From the Guidelines
The primary treatment for gastroenteritis should focus on oral rehydration therapy, with antimotility and antiemetic agents used judiciously based on patient age and symptoms. The cornerstone of treatment is preventing dehydration, and oral rehydration solutions like Pedialyte or homemade mixtures (1 teaspoon salt, 8 teaspoons sugar in 1 liter of clean water) should be used 1. Adults should aim to drink at least 2-3 liters daily, while children require smaller, more frequent amounts based on their weight.
Key Considerations for Treatment
- Oral rehydration therapy is essential for all ages to prevent dehydration.
- Anti-diarrheal medications like loperamide can be considered for adults but should be avoided in children under 18 years of age and in cases with high fever or bloody stools 1.
- For nausea and vomiting, ondansetron can be used in children over 4 years of age and in adults to facilitate oral rehydration 1.
- A bland diet including bananas, rice, applesauce, toast, and crackers can help ease digestive stress during recovery.
Important Safety Precautions
- Loperamide should not be given to children under 18 years of age due to the risk of adverse events like ileus, abdominal distension, and lethargy 1.
- Patients should be advised about the potential risks of complications from diarrhea when using antidiarrheal and antimicrobial agents, especially in cases of C. difficile and Clostridium perfringens infections 1.
- The use of antimotility agents in patients with shigellosis and STEC infections may increase the risk of severe outcomes, including death 1.
Monitoring and Follow-Up
- Most cases of gastroenteritis resolve within 1-3 days without antibiotics, as the condition is typically viral.
- Medical attention should be sought if symptoms persist beyond 3 days, or if there are signs of severe dehydration, bloody stools, or high fever (above 102°F/39°C).
- Handwashing and food safety practices are crucial to prevent the spread of gastroenteritis to others during recovery.
From the Research
Treatment Options for Gastroenteritis
- Oral rehydration therapy is an effective and inexpensive treatment for dehydration associated with gastroenteritis in children 2
- Oral rehydration solutions such as Pedialyte, Gatorade, and New Oral Rehydration Solution (N-ORS) can be used to treat dehydration in adults with viral gastroenteritis 3
- The mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration 4
Medications and Interventions
- Antiemetics can be used to improve tolerance of oral rehydration solution and decrease the need for intravenous fluids and hospitalization 5
- Ondansetron can decrease vomiting, but it may increase episodes of diarrhea 6
- Probiotics can be used to shorten the course of diarrhea 6
Prevention and Management
- Good handwashing can reduce the incidence of acute gastroenteritis 6
- Rotavirus vaccines can significantly reduce the incidence of rotavirus gastroenteritis 4, 6
- A child's regular diet can reduce the duration of diarrhea, and oral rehydration therapy with a rehydration solution can be used to treat diarrhea in children with mild to moderate dehydration 6