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Consider counseling parents on managing acute gastroenteritis in children traveling during spring break
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Acute gastroenteritis, although not fatal, can have serious adverse effects, such as dehydration. If patients and their families plan to travel during spring break, counseling them on how to treat and prevent diarrhea before their departure may help them enjoy their time away.
In the United States and Canada, most cases of acute diarrhea are caused by viral infections, unlike travelers’ diarrhea, which affects up to half of all travelers and is caused by bacterial contamination of food and water, according to the CDC.
“Children who contract acute diarrhea while traveling domestically tend to get it from regional outbreaks of a virus, or maybe they are reacting to unfamiliar situations,” Edward A. Bell, PharmD, BCPS, Pharmacology Consult columnist for Infectious Diseases in Children, said in an interview.
Rehydration is essential
Bell said traveling families should consider packing some basic items in case acute diarrhea strikes.
“Families can probably find most of these items at the local drug store where they will be staying, but it is not a bad idea to take along an oral rehydration solution such as Pedialyte (Abbott Laboratories) for replenishing fluids and electrolytes. That’s critical. Patients and their families might be more focused on stopping the diarrhea than on replacing fluids, but it’s the fluid replenishment that matters most,” he said.
Children who fall below certain hydration thresholds, according to Bell, may become hypokalemic or hyponatremic, two potentially dangerous conditions that can also aggravate any underlying health conditions.
“It’s helpful to remind patients and their families that drinking water is not enough to replace essential electrolytes, sodium and glucose in the body,” he said.
Not recommended for use as treatment
Bell said he does not recommend treating acute diarrhea with bismuth subsalicylate (Pepto-Bismol, Procter & Gamble; Kaopectate, Chattem).
“These products are aspirin-based, and so they run the risk of provoking Reye’s syndrome in a patient,” he said. “Children’s Pepto-Bismol is not of much use either, because its active ingredient is calcium carbonate, which does nothing to treat diarrhea.”
Antibiotics are also not generally recommended for acute diarrhea. “Most of these cases are viral in nature, so the antibiotics wouldn’t have any effect,” Bell said.
According to Bell, loperamide (Immodium AD, McNeil Consmer) has no role for most episodes of diarrhea in pediatric patients because “it has the potential to cause paralytic ileus in the gastrointestinal tract of a child, leading to a potential overflow of toxic fluids in the body,” he said.
Acute diarrhea tends to clear up on its own within 1 or 2 days, he said; however, parents of infants with diarrhea should seek a medical evaluation, especially if the patient has a fever or bloody stools.
Disclosures: Bell reports no relevant financial disclosures.