Vomiting and diarrhea are mostly caused by viral infections of the GI tract. Sometimes, they could be caused by bacteria or parasites (especially after travel) or spoiled food. Other illnesses that may cause these symptoms include respiratory infections, otitis media, strep throat, and urinary tract infections. In rare instances a more serious condition, such as bowel obstruction, appendicitis, meningitis, poisoning, or head injury, may cause vomiting with or without diarrhea. Bilious (green) vomiting, bloody vomiting, or bloody diarrhea need urgent evaluation.

Treatment of Vomiting and Diarrhea:

Mostly, vomiting will stop within 24 to 48 hours. Diarrhea will often continue for over a week, and it may be over 2-3 weeks before the stools return to normal. Unfortunately, Kaopectate and other over the counter mediacations are not helpful. Actually, all they do is stop the intestines from moving, allowing the virus to continue to do its damage. It is better to get the virus out of the body, even if it takes a few extra days. Antibiotics or other prescription medications are only used in the few cases that are caused by bacterial or parasitic infections. Majority of bacterial infection are not treated with antibiotics as they tend to get better on their own.

The main goal of management of vomiting and diarrhea is to prevent dehydration.

When hydrating the body, it usually is best to give Pedialyte or another  oral rehydrating electrolyte solution. During the vomiting phase, it is best to give small amounts like a sip or a dropper every 5-10 minutes. Increase the amounts slowly and if your child begins to vomit again, you probably went too quickly. We recommend then giving a stomach a rest  for 30 minutes before starting again with small sips.

Once the vomiting has passed for at least 6-8 hours, your child can begin solid foods. Simple foods will be the best – Cheerios, crackers, rice, bananas, apple sauce or chicken noodle soup. You also want to add simple proteins like lean meats. Please avoid fatty foods and fruit juices.

Sometimes after a bout of diarrhea children can have a temporary lactose deficiency and then all products with lactose should be stopped.

Use of a probiotic is helpful in decreasing the amount and frequency of diarrhea when caused by a viral illness. This good bacteria now available in powder or capsules and helps to restore the balance in the digestive system. Currently our favorite probiotic is Bio-Gaia or Florastor, available at well stocked pharmacies and online.

Signs of dehydration

• Few or no tears when crying
• Dry or sticky mouth
• Eyes that look sunken into the head
• Soft spot (fontanelle) on top of baby’s head that looks sunken
• Lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)
• Lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)
  Dry, cool skin
• Lethargy or irritability

Reasons to call us

• Vomiting not improved after 24 hours.
• Greater than 10 episodes of vomiting and/or diarrhea in a 12 hour period.
• Fever greater than 103 degrees.
• Bloody or green vomiting or bloody stool
• Infant or child who is listless, difficult to awaken, disoriented, or irritable.
• Abdominal pain that becomes worse and is not relieved by the vomiting or diarrhea.
• Abdominal pain that becomes worse and is not relieved by the vomiting or diarrhea.
• Swollen or distended abdomen.
• Vomiting associated with a severe headache, stiff neck, or painful urination.
• Infant or child who cannot cry tears or has not urinated in greater than 8 to 10 hours.