Viral Gastroenteritis Treatment & Management

  • Author: Michael Vincent F Tablang, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Mar 19, 2012
 

Medical Care

In 1996, the American Academy of Pediatrics formulated and published practice guidelines for the management of acute gastroenteritis in children. Use the following parameters to assess the degree of dehydration: blood pressure, pulse, heart rate, skin turgor, fontanelle, mucous membranes, eyes, extremities, mental status, urine output, and thirst.

  • The treatment of rotavirus diarrhea is based primarily on replacing fluids and electrolytes, as directed by the estimated degree of dehydration.
  • Oral rehydration therapy is recommended for preventing and treating early dehydration and continued replacement therapy for ongoing loses.
  • Shock, severe dehydration, and decreased consciousness require intravenous therapy.
  • Age-appropriate diets should be continued in children with diarrhea who are not dehydrated. When mild-to-moderately dehydrated children are rehydrated, resume age-appropriate diet.
  • Administering antiemetics and antidiarrheal agents to small children is not recommended.
  • Several studies have shown that antirotavirus immunoglobulin, as pooled gamma globulin, bovine colostrum, or human milk, may decrease frequency and duration of diarrhea.
  • Small studies have suggested that zinc supplements may reduce the severity and duration of illness.

Probiotics are nonpathogenic live microorganisms that provide beneficial effects on the health of the host. In recent years, probiotics have entered mainstream medical practice, as a decrease in the severity and duration of infectious gastroenteritis has been shown in some strains.[13]

  • Probiotics help to improve the balance of the intestinal microflora, although the exact mechanism of action is incompletely understood. Hypothesized mechanisms include suppression of growth or invasion by pathogenic bacteria, improvement of intestinal barrier function, and effects on immune function.[14]
  • Literature shows a statistically significant, but clinically moderate, benefit for some strains, mainly in infants and young children, in the treatment of acute watery diarrhea, especially in rotavirus gastroenteritis.[13]
  • Until further data are available, only those organisms that have been clinically tested can be reasonably recommended, Lactobacillus casei GG and S boulardii being the most reported. Limited data and modest expected benefit must be explained to patients.[13]
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Contributor Information and Disclosures
Author

Michael Vincent F Tablang, MD  Resident Physician, Department of Internal Medicine, University of Connecticut Health Center

Michael Vincent F Tablang, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Grupka, MD  Physician, Atlanta Center for Gastroenterology

Disclosure: Nothing to disclose.

George Y Wu, MD, PhD  Professor, Department of Medicine, Director, Hepatology Section, Herman Lopata Chair in Hepatitis Research, University of Connecticut School of Medicine

George Y Wu, MD, PhD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, American Medical Association, American Society for Clinical Investigation, and Association of American Physicians

Disclosure: Springer Consulting fee Consulting; Gilead Consulting fee Review panel membership; Vertex Honoraria Speaking and teaching; Bristol-Myers Squibb Honoraria Speaking and teaching; Springer Royalty Review panel membership; Merck Honoraria Speaking and teaching

Specialty Editor Board

John Gunn Lee, MD  Director of Pancreaticobiliary Service, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, University of California at Irvine School of Medicine

John Gunn Lee, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Noel Williams, MD  Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

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