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Davis Square Family Practice
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Deborah Bershel, MD
Michelle Clark, NP
Carmen Phillips, NP
"Call our office to receive logon credentials."
Barbara Kaplan, LICSW
Christopher Mulvey, NP
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Diarrhea and Vomiting: Adults, Children & Infants
General concepts:

For most adults and children vomiting and diarrhea are mere nuisances. They are self-limited conditions that resolve within 24-48 hours or less. Nonetheless, the symptoms can put a damper on your plans for the day and occasionally they are signs of more serious illness. If you can just make sure you avoid significant dehydration you should be able to avoid a serious complication.

In children and in adults Rotavirus or some other type of virus is the culprit. Rota virus can give you fever, nausea, vomiting and diarrhea that lasts for several days. Travelers diarrhea, which is typically caused by a bacterium, is usually caused by eating food that has come in contact with contaminated water. Salmonella and shigella bacterial infection are spread when food is handled by an infected person who has inadequately washed her hands. And giardia (a parasite) is contracted from drinking water from a stream or lake. Finally, antibiotics especially (and some other medications) can cause diarrhea and sometimes this diarrhea can be prolonged and serious.

Considerations:

If you or your child has abdominal pain, then you may have an illness going on that requires clinician input. Appendicitis, pelvic infections, and other complex illnesses typically cannot be diagnosed over the phone and it might be wise to call us if you or your child have significant pain.

Do not worry if you or your child does not eat solids for even a few days - remember that gastrointestinal illness is all about replacing lost fluids.

Fevers can accelerate fluid loss.

Treatment

Instructions for Diarrhea - Adults and Children

Studies donít seem to show that any particular diet is useful when you have vomiting or diarrhea.
Everyone is an individual, but research has shown that if you are nauseous all liquids are equally likely to trigger you to vomit. It is most important that you replace fluids that have been lost. Most adults and children over 2 years of age are not going to get dehydrated after 24 hours of not drinking if there isnít significant diarrhea too. Likewise, most children and adults will not get dehydrated by 24-48 hours of diarrhea if you can replace the fluids by drinking. There is no ostensible value in getting intravenous fluids if your child or you can drink and hold down fluids.

For children, Ricelyte or Pedialyte has a better balance of salts and sugar than water or Gatorade but for mild vomiting or diarrhea it is okay to try most any liquid.

Probiotics (more than just the colony counts in yogurt) have been shown to prevent diarrhea and shorten the course of diarrhea. I recommend Align (once a day) and Florastor (twice a day) or go to a health food store or Whole Foods.

Remember:If you have abdominal pain -call us

Last screened and modified by Dr. Bershel 1/2010