eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Gastroenteritis: Follow-up

Author: Randy P Prescilla, MD, Instructor in Anesthesia, Harvard Medical School; Assistant in Perioperative Anesthesia, Children's Hospital Boston
Contributor Information and Disclosures

Updated: Jan 5, 2009

Follow-up

Transfer

  • Transfer by emergency medical service unit any patient with gastroenteritis who has moderate-to-severe dehydration to the nearest emergency department for intravenous rehydration.

Deterrence/Prevention

  • Rotavirus vaccines: Currently, 2 rotavirus vaccines are approved in the United States (ie, RotaTeq [Merck & Co, Inc] and Rotarix [GlaxoSmithKline]). See Medication.

Prognosis

  • Prognosis is excellent because gastroenteritis is usually self-limited.
  • Children usually improve after an intravenous bolus.
  • Patients who receive oral rehydration solutions (ORSs) gradually improve.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to assess the extent of dehydration (sometimes due to insufficient information provided by parents who have telephoned the physician for advice)
  • Failure by parents/patients to understand instructions
  • Failure to schedule a follow-up visit
  • Failure to diagnose ingestion(s)
  • Failure to diagnose renal or acid-base abnormalities
  • Failure to exclude anatomical abnormalities (eg, obstruction, abdominal infections)

Special Concerns

  • Manage dehydration aggressively in patients who have sickle cell disease to prevent sequelae (eg, infarction, stroke, splenic sequestration). Administration of 1.5 times the normal rate of maintenance fluid infusion is a routine practice.
 


More on Gastroenteritis

Overview: Gastroenteritis
Differential Diagnoses & Workup: Gastroenteritis
Treatment & Medication: Gastroenteritis
Follow-up: Gastroenteritis
References
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References

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  5. Amieva MR. Important bacterial gastrointestinal pathogens in children: a pathogenesis perspective. Pediatr Clin North Am. Jun 2005;52(3):749-77, vi. [Medline].

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  20. US Food and Drug Administration. Rotarix Product Information. FDA.gov. Available at http://www.fda.gov/cber/label/rotarixLB.pdf. Accessed 11/27/2008.

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Further Reading

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Keywords

gastroenteritis, enterogastritis, viral diarrhea, prematurity, dehydration, Shigella, enterohemorrhagic Escherichia coli, electrolyte imbalance, hyponatremia, hypernatremia, hypernatremic dehydration, rotavirus, dehydrating diarrhea, Norwalk virus, enteric adenovirus, calicivirus, sickle cell disease, Giardia lamblia, Cryptosporidium parvum, Cyclospora cayetanesis, Entamoeba coli, Endolimax nana, Iodamoeba butschlii, Blastocystis hominis, HIV, AIDS, cytomegalovirus

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Contributor Information and Disclosures

Author

Randy P Prescilla, MD, Instructor in Anesthesia, Harvard Medical School; Assistant in Perioperative Anesthesia, Children's Hospital Boston
Disclosure: Nothing to disclose.

Medical Editor

Ashir Kumar, MBBS, MD, FAAP, Professor, Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University; Consulting Staff, Department of Pediatrics, EW Sparrow Hospital
Ashir Kumar, MBBS, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association of Physicians of Indian Origin, American Federation for Clinical Research, American Society for Microbiology, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Joseph Domachowske, MD, Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York-Upstate Medical University
Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Consulting; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; sanofi pasteur Grant/research funds Unrestricted research grant; sanofi pasteur  Consulting; sanofi pasteur Honoraria Speaking and teaching; Tap Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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