Patient's question:
But I don't know what dirty thing I ate the day before yesterday. When he came back home, he kept acting abnormal. Now, diarrhea has lasted for three days already. He has taken diarrhea medicine, but it hasn't been effective. He is very anxious. How can this be resolved? Please help.Doctor's answer:
Autumn and winter are peak seasons for infantile gastroenteritis, most of which is caused by rotavirus infection. Because it commonly occurs during these seasons, it is often referred to as "autumnal gastroenteritis." This condition can manifest as sporadic cases or small outbreaks and is transmitted through the fecal-oral route or via respiratory droplets. The incubation period is 1 to 3 days. It primarily affects infants aged 6 to 24 months, with cases in children over 4 years old being rare. The onset is abrupt, often accompanied by fever and upper respiratory infection symptoms, but without significant signs of toxicity. Vomiting may occur at the beginning of the illness, usually before diarrhea develops. Diarrhea is characterized by frequent, large-volume, and watery stools (yellow and watery or resembling egg whites with a small amount of mucus, without a foul odor). This condition is self-limiting, with a natural course of approximately 3 to 8 days. With proper diet and medication, children recovering from autumnal gastroenteritis can shorten the duration of illness and recover quickly, with minimal impact on their health. However, if not managed properly, it may lead to dehydration, acidosis, and electrolyte imbalances, which can be life-threatening in severe cases. Alternatively, it may result in prolonged illness and malnutrition, affecting the child's growth and development. Therefore, parents should be familiar with home treatment and care methods for infantile gastroenteritis.The principles of treating gastroenteritis are: ① preventing dehydration; ② correcting dehydration; ③ maintaining adequate nutrition; and ④ using appropriate medications. Based on these principles, children with mild symptoms and no signs of dehydration can be treated at home with the following measures. Severe cases should be treated in a hospital.
1. Administer sufficient oral fluids to prevent dehydration. The following fluids can be used:
① Salted rice water solution:
- Preparation: 500 ml of rice water (1-pound bottle) + 1.75 g of fine salt (half of a standard beer bottle cap); or 25 g of cooked rice flour + 1.75 g of fine salt + 500 ml of water, boiled for 2–3 minutes.
- Prevention of dehydration: Initially, give 20–40 ml/kg in small, frequent doses, completing within 4 hours. Afterward, provide fluids as tolerated.
② Sugar saline solution:
- Preparation: 500 ml of boiled water + 10 g of sugar (2 small spoons) + 1.75 g of fine salt.
- Dosage and administration: Same as above.
③ Oral rehydration salts (ORS) solution (use with caution in newborns). For children aged 10 years, ORS can be given as tolerated, with a daily intake of 2000 ml. It should be administered in small, frequent doses: 1–2 minutes per spoon (about 5 ml) for children under 2 years old; older children can drink directly from a cup. If vomiting occurs, pause for 10 minutes before resuming feeding (1 spoon every 2–3 minutes). If diarrhea persists after ORS is depleted, provide fluids as mentioned above or consult a doctor.
2. Provide sufficient food to prevent malnutrition:
- Breastfed infants should continue breastfeeding, with appropriate intervals between feeds.
- Non-breastfed infants under 6 months old can continue with regular milk or dairy products, diluted with an equal amount of rice water or water. Gradually return to normal diet after improvement, or use yogurt or milk-grain mixtures. If possible, switch to lactose-free formula.
- Infants over 6 months old can be given familiar foods such as congee, noodles, soft rice, vegetables, fish, or meat. Introduce these in small amounts. Fresh fruit juice or fruit can be given to supplement potassium. These foods should be well-cooked, mashed, or crushed for easier digestion. Older children can eat nutrient-rich, easily digestible foods. Avoid greasy foods.
3. Medications that may be used:
① Probiotics: To restore normal gut flora and rebuild the natural biological barrier. Common examples include bifidobacteria, acidophilus, and enterococci.
② Intestinal mucosal protective agents: Adsorb pathogens and maintain normal intestinal cell absorption and secretion functions. They interact with intestinal mucin glycoproteins to enhance barrier function, preventing pathogenic microorganisms from attacking. Examples include Smecta.
4. If the child does not improve after 3 days, or if any of the following symptoms appear within 3 days, seek medical attention: increased diarrhea frequency and volume, inability to eat normally, frequent vomiting, fever, significant thirst, or bloody stools.
Wishing your baby a speedy recovery!