderate dehydration, with the introduction of an age-appropriate normal diet after rehydration is complete. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, ORS is recommended for all age groups, regardless of the cause of diarrhea. The guidelines suggest that breastfed infants should continue nursing throughout the illness, and children previously receiving a lactose-containing formula can tolerate the same product in most instances.
Key points to consider when managing acute gastroenteritis include:
- Using low-osmolarity ORS, which can be given to all age groups and is safe in the presence of hypernatremia as well as hyponatremia (except when edema is present) 1
- Administering ORS, 50–100 mL/kg over 3–4 hours for infants and children, and 2–4 L for adolescents and adults (≥30 kg) 1
- Replacing ongoing losses in stools with ORS until diarrhea and vomiting are resolved 1
- Introducing an age-appropriate normal diet after rehydration is complete, with maintenance fluids administered as needed 1
It is essential to note that popular beverages like apple juice, Gatorade, and commercial soft drinks should not be used for rehydration 1. Instead, ORS can be used, and some commercially available formulations include Pedialyte Liters, CeraLyte, and Enfalac Lytren. If symptoms persist or worsen, it is crucial to seek medical attention, especially if there are signs of severe dehydration, shock, or altered mental status.
From the Research
Recommended Diet for Acute Gastroenteritis
The recommended diet for acute gastroenteritis, also known as food poisoning, is a topic of interest in various studies.
- A study published in 2002 2 suggests that patients with acute gastroenteritis can be discharged and continue standard oral rehydration at home with the introduction of a bananas, rice, applesauce, and toast (BRAT) diet after the first 24 hours.
- However, a study published in 2012 3 recommends reexamining the BRAT diet in light of new evidence and suggests that a diet containing probiotics may be more effective in managing acute diarrhea.
- There is no direct evidence from the other studies 4, 5, 6 to support a specific diet for acute gastroenteritis.
Key Considerations
When considering a diet for acute gastroenteritis, the following points are important:
- The BRAT diet has been traditionally recommended, but its effectiveness is being reevaluated 3.
- Probiotics may play a role in reducing diarrheal duration and managing acute diarrhea 3.
- A low-FODMAP diet has been shown to be effective in reducing symptoms of irritable bowel syndrome, but its application to acute gastroenteritis is unclear 5.
- Dietary modifications or nutritional support may be necessary for individuals with gastrointestinal disease, including those with inflammatory bowel disease or short gut syndrome 6.