From the Guidelines
Treatment for viral gastroenteritis in healthy pediatric patients primarily involves supportive care focused on preventing dehydration, with oral rehydration therapy as the cornerstone of treatment. The most recent and highest quality study, published in 2017 by the Infectious Diseases Society of America, recommends oral rehydration therapy for all ages, and antiemetics such as ondansetron may be beneficial in children with significant vomiting 1. Children should be offered small amounts of oral rehydration solution frequently, typically 5-15 ml every 5-10 minutes, gradually increasing as tolerated.
Key Components of Treatment
- Continue regular feeding as soon as the child can tolerate it, avoiding dairy products temporarily if they worsen symptoms
- Breastfeeding should continue throughout the illness
- Antipyretics like acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours) can be used for fever or discomfort
- Avoid antidiarrheal medications like loperamide as they can prolong the infection and cause complications, as recommended by the 2017 guidelines 2
- Probiotics such as Lactobacillus GG or Saccharomyces boulardii may help reduce the duration of diarrhea by 1-2 days
When to Seek Medical Attention
- Signs of severe dehydration (decreased urination, excessive lethargy, sunken eyes)
- Persistent vomiting
- Bloody diarrhea
- High fever It is essential to note that viral gastroenteritis is self-limiting, and the body will clear the infection while maintaining hydration prevents complications, as supported by the study published in 1990 3. Most cases resolve within 3-7 days with proper hydration.
From the Research
Treatment Overview
The treatment for viral gastroenteritis in healthy pediatric patients is primarily focused on managing symptoms and preventing dehydration.
- Oral rehydration therapy (ORT) is effective and successful in the majority of patients 4, 5.
- Adequate fluids containing physiological concentrations of glucose and electrolytes should be provided to compensate for gastrointestinal losses and cover maintenance needs 4.
Role of Anti-emetic Medication
Anti-emetic medications, such as ondansetron, can facilitate ORT and minimize the need for intravenous hydration and hospitalization.
- Ondansetron is efficacious and superior to other anti-emetic medications in the treatment of gastroenteritis-related vomiting 5, 6.
- Judicious use of ondansetron can increase the success rate of ORT and reduce healthcare costs 4, 5, 7.
Additional Considerations
- Measurements of serum electrolytes, creatinine, and glucose are usually not necessary and should only be considered in a subset of children with severe dehydration who require hospitalization and IV therapy 4.
- Physicians should educate caregivers on proper personal hygiene and handwashing to prevent fecal to oral transmission of the pathogen, as well as the importance of rotavirus vaccine in the prevention of rotavirus gastroenteritis 4.
- Probiotics may improve patient outcomes in pediatric acute gastroenteritis, but current data are insufficient to support the routine use of probiotics in outpatient pediatric care 7.