Clinical Review

Acute gastroenteritis in children

BMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39036.406169.80 (Published 04 January 2007) Cite this as: BMJ 2007;334:35
  1. Elizabeth Jane Elliott, professor in paediatrics and child health
  1. 1Discipline of Paediatrics and Child Health, University of Sydney, Sydney 2006, NSW, Australia
  1. Correspondence to: E Elliott, c/o Children's Hospital at Westmead, Westmead 2145, NSW, Australia elizabe2{at}chw.edu.au
  • Accepted 9 November 2006

Acute gastroenteritis accounts for millions of deaths each year in young children, mostly in developing communities. In developed countries it is a common reason for presentation to general practice or emergency departments and for admission to hospital. Dehydration, which may be associated with electrolyte disturbance and metabolic acidosis, is the most frequent and dangerous complication. Optimal management with oral or intravenous fluids minimises the risk of dehydration and its adverse outcomes. Routine use of antibiotics, antidiarrhoeal agents, and antiemetics is not recommended and may cause harm. Prevention is the key to controlling gastroenteritis, and recently licensed, highly effective rotavirus vaccines will have a major effect on public health.

Sources and selection criteria

I searched the Cochrane Library database using the keywords “acute gastroenteritis” (all text), “acute disease”, “gastroenteritis”, and “child”. I searched Medline via PubMed clinical queries using the keywords “gastroenteritis” together with “oral rehydration”, “antidiarrheal”, “antiemetic”, “probiotic”, and “zinc” with the options “find systematic reviews” and “search by study category—therapy.” The options of “aetiology” and “diagnosis” were also applied using the term “gastroenteritis”. I also searched the child health section of Clinical Evidence and reviewed the reference lists of publications found during searches for other relevant manuscripts

What is the epidemiology and impact of gastroenteritis?

Acute gastroenteritis—diarrhoea or vomiting (or both) of more than seven days duration—may be accompanied by fever, abdominal pain, and anorexia. Diarrhoea is the passage of excessively liquid or frequent stools with increased water content. Patterns of stooling vary widely in young children, and diarrhoea represents a change from the norm.1 Worldwide, 3-5 billion cases of acute gastroenteritis and nearly 2 million deaths occur each year in children under 5 years.2 In the United States, gastroenteritis accounts for about ∼10% (220 000) of admissions to hospital, more than 1.5 million outpatient visits, and around 300 deaths in children under 5 annually, with a cost of around …

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