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Clinical assessment of child with gastroenteritis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Suspect gastroenteritis if there is a sudden change in stool consistency to loose or watery stools, and/or a sudden onset of vomiting. The clinician should be aware that in children with gastroenteritis:

  • diarrhoea usually lasts for 5-7 days, and in most it stops within 2 weeks
  • vomiting usually lasts for 1-2 days, and in most it stops within 3 days (1)

A complete history and physical examination should be carried out to determine whether the child is dehydrated and if possible the aetiology of acute gastroenteritis (2,3)

  • duration of illness
  • the number of episodes per day
    • vomiting
      • whether vomiting is interfering with the child's ability to keep down fluids and solid food
      • type of emesis (e.g., whether bile is present)
    • diarrhoea
      • whether blood or mucus is present
  • urine output
  • the presence of blood in the stool
  • accompanying symptoms such as fever, abdominal pain, and urinary complaints
  • child's mental status
  • any accompanying medical conditions
  • whether oral rehydration therapy has been attempted with any success
  • recent contact with someone with acute diarrhoea and/or vomiting and
  • exposure to a known source of enteric infection (possibly contaminated water or food) and
  • recent travel abroad (1,2,3)

Physical examination can be useful in identifying signs of dehydration e.g. - level of alertness, presence of sunken eyes, dry mucous membranes, and skin turgor

Recognise that the following are at increased risk of dehydration:

  • children younger than 1 year, particularly those younger than 6 months
  • infants who were of low birth weight
  • children who have passed more than five diarrhoeal stools in the previous 24 hours
  • children who have vomited more than twice in the previous 24 hours
  • children who have not been offered or have not been able to tolerate supplementary fluids before presentation
  • infants who have stopped breastfeeding during the illness
  • children with signs of malnutrition (1).


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


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