Gastroenteritis: What you need to know

NHS Inform, a health information service, defines viral gastroenteritis as an intestinal infection marked by watery diarrhoea, abdominal cramps, nausea or vomiting, and sometimes fever.  It affects people of all ages, but is particularly common in young children.

The platform mentions that the most common way to develop viral gastroenteritis — often called stomach flu —is through contact with an infected person or by ingesting contaminated food or water. If you’re otherwise healthy, you’ll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.

There’s no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defence.

Each season, medics say, come with common ailments. For example, in Rwanda, there are two seasons in a year—dry and rainy (or wet) seasons.

In the dry season, Dr Charles Nuwagaba, a paediatrician at Polyfarm Clinic in Remera, Kigali, says diarrheal diseases or gastroenteritis diseases among children are common.

He says 99 per cent of the cases they handle at the clinic are diarrheal diseases in children under the age of five.

The symptoms, he says, range from vomiting, diarrhoea to abdominal pains, which he believes is mainly due to dirty/contaminated water.

He explains that during dry seasons in some places, people experience shortness of water for some time or days, and when it comes back, it’s normally contaminated.

“This water is what people use domestically, for cooking and drinking. In children, it can cause acute gastroenteritis,” he says.

He notes that vomiting and diarrhoea are very dangerous to children and if this happens several times, without quick intervention, there are many complications associated with it.

Mainly, he says, children with this condition   get dehydrated quickly, with signs such as sunken eyes, sunken fontanel, and poor skin turgor in the abdomen, among others.

According to him, the end result of severe dehydration is shock and then death.

UNDERSTANDING THE CONDITION

According to medics, acute gastroenteritis is the inflammation of the stomach and bowel, and results in vomiting and diarrhoea.

In children, Nuwagaba says gastroenteritis is usually caused by bacteria or parasites or infection, most often with a virus.

Charles Sindabimenya, a specialist in internal medicine at Doctors Plaza Kimironko, says acute gastroenteritis often comes suddenly with nausea, vomiting, and diarrhoea (frequent and loose or watery bowel movements).

He says a child with this condition may also have a fever, reduced appetite, and abdominal pains.

These symptoms, he says, can last 24 hours to a week. This, however, he says, depends on the cause of the gastroenteritis, whereby sometimes diarrhoea may persist for a longer period of time.

“Gastroenteritis caused by an infection with a parasite can cause longer-lasting diarrhoea that comes and goes, as well as tiredness and weight loss,” Sindabimenya says.

DEHYDRATION AND GASTROENTERITIS

Dr Janvier Rusizana, a general practitioner at La Nouvelle Clinic in Remera, says a major concern in children with acute gastroenteritis is that they become dehydrated.

This, he explains, is due to the fluid they normally lose through vomiting and diarrhoea, adding that the younger the child, the higher the risk of dehydration.

He says dehydration normally comes with signs, such as constant thirst.

They may also not pass urine frequently, have a dry mouth and skin, and feel faint or lightheaded.

He notes that dehydration is classified into three; mild, moderate and severe.

In mild, Rusizana says, the signs are rarely observed but the child most of the time has the urge to drink water.

With moderate and severe dehydration, the signs are almost similar and include drowsiness, rapid or deep breathing, and cold hands or feet, sunken eyes, low energy levels, and no tears while crying, among others.

“Dehydration should be taken seriously, because if there is no quick medical intervention, the child may develop serious complications or even die,” Rusizana says.

If the child has symptoms that last for more than one to two days, Rusizana says it’s advisable to seek medical attention.

HOW TO GO ABOUT IT

Nuwagaba says acute gastroenteritis is usually caused by parasites such as giardisitesa and cryptosporidium, usually via contaminated water or close contact with others, which is common during dry seasons.

Other ways one can get the condition, he says, is through swimming or playing in contaminated water.

If the child is suffering from this condition, he says that during examination, it’s important for a medic to always look for signs of dehydration.

In most children with mild gastroenteritis, Nuwagaba says the diagnosis can usually be made based on their symptoms and physical examination.

For severe gastroenteritis or dehydration, proper treatment is needed and in most cases, it’s considered as an emergency case, therefore, requiring immediate treatment.

When it comes to the treatment, Rusizana says, mild acute gastroenteritis requires adequate fluids to prevent dehydration. Also, resting as much as possible during recovery is necessary.

Whereas for more severe symptoms, there is a risk of severe dehydration, therefore, close monitoring and treatment with fluids and medicines at a health facility is important.

WHY FLUIDS ARE IMPORTANT

Nuwagaba says fluids are essential for children with acute gastroenteritis to keep them well hydrated.

However, he says, in case of vomiting, drinking small amounts of fluid frequently is often the best approach. This should be done after a child vomits.

He notes that fluids may include breast milk, especially for children who are still breastfeeding.

It’s also recommended to give the children oral rehydration solution. Fluids such as fruit juice are a better option only if the child is not dehydrated.

Oral rehydration solution is recommended in cases of dehydration.

“It’s also important to seek advice from a medic on the type of fluid, and how much to give depending on the child’s case at the moment,” Nuwagaba says.

When it comes to food, Sindabimenya says it’s advisable to give children easily digested foods whenever they feel like eating, and starting with smaller amounts is essential.

In some cases, he notes that babies or children with bacterial or parasitic gastroenteritis may be treated with antibiotics to reduce the length and the severity of the illness, or to prevent complications.

Meanwhile, Nuwagaba says maintaining good hygiene is important and boiling drinking water at 100 degrees Celsius and treating it is important.

Although in some cases it’s hard to prevent acute gastroenteritis in children, Nuwagaba says when parents ensure hygiene around them, it can help keep the condition at bay, especially in young children.

editorial@newtimesrwanda.com

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