Vomiting/diarrhea help

Vomiting / Diarrhea Management

The Problem

Vomiting and diarrhea often occur together and are usually caused by a "cold" or "flu" of the bowels. Specifically, in the majority of cases the cause is a virus which can inflame the lining of the intestines. Rotavirus is the most common one in infants and children. The medical terminology given this is gastroenteritis. The bodies defense against the infection is to remove the offending agent by decreasing the time it remains in the intestines - hence the vomiting and/or diarrhea to get it out of the system.

Water, which makes up about 80% of small children’s bodies, is the main thing lost. Also lost are body salts - both sodium and potassium - and these must be replaced if the vomiting or diarrhea is severe. Just replacing water alone in big quantities can be very dangerous!

We used to tell people to give the bowels a "rest" when treating gastroenteritis, and then to slowly re-start the diet with clear liquids and then slowly adding back other foods as they were tolerated. We now know that diarrhea resolves more quickly by "feeding through" the episode and adding extra oral rehydration fluids with sodium, potassium, and very minimal sugar to treat any dehydration that results from the loss of fluids due to any vomiting or diarrhea.

Things to Help

Infants should continue receiving breast milk or formula - DO NOT stop foods or liquids. Replace feedings lost to vomiting or diarrhea with breast feeding or more formula. BUT give only 1 ounce of formula every 10 minutes and allow only short but more frequent breastfeeding sessions to avoid overwhelming the intestines and causing further vomiting or diarrhea.

Only if your child has any signs of dehydration (dry mucous membranes, decreased urine output with less frequent wet diapers) do you need to use additional oral rehydration solutions such as Pedialyte (or the generic equivalent), or the oral rehydration formula listed below. Use several teaspoons of the oral rehydration solution every 1-2 minutes to avoid overwhelming the intestines and worsening vomiting or diarrhea.

Home oral rehydration formula - WHO (World Health Organization) Mixture:

	1 liter of water
	1/2 teaspoon Table Salt
	1/2 teaspoon Potassium Chloride or Potassium Salt
	1/2 teaspoon baking soda
	4 Tablespoons table sugar

Older children and adults should continue a regular diet in frequent but smaller portions avoiding uncooked milk or dairy products, fruit juices and drinks high in sugar (like soda and even sports drinks like Gatorade), as well as heavy, greasy meals.

Some foods are naturally constipating by bulking the stools: ripe bananas, plain cooked rice, cooked carrots, applesauce, and dry toast. These can be offered liberally and are the traditional components of the pediatric BRAT diet.

For infants taking solid foods, try 1 part pureed carrots and 1 part water in a bottle or cup with a large nipple hole, this will bulk the stools and cause "carrot patty stools"

Adults may try Kaopectate or Pepto Bismol per label directions with every episode of loose stool.

Things to Avoid

	*DO NOT USE Pepto Bismol* in children under age 18 - it contains aspirin and can cause deadly Reyes syndrome**.
	DO NOT use anti-diarrhea medications like Imodium, Kaopectate, or Lomotil unless specifically told to do so by your doctor. These can actually prolong the course of your illness!

When to Call Your Doctor

	Baby less than 6 months old OR over 6 months old and a fever over 101.5 F
	Vomiting over 8 hours or with great force
	Bloody or green slimy vomit
	Hasn’t urinated in 8 hours
	Bloody or slimy stools
	Might have swallowed something poisonous
	Is listless or unusually sleepy
	Has had continuous abdominal pain for over 2 hours