Skip to main content
SpringerLink
Log in

Management of Gastroenteritis in Early Childhood

  • Practical Therapeutics
  • Published:
Drugs Aims and scope Submit manuscript

Summary

The most important aspect of modern management of acute diarrhoeal illness in children is that of oral rehydration therapy, and drug therapy is very rarely indicated. Despite the dramatic decline in mortality and morbidity in recent years, there is still the need for continuing education in the appropriate use of oral rehydration solutions. The constitution of oral rehydration solutions and policies of feeding practices during illness continue to be controversial, mainly because of wide variation in the aetiology of the diarrhoea, the nutrition of the child, and the economic and public health factors involved in any particular community. The priority of all healthcare workers is to provide simple guidelines in the use of a safe oral rehydration solution while discouraging unsafe treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Armistead J, Kelly D, Walker-Smith JA. Evaluation of infant feeding in acute gastroenteritis. Journal of Pediatric Gastro-enterology and Nutrition 8: 240–244, 1989

    Article  Google Scholar 

  • Aserkoff B, Bennett JV. Effect of antibiotic therapy in acute sal-monellosis on the fecal excretion of salmonellae. New England Journal of Medicine 281: 636–640, 1969

    Article  PubMed  CAS  Google Scholar 

  • Bhutta TI. Loperamide poisoning in children. Lancet 1: 363, 1990

    Article  Google Scholar 

  • Brown KH. Dietary management of acute childhood diarrhoea: optimal timing of feeding and appropriate use of milks and mixed diets. Journal of Pediatrics 118: S92–98, 1991

    Article  PubMed  CAS  Google Scholar 

  • Brown KH, Gastanaduy AS, Saavedra JM, Lembcke J, Rivas D, et al. Effect of continued oral feeding on clinical and nutritional outcomes of acute diarrhoea in children. Journal of Pediatrics 112: 191–200, 1988

    Article  PubMed  CAS  Google Scholar 

  • Costella AM de la, Bhutta TI. Antidiarrhoeal drugs for acute diarrhoea in children. British Medical Journal 304: 1–2, 1992

    Article  Google Scholar 

  • da Cunha Ferreira RMC. Optimising oral rehydration solution composition for the children of Europe: clinical trials. Acta Paediatrica Scandinavica (Suppl.) 364: 40–50, 1989

    Article  Google Scholar 

  • Dupont HL, Hornick RB. Adverse effect of ‘Lomotil’ therapy in shigellosis. Journal of the American Medical Association 226: 1525–1528, 1973

    Article  PubMed  CAS  Google Scholar 

  • Editorial. What has happened to carbohydrate intolerance following gastroenteritis? Lancet 1: 23–24, 1987

    Google Scholar 

  • Editorial. Cereal-based oral rehydration solutions — bridging the gap between fluid and food. Lancet 339: 219–220, 1992

    Article  Google Scholar 

  • Elliott EJ, Armistead JCM, Farthing MJG, Walker-Smith JA. Oral rehydration therapy without bicarbonate for prevention and treatment of dehydration: a double-blind controlled trial. Journal of Alimentary Pharmacology and Therapeutics 2: 253–262, 1988

    Article  CAS  Google Scholar 

  • Elliott EJ, Walker-Smith JA, Farthing MJG. The role of bicarbonate and base precursors in treatment of acute gastroenteritis. Archives of Disease in Childhood 62: 91–95, 1987

    Article  PubMed  CAS  Google Scholar 

  • Finberg L. The role of electrolyte-glucose solutions in hydration for children — international and domestic aspects. Journal of Pediatrics 96: 51–54, 1980

    Article  PubMed  CAS  Google Scholar 

  • Fox R, Leen CLS, Dunbar EM, Ellis ME, Mandai BK. Acute gastroenteritis in infants under 6 months old. Archives of Disease in Childhood 65: 936–938, 1990

    Article  PubMed  CAS  Google Scholar 

  • Islam MR. Can potassium citrate replace sodium bicarbonate and potassium chloride in oral rehydration solution? Archives of Disease in Childhood 60: 852–855, 1985

