Treatment of Gastroenteritis

Initial Assessment

The American College of Physicians recommends evaluating hydration status through specific clinical signs, including skin turgor, mental status, mucous membrane moisture, capillary refill time, and urine output 1, 2
Hydration status can be categorized into mild (3-5% body weight loss), moderate (6-9% body weight loss), and severe (≥10% body weight loss) dehydration 2

The American Academy of Pediatrics recommends using commercially available low-osmolarity oral rehydration solution (ORS) as the primary rehydration fluid for mild to moderate dehydration 2
For children and infants, 50-100 mL/kg of ORS should be administered over 3-4 hours, while adolescents and adults should receive 2-4 L of ORS over 3-4 hours 2
Isotonic intravenous fluids (lactated Ringer's or normal saline) should be administered at 20 mL/kg over 30 minutes for severe dehydration 2

The American Gastroenterological Association recommends resuming age-appropriate diet during or immediately after rehydration, without fasting or restricting diet 1, 2
Breastfeeding should be continued throughout the diarrheal episode in infants 1, 2

The American Academy of Pediatrics recommends ondansetron for children >4 years and adolescents with significant vomiting to facilitate oral rehydration 1, 2
Loperamide is contraindicated in children <18 years with acute diarrhea, but may be given to immunocompetent adults with acute watery diarrhea once adequately hydrated 1, 2
Zinc supplementation reduces diarrhea duration in children 6 months to 5 years in areas with high zinc deficiency prevalence or in malnourished children 1

The Centers for Disease Control and Prevention recommends practicing proper hand hygiene, using gloves and gowns when caring for people with diarrhea, and cleaning and disinfecting contaminated surfaces promptly 1, 2, 3
Ill persons should be separated from well persons until at least 2 days after symptom resolution 1