Vomiting and Diarrhea

Overview

Acute gastroenteritis (AGE) is an infection of the stomach and intestines.
- These infections cause vomiting, diarrhea, abdominal pain, decreased appetite, and (sometimes) fever.
In children, AGE is most commonly caused by viruses, and many different viruses cause these same symptoms.
Although your child’s body will beat the virus in 10-14 days, it’s important to understand how to keep them safe while their body fights the virus.

Typically occurs at the beginning of the infection, but can continue here and there after the diarrhea starts.
Lasts about 24 hours, before giving way to diarrhea.
Some children vomit occasionally with AGE, while others will vomit everything you give them.
If your child is vomiting everything you give them, please read our rehydration article to understand how to keep them hydrated.

Happens for solids and liquids.
What matters most is that they avoid dehydration (longer than 8 hours without urinating).

Large increase in the number of stools per day.
- One or two loose poops is not true diarrhea.
Often follows the vomiting phase.
May persist up to 3 weeks.

Pain just before an episode of vomiting or diarrhea is very common.
Constant pain between episodes of vomiting or diarrhea is not normal and should prompt you to contact us right away.

Most children will avoid dehydration if they are able to keep some food and liquids down.
If your child is vomiting everything you give them, please read our oral rehydration article to understand how to keep them hydrated.

If your child is vomiting everything you give them, please study the oral rehydration article.
If they are keeping some food down, please continue to offer whatever healthy options your child is hungry and thirsty for.
- A bland or “BRAT” diet will not be appetizing, which prevents proper nutrition and delays intestinal healing.
Children have plenty of caloric reserves in their bodies, so refusing solid food intake is not worrisome.

We want the body to flush the virus, so over the counter medications to prevent diarrhea are not recommended.

This symptom is uncomfortable, but should pass after an episode of vomiting or diarrhea.
We do not recommend treating this symptom.

Rectal tylenol is an excellent option if your child is vomiting with a fever.
Ibuprofen can irritate an empty stomach, and should be avoided if your child’s stomach is empty.
If your child vomits within 15 minutes of receiving oral tylenol or ibuprofen, you can give them another full dose.
If they vomit more than 15 minutes after receiving the dose, you can assume their body has absorbed the medicine, and you should wait until they are due for their next dose.
Please review our fever guide for full details.

Gastroenteritis is very contagious.
- Typically spread by close contact with infected people (i.e. sharing food/ drinks or touching contaminated surfaces) or eating contaminated food.
Good hand washing is key.
- That being said, please don't be discouraged if the infection spreads throughout your home.
  - This is the most common scenario.
Return to School:
- Only when the following have occurred:
  - Fever free without fever reducing medicine x 24 hours.
  - Vomit free x 24 hours.
  - Stools at a normal frequency.
    - Contained within the diaper for infants.
  - Older children must have full control of bowel movements.

Red Flag Symptoms
- Please read our article on the “red flag” symptoms which are always concerning to your pediatrician.
  - The presence of these symptoms should prompt you to call us any time of day or night.
Less than 2 months old and vomiting with every feed.
Vomiting dark green fluid.
Constant and severe abdominal pain.
- Pain/fussiness/discomfort does not resolve after an episode of vomiting or diarrhea.
- Child is hunched over and unable to walk.