My tummy doesn’t feel well!
No parent wants to see their child ill with an upset tummy, nausea and vomiting, especially when there are summer vacations and play dates to attend, but what should you do if the stomach bug hits your family?
Let’s explore some of the common reasons and concerns for nausea and vomiting, and when you should seek medical attention, to keep your children and yourself safe this summer.
For children, it is common for vomiting to occur from a viral infection. Parents also need to consider food poisoning, milk allergy, motion sickness, overeating or feeding, or blocked intestines. Illnesses in which the child has a high fever, like appendicitis, and urinary tract infections must also be considered. There are also bacterial causes like Campylobacter and Salmonella, which are rarer forms of diarrhea and vomiting which should be ruled out by a culture if symptoms persist for longer than 5 days, if there is severe cramping, abdominal pain or blood in the diarrhea.
Viral Gastroenteritis is an inflammation of the lining of the stomach and intestines that can be caused by any number of viruses. The most common are the Rotavirus and Enterovirus and most currently, our area has been affected by the Norovirus, so let’s talk about that one specifically.
Norovirus is a highly contagious infection which spreads quickly through contact with an infected person, usually it comes from a fecal contaminated food or water source. Symptoms of Norovirus are:
- Nausea and Vomiting that strikes quickly, suddenly and violently typically within 12 hours of exposure to the contact or contamination
- Fever and chills
- Migraines – usually due to the associated dehydration
- Stomach cramps, sore, achy muscles
- Urine changes – becomes darker in color due to dehydration
- Increased heart rate
With any vomiting, the biggest concern is for dehydration. Treatment is usually supportive in clear liquids, (avoiding milk or milk products) a bland diet, and avoiding solid food until the vomiting has stopped. Anti-diarrheal and anti-vomiting medications are not indicated as many times it makes the child feel more bloated and it is important not to suppress the vomiting until you find out the cause. Pedialyte or other oral rehydrating products can be used if the vomiting and diarrhea persists for over 24 hours, or if recommended by your pediatrician.
But when should I take my child to the doctor? Here is a general rule of thumb:
- Take an infant or child under six to the doctor if vomiting lasts more than a few hours, diarrhea is present, signs of dehydration occur, there is a fever, or if the child hasn't urinated for 4-6 hours.
- Take a child over age six years to the doctor if vomiting lasts one day, diarrhea combined with vomiting lasts for more than 24 hours, there are any signs of dehydration, there is a fever higher than 101 degrees, or the child hasn't urinated for six hours.
You should seek immediate medical care if any of the following situations occur with vomiting:
- There is blood in the vomit (bright red or "coffee grounds" in appearance)
- Severe headache or stiff neck
- Lethargy, confusion, or a decreased alertness
- Severe abdominal pain
- Bloody diarrhea
- Rapid breathing or pulse
The number one rule for prevention to always follow, and teach your children to follow is good HANDWASHING!
Now go out there and enjoy those summer picnics and outdoor barbeques!
Kirk D. Coverston M.D. FAAP
Visalia Medical Clinic
(Kirk D. Coverston M.D. is a Board-certified pediatrician who practices at Visalia Medical Clinic. His practice covers all general pediatrics, from newborns to adolescence, with a special interest in behavioral pediatrics and ADHD.)