Pediatric Acute Gastroenteritis: Clinical Assessment, Oral Rehydration and Antiemetic Therapy

Wendy L. Woolley; John H. Burton

Disclosures

Pediatr Health. 2009;3(2):191-197. 

In This Article

Abstract and Introduction

Abstract

Acute gastroenteritis (AGE) in the pediatric population remains a significant cause of pediatric patient morbidity and mortality. For these patients, oral rehydration therapy is an intervention that should be initiated with the first signs and symptoms of AGE. Oral rehydration therapy should be based on the degree of clinical dehydration. Clinical findings, such as those used in the clinical dehydration score, should be utilized as a means to standardize the dehydration assessment. Recent evidence supports the use of ondansetron, both orally and intravenously, to facilitate oral rehydration when vomiting is a concern. Consideration should be given to a trial of ondansetron therapy in the management of children with AGE to potentially avoid intravenous rehydration and hospital admission.

Introduction and Epidemiology

Acute gastroenteritis (AGE) in the pediatric population remains a significant cause of pediatric patient morbidity and mortality, both in the USA and worldwide.[1,2] In the US population, AGE accounts for greater than 1.5 million annual physician visits with 200,000 hospital admissions and approximately 300 deaths annually attributed to pediatric AGE. The financial impact of pediatric AGE is also significant with more than 900,000 hospital days and direct costs of more than $2 billion per year in the US healthcare system.

Worldwide, AGE provokes an estimated 125 million physician visits, 9 million hospital admissions and 1.8 million annual deaths in children less than 5 years of age. Although worldwide mortality from this illness remains a significant challenge, pediatric death rates from diarrheal illnesses have recently been substantially reduced, largely secondary to worldwide campaigns for treatment of affected children with oral rehydration therapy (ORT).[2]

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