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Dr. Fred Piaser

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DIARRHEA   Gastroenteritis, a common childhood illness, is usually not serious. Diet modification is the treatment of choice. It can affect children of all ages, but can be more serious if he or she is less than one year old. The major concern is dehydration. This illness is usually caused by a stomach virus but occasionally it is caused by bacteria or parasites.

The symptoms include vomiting, frequent loose bowel movements, abdominal pain and low grade fever. The main object in treatment is to rest the bowels and prevent dehydration. To this end, I recommend small frequent feedings of clear liquids. Avoid milk products, fats, butter, and oils. Also avoid citric juices, eggs, chocolate, candy and spicy foods. Unless the child has special dietary needs, the older (non diabetic) child may have a clear fluid diet the first day. This diet can include weak tea, flat sodas, sugar water, diluted apple juice or Gatorade. The key here is frequent feedings in small amounts. The sick bowels cannot handle too much fluid at one time so you should give your child small amounts so the bowels can rest. Your child should be offered fluids frequently to prevent dehydration.

Contact me if the symptoms persist past 2-3 days for the older child. Call me sooner if your child is less than one year old. I am especially cautious with the younger child because it is easier for him to become dehydrated. This problem rarely occurs, but when it does it could be serious. I will discuss dehydration later on in this article. Your child looses fluids through diarrhea and vomiting and it is important to make sure that you replace these fluids. Also, during diarrhea it is hard for your child to digest solid foods. The first day I usually suggest clear fluids such as Pedialyte, a solution of plain water with added minerals and sugar. The next day advance the diet by adding rice, cereal, jello, banana and apple white or apple sauce. If there is less diarrhea, the next day try some chicken broth, boiled chicken, and mashed potatoes. You can also try some diluted formula or, if your child is on regular milk, skim milk. Over the next few days advance to a regular diet. When starting vegetables, begin with the yellow ones and then go to the green ones. When beginning meats, start with chicken and turkey and go to the red meats last.

Dehydration is the condition that develops from excessive loss of body water. You should be aware of the warning signs of dehydration. These signs include dryness of the skin and mucous membranes, crying without tears, and not urinating for over twelve hours. Other signs include lethargy or excessive tiredness, sunken eyes and, in the younger child, a sunken fontanelle (soft spot). Gastroenteritis is a common illness that is usually not serious. It is usually a viral infection and in such cases we do not use antibiotics for treatment. In the event that the abdominal pain or diarrhea is severe or persistent, do not hesitate to call me. I may have to get additional tests or suggest a different treatment. These tests can measure hydration or can identify the specific germ or condition involved. Usually diarrhea caused by gastroenteritis is not a serious condition. We can managed this condition by diet modification and by being aware of the signs of dehydration.

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