Hamilton Spectator — Housecalls
May 20, 2010
By Dr. April Kam
Q: What do I do when my two-year-old son is vomiting and has diarrhea? How concerned should I be? How long will it last?
A: Vomiting and diarrhea are both common complaints. When coupled together, they are often symptoms of a virus affecting your child's gastrointestinal tract.
Your doctor may tell you that your child has viral gastroenteritis, which is commonly referred to as the stomach flu.
However, this is misleading as it is not caused by the influenza virus and doesn't infect the stomach itself.
Doctors usually diagnose viral gastroenteritis based on the symptoms and a physical examination. No tests are usually needed.
If you have not travelled outside the country and do not have bloody diarrhea, you generally do not need any medicine or antibiotics.
Luckily, most cases of viral gastroenteritis resolve themselves with time without any specific treatment.
If your son is still tolerating his regular diet, you can continue to offer it. Often, your child's appetite may be decreased and he may eat little to nothing for a few days. The vomiting and diarrhea can last for as little as two days or as long as 10.
The most important thing you can do is prevent dehydration. In the case of vomiting and diarrhea, important salts or minerals known as electrolytes may also be lost.
Prevent dehydration by offering your child an oral rehydration solution such as Pedialyte in order to replace fluids and nutrients lost.
Pedialyte is commonly available at drugstores as both a juice or a frozen Popsicle. If your child is still drinking, put it in his bottle or sippy cup.
If he refuses his bottle or sippy cup during the bout of illness, you can give him the solution by squirting a syringe of it into his mouth. For example, giving a teaspoon (5 mL) every five minutes, depending on the size of your child.
It is important not to give only water or juice to your child because those liquids do not contain the important electrolytes that the body is losing through the vomit and diarrhea.
Some signs of dehydration, and when you should go to the doctor include:
- little or lack of urine
- dry mouth
- no tears when crying
- excessive sleepiness
- Some signs that this may not just be gastroenteritis and you should go to the emergency department include:
- dark green or bloody vomit
- bloody diarrhea
- severe and worsening abdominal pain
Gastroenteritis, or the stomach flu, is easily spread from child to child. Help prevent infection by disposing of dirty diapers properly and by washing your hands often.
Make sure your child also washes his hands frequently, especially after going to the bathroom and before eating. Avoid sending your child to playgroups or day care when he is experiencing diarrhea or vomiting to prevent the spread of the virus.
About one in five cases of childhood gastroenteritis is caused by rotavirus, so ask your family doctor about the new rotavirus vaccine, now available in Ontario.
Dr. April Kam is a pediatric emergency physician at McMaster Children's Hospital.