The ‘stomach flu’ (gastroenteritis) is one of the most common reasons that we see kids in the pediatric office. The typical stomach flu starts with about 24 hours of lots of vomiting followed by several days and up to a couple of weeks of diarrhea. This is different than The Flu (short for influenza) of the winter flu season which presents with cough, chills, fevers, muscle aches, headaches and only occasionally with vomiting. Unlike influenza, kids with the stomach flu often don’t have the fevers, respiratory symptoms, aches and pains of the regular flu. Also we tend to see a lot more stomach flu in the summertime.
Most kids will recover from the stomach flu just fine with a few simple measures. Hydration is the key to improvement. Most kids with the tummy flu will keep vomiting if you let them drink everything they want. The best way to rehydrate a child with the tummy flu is to give sips of fluid every 15-30 minutes. Popsicles can also work for this because kids can’t take in too much liquid at once. It is also important that you try to get their electrolytes replaced – things like sugar and salt. Water will keep kids hydrated, but it won’t replace the electrolytes that they are losing through their vomiting and diarrhea. The best option out there is Pedialyte. If your child doesn’t like the flavor, try dissolving a popsicle in the Pedialyte. Gatorade is another option although the electrolyte balance is not quite as good. One common worry that parents have is that their child is not eating. It is okay if your child is not eating for a few days as long as they are still drinking and getting some sugar through their liquids. HYDRATION IS KEY and kids will often take longer to get better if they get significantly dehydrated.
Often after the vomiting has resolved, diarrhea will start. It can be pretty significant and last for a while. At this stage, kids are less likely to get dehydrated because they are able to take liquids in without vomiting. It is still important to try to get in electrolyte containing fluids because they will be losing lots of electrolytes still through the diarrhea. At this point starting on a bland diet is appropriate as well. There have also been studies that have shown that probiotics can decrease the duration of diarrhea in the stomach flu.
So when should you come in to see your doctor? If it seems like a straightforward tummy flu, I usually recommend that parents try to wait out the vomiting for a day or two depending on how much vomiting they are having and how dehydrated they seem. Some signs of dehydration that you can look for include a dry mouth, not making tears when crying, peeing less than 1-2 times per day, and a fontanel that is sunken. Other reasons to come in would include severe and worsening tummy pain, (occasional tummy cramps are common with the stomach flu), dark green or bloody vomiting, pain with peeing, diarrhea that lasts for more than a couple of weeks or starts to have blood in it.
A final thing to remember is that the tummy flu is contagious so try to keep surfaces as clean as possible and don’t let your kids go swimming or back to daycare until the diarrhea has improved.