    Article  PubMed  CAS  Google Scholar 

  • Islam MR, Ahmed SM. Oral rehydration solution without bicarbonate. Archives of Disease in Childhood 59: 1072–1075, 1984

    Article  PubMed  CAS  Google Scholar 

  • Jenkins HR, Ansari BM. Management of gastroenteritis. Archives of Disease in Childhood 65: 939–941, 1990

    Article  PubMed  CAS  Google Scholar 

  • Jones BMJ, Brown BE, Silk DBA. Intestinal absorption of mal-totriose and a maltopentose-lexose mixture in man. Gut 22: A868, 1981

    Google Scholar 

  • Khin Maung U, Nyunt Nyunt Wai, Myo Khin, Mu Mu Khin, Tin U, Thane toe. Effect on clinical outcome of breast feeding during acute diarrhoea. British Medical Journal 290: 587–589, 1985

    Article  Google Scholar 

  • Lifschitz CH, Schulman RJ. Nutritional therapy for infants with diarrhoea. Nutrition Reviews 48: 329–338, 1990

    Article  PubMed  CAS  Google Scholar 

  • Mackenzie A, Barnes G, Shann F. Clinical signs of dehydration in children. Lancet 2: 605–607, 1989

    Article  PubMed  CAS  Google Scholar 

  • Mackenzie A, Barnes G. Randomized controlled trial comparing oral and intravenous rehydration therapy in children with diarrhoea. British Medical Journal 303: 393–396, 1991

    Article  PubMed  CAS  Google Scholar 

  • Malawer SJ, Ewton M, Fordtran JS, Ingelfurger FJ. Interrelation between jejunal absorption of sodium, glucose and water in man. Journal of Clinical Investigation 44: 1072–1073, 1965

    Article  Google Scholar 

  • Mazumder RN, Nath SK, Ashraf H, Patra FC, Alam AN. Oral rehydration solution containing trisodium citrate for treating severe diarrhoea: controlled clinical trial. British Medical Journal 302: 88–89, 1991

    Article  PubMed  CAS  Google Scholar 

  • Molla AM, Molla A, Nath SK, Khatun M. Food-based oral rehydration salt solution for acute childhood diarrhoea. Lancet 2: 429–431, 1989

    Article  PubMed  CAS  Google Scholar 

  • Molla AM, Rahman M, Sarker SA, Sack DA, Molla A. Stool electrolyte content and purging rates in diarrhoea by rotavirus, enterotoxigenic E. coli and Vibrio cholerae in children. Journal of Pediatrics 98: 835–838, 1981

    Article  PubMed  CAS  Google Scholar 

  • Molla AM, Sarker SA, Hossain M, Molla A, Greenough III NB. Rice-powder electrolyte solutions as oral therapy in diarrhoea due to Vibrio cholerae and Escherichia coli. Lancet 1: 1317–1319, 1982

    Article  PubMed  CAS  Google Scholar 

  • Motala C, Hill ID, Mann MD, Bowie MD. Effect of loperamide on stool output and duration of acute infectious diarrhoea in infants. Journal of Pediatrics 117: 467–471, 1990

    Article  PubMed  CAS  Google Scholar 

  • Nalin DR, Cash RA, Rahman M, Yurns MD. Effects of glycine and glucose on sodium and water absorption in patients with cholera. Gut 11: 768–772, 1970

    Article  PubMed  CAS  Google Scholar 

  • Nalin DR, Harland E, Ramlal A, Swaby D, McDonald J, et al. Comparison of low and high sodium and potassium content in oral rehydration solution. Journal of Pediatrics 97: 848–893, 1980

    Article  PubMed  CAS  Google Scholar 

  • Nelson JD, Kusmiesz H, Jackson LH, Woodman E. Treatment of Salmonella gastroenteritis with ampicillin, amoxicillin, or placebo. Pediatrics 65: 1125–1130, 1980

