Common Gastrointestinal Infections in Children: Symptoms and Treatment

Gastrointestinal infections, in children can be acute or chronic. The most common is acute infection, meaning of recent onset i.e. symptoms for a few days generally, and chronic is symptoms lasting months like in Intestinal Tuberculosis.  We discuss here acute gastrointestinal infections often referred to as acute gastroenteritis.  Acute gastroenteritis is a very common problem in children, especially between 6 months to five years of age. This is generally a condition that heals rather fast; however, parental anxiety can result from a lack of knowledge regarding the management of their sick child. It is, therefore essential that parents be informed of the symptoms and appropriate treatment methods for such infections.

What are pediatric gastrointestinal infections?

Pediatric Gastrointestinal Infections in Children

A variety of microorganisms can gain access to the gut via contaminated food, water, or through the environment and cause gastrointestinal infections in children. Acute gastroenteritis is often caused in children by viruses, and bacteria and rarely by fungus, parasites, or other opportunistic microorganisms. Infection can be mild to severe and can cause life-threatening complications like dehydration, especially in the younger ones.

Viral

Gastrointestinal viral infections are quite prevalent and frequently referred to as the “stomach flu.”

Rotavirus-The most common cause of viral gastroenteritis in children globally is rotavirus. 

Rotavirus is one of the viral illnesses that vaccinations help prevent.

Norovirus- Globally, noroviruses are the most frequent cause of foodborne illness. 

Bacterial

Bacterial gastrointestinal infections are usually acquired by the foodborne route.

Gastrointestinal tract infections caused by bacteria can originate from the following:

Salmonella

Escherichia coli, or E. coli

Shigella

Cholera

While most contaminated foods can lead to infection, certain foods carry higher risks than others. These include:

Undercooked or raw meat, eggs, or poultry

Unpasteurized dairy and juices

Contaminated water

Unwashed or raw fruits and vegetables

Poor hygiene eg: flies at home, untrimmed nails, no hand washing etc. 

Parasitic

Parasitic gastrointestinal infections are caused by protozoan parasites and intestinal helminths, or worms, often causing chronic infection.

Of the parasitic illnesses, giardiasis and cryptosporidiosis are the most common.

What is the most common GI infection in children?

The most common cause is viral gastroenteritis often caused by rotavirus, norovirus. Salmonella, Escherichia coli (E. coli), and Shigella are the most frequent sources of bacteria.

What is Gastroenteritis? What are its Symptoms and Signs?

It is an infection in the stomach and intestines. Intestinal affection can be limited to small intestines or large intestines or involve both. It is more serious in newborns and young children because they are much more at risk for dehydration with vomiting and diarrhea.

Signs and symptoms 

Signs and Symptoms of Gastrointestinal Infections

Diarrhea is the most common symptom of gastroenteritis. A child may have frequent loose, watery stools along with stomach discomfort, vomiting, and fever. When there is a high volume of watery loose stools, it can lead to dehydration rapidly, especially in infants.

If the large intestine is affected, the child has diarrhea in the form of small-volume loose stools containing blood and/or mucus.
Sometimes children will also have additional symptoms including headaches, body pains, and nausea. 

When a newborn is ill, parents or caretakers should make sure they keep the newborn hydrated by giving them smaller amounts of breast milk or formula regularly. 

Gastroenteritis Treatments

The main objectives of the treatment of gastroenteritis in children are rehydration, symptomatic treatment, and prevention of complications. 

Treatment: 

Gastroenteritis Treatment in Children

Oral rehydration solutions: These are the solutions made up of the ideal ratio of glucose and salts that replace the lost electrolytes and fluids resulting from vomiting and diarrhea. ORS is the single most important treatment in the management of watery gastroenteritis. WHO-ORS sachets/tetra packs only have the recommended composition of these substances; none of the other over-the-counter “Pseudo ORS” should be used.

Fluid replacement: In severe dehydration, intravenous fluids might be necessary to replace fluids and electrolytes.

Relieving symptoms: Medications such as paracetamol, antiemetics (which lessen vomiting) and antidiarrheal medicines, probiotics may be used, but a healthcare provider should always advise before using them.

Usage of Antibiotics

Antibiotics are not usually necessary for treating gastroenteritis caused by viral infections, since they are inefficient against viruses. 

However, to treat the underlying bacteria, some antibiotics may be required for bacterial gastroenteritis. Antibiotic resistance can result from improper use of antibiotics, thus it’s important to keep in mind that they should only be prescribed by medical professionals.

When to See a Physician for Pediatric Gastrointestinal Infection 

For Children- See your pediatrician right away if your child:

Has a fever of above 102°F (39°C) or is persistent for >3 days

Appears lethargic

Is irritable

Has bloody diarrhea (Blood and /or mucus in stools)

Has uncontrolled vomiting limiting oral intake of WHO-ORS

Drinks eagerly appear dehydrated

You should keep an eye on your child’s drinking, activity, and urination habits and compare them to their usual levels to determine whether they are dehydrated. 

For Infants- Get your baby to their pediatrician right away if they:

Has high volume watery loose stools 

Have been vomiting (not just normal spitting up) for more than several hours

Haven’t had wet diapers in six hours

Have bloody stools

Unusually drowsy or sleepy

Fever

Have a dry mouth

Cries without tears

Unresponsive

Have a sunken soft spot on the top of their head

Note: It is always recommended to visit the doctor when there is acute gastroenteritis, especially in infants. The above signs are for home monitoring and for caregivers to be on guard. Requires to revisit if they develop.

Care at home

Maintaining your child’s frequent consumption of fluids, such as water, oral rehydration solution (WHO-ORS), breastmilk, or formula, is the primary course of treatment. 

Replacing the fluids lost as a result of the vomiting and diarrhea is crucial. 

Medications as prescribed by your doctor and home monitoring as emphasized.
Sugar-filled drinks should never be given, since they exacerbate dehydration. 

Conclusion

Acute gastroenteritis can cause dehydration, a life-threatening condition in infants and young children. Visiting your doctor (Pediatrician/Pediatric Gastroenterologist) is the best way to know the severity of the problem, start appropriate treatment, and understand preventive aspects. Self-care techniques like making sure the child is hydrated and keeping an eye on things are important.