    PubMed  CAS  Google Scholar 

  • Palmer DL, Koster FT, Islam AFMR, Raham ASMM, Sack RB. Comparison of sucrose and glucose in the oral electrolyte therapy of cholera and other severe diarrhoeas. New England Journal of Medicine 297: 1107–1110, 1977

    Article  PubMed  CAS  Google Scholar 

  • Patra FC, Mahalanabis D, Jalan KN, Sen A, Banerjee P. Can acetate replace bicarbonate in oral rehydration solution for infantile diarrhoea? Archives of Disease in Childhood 57: 625–627, 1982a

    Article  PubMed  CAS  Google Scholar 

  • Patra FC, Mahalanabis D, Jalan KN, Sen A, Banerjee P. Is oral rice electrolyte solution superior to glucose electrolyte solution in infantile diarrhoea? Archives of Disease in Childhood 57: 910–912, 1982b

    Article  PubMed  CAS  Google Scholar 

  • Patra FC, Mahalanabis D, Jalan KN, Sen A, Banerjee P. In search of a super solution: controlled trial of glycine-glucose oral rehydration solution in infantile diarrhoea. Acta Paediatrica Scandinavica 73: 18–21, 1984

    Article  PubMed  CAS  Google Scholar 

  • Pickering LK. Therapy for acute infectious diarrhoea in children. Journal of Pediatrics 118: S118–128, 1991

    Article  PubMed  CAS  Google Scholar 

  • Pizarro D, Posada G, Sandi L, Movon JR. Rice-based oral electrolyte solutions for the management of infantile diarrhoea. New England Journal of Medicine 324: 517–521, 1991

    Article  PubMed  CAS  Google Scholar 

  • Rosenthal SL. Exacerbation of Salmonella enteritis due to ampicillin. New England Journal of Medicine 281: 636–640, 1969

    Article  Google Scholar 

  • Santosham M, Burns B, Nadkarni V, Foster S, Garrett S, et al. Oral rehydration therapy for acute diarrhoea in ambulatory children in the United States: a double-blind comparison of four different solutions. Pediatrics 76: 159–166, 1985

    PubMed  CAS  Google Scholar 

  • Santosham M, Burns BA, Reid R, Letson GW, Duncan B, et al. Glycine-based oral rehydration solution: reassessment of safety and efficacy. Journal of Pediatrics 109: 795–801, 1986

    Article  PubMed  CAS  Google Scholar 

  • Semrad CE, Chang EB. Calcium-mediated cyclic AMP inhibition of Na+-H+ exchange in small intestine. American Journal of Physiology 242: C315–322, 1987

    Google Scholar 

  • Sladen GE, Dawson AM. Interrelationships between the absorptions of glucose of sodium and water by the normal human jejunum. Clinical Science 36: 119–32, 1969

    PubMed  CAS  Google Scholar 

  • World Health Organization. The rational use of drugs in the management of acute diarrhoea in children. World Health Organization, Geneva 1990

    Google Scholar 

  • Walker-Smith JA. Disease of the small intestine, 3rd ed., Butter-worth & Co, London, 1988

    Google Scholar 

  • Walker-Smith JA. Advances in oral rehydration. Drugs 36(Suppl. 4): 99–108, 1988

    Google Scholar 

  • Walker-Smith JA. Management of infantile gastroenteritis. Archives of Disease in Childhood 65: 917–918, 1990

    Article  PubMed  CAS  Google Scholar 

  • Wharton BA, Pugh RE, Taitz LS, Walker-Smith JA, Booth IW. Dietary management of gastroenteritis in Britain. British Medical Journal 296: 450–452, 1988

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Child Health, Cardiff Royal Infirmary, Newport Road, Cardiff, Wales, CF2 1SZ, England

    Anne Danes &  Huw R. Jenkins

Authors
  1. Anne Danes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Huw R. Jenkins
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Danes, A., Jenkins, H.R. Management of Gastroenteritis in Early Childhood. Drugs 44, 57–64 (1992). https://doi.org/10.2165/00003495-199244010-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-199244010-00005

Keywords

Search

Navigation