Causes of gastroenteritis in children and methods of prevention

Gastroenteritis in children is a common health issue that worries every parent. It usually appears as diarrhea, vomiting, stomach cramps, and fever, and its causes can be viral, bacterial, parasitic, or due to food allergies. Understanding the causes, types, and symptoms of gastroenteritis in children helps parents act quickly and protect their child from dehydration and serious health complications. we will cover all the essential details you need to know, from diagnosis and treatment to suitable foods and prevention, in an easy and simple way for every parent.

Causes of Gastroenteritis in Children

Gastroenteritis in children happens when there’s a sudden disturbance in the digestive system. The child may start experiencing diarrhea, vomiting, stomach cramps, or fever. The main causes usually include:

Viral infection (most common)
- The most common viruses: Rotavirus and Norovirus.
- They spread very easily between children, especially in daycare or school.
- They can also come from contaminated food or water.
Bacterial infection
- Examples: Salmonella or Escherichia coli (E. coli).
- Usually caused by undercooked foods (like eggs or chicken) or improperly stored or unwashed food.
Parasitic infection
- Example: Giardia.
- Can spread through unclean water or not washing hands properly after using the toilet.
Food allergies
- Some children’s digestive systems react to foods like:
  - Cow’s milk
  - Gluten (in wheat)
- This can cause irritation in the stomach and recurrent diarrhea.
Certain medications
- Some antibiotics can destroy the good bacteria in the gut, leading to inflammation and digestive problems.
Weak immunity
- Children with a weak immune system are more susceptible to infections, even mild ones.

Important tip for mothers:
If your child shows symptoms like diarrhea or vomiting, monitor them closely, give plenty of fluids, and consult a doctor if symptoms persist or worsen.

Types of Gastroenteritis in Children

Gastroenteritis in children comes in different types, depending on the cause and symptoms. Here are the four most common types:

Viral gastroenteritis
- Most common among children, usually caused by Rotavirus or Norovirus.
- How it spreads: From child to child in daycare or school, or by touching contaminated surfaces.
- Symptoms:
  - Watery diarrhea
  - Frequent vomiting
  - Mild fever
  - Mild stomach cramps
  - Loss of appetite
Bacterial gastroenteritis
- Caused by bacteria like Salmonella or E. coli.
- How it spreads: Contaminated food or undercooked meals.
- Symptoms:
  - Diarrhea with blood or mucus
  - High fever
  - Severe stomach cramps
  - Nausea and vomiting
  - Dehydration and fatigue
Parasitic gastroenteritis
- Caused by parasites like Giardia and usually lasts longer than viral or bacterial infections.
- How it spreads: Contaminated water or poor hand hygiene.
- Symptoms:
  - Chronic diarrhea
  - Gas and bloating
  - Recurrent stomach cramps
  - Weight loss
  - Poor appetite
Gastroenteritis from food allergies
- Caused by certain foods triggering an immune reaction, not an infection.
- Common triggers: Milk, gluten, eggs.
- Symptoms:
  - Diarrhea after eating
  - Skin rash or redness around the mouth
  - Vomiting or nausea
  - Stomach cramps
  - Sometimes difficulty breathing (if severe)
  - Bloating or gas

Note for mothers:
Knowing the type of gastroenteritis is essential for the doctor to determine the proper treatment. If symptoms are severe or persistent, medical examination and stool tests are necessary.

Complications of Different Types of Gastroenteritis in Children

Although gastroenteritis is usually mild, neglecting treatment or delaying care can cause serious complications. Here are the potential risks for each type:

Viral gastroenteritis complications
- Severe dehydration due to diarrhea and vomiting
- General weakness and fatigue
- Temporary weight loss
- Loss of appetite even after recovery
Bacterial gastroenteritis complications
- Severe dehydration (sometimes requiring IV fluids)
- Colon inflammation (like hemorrhagic colitis)
- Persistent bloody diarrhea
- Rare kidney complications with certain bacteria (like E. coli)
Parasitic gastroenteritis complications
- Malabsorption of nutrients
- Continuous weight loss
- Growth delay if the infection persists
- Weak immunity and general weakness
Food allergy-related gastroenteritis complications
- Chronic intestinal inflammation
- Frequent fatigue after meals
- Vitamin and mineral deficiencies
- Negative impact on growth
- Rarely, difficulty breathing if allergy is severe

Important tip:
If your child has persistent symptoms or signs of dehydration (dry mouth, little urine, lethargy), consult a doctor immediately to avoid complications.

Stages of Gastroenteritis in Children

Gastroenteritis does not appear suddenly; it goes through several stages. Understanding these stages helps you monitor your child and respond appropriately.

Incubation stage
- The child has been exposed to the infection, but no symptoms appear yet.
- Duration: 1–3 days
- Note: The child looks normal but can still spread the infection.
Symptom onset stage
- Symptoms start to appear:
  - Diarrhea
  - Vomiting
  - Fever
  - Stomach cramps
- Duration: 2–5 days (depending on the type of infection)
Peak stage (most severe symptoms)
- Symptoms reach their worst:
  - Dehydration
  - Refusal to eat
  - Lethargy
  - May require rehydration solution or medical care
- Duration: Usually 1–2 days

Recovery and Convalescence Stage

During this stage, the symptoms start to gradually decrease:

Diarrhea and stomach cramps become milder
The child begins to move around and eat normally
⏱️ Duration: 2 days to 1 week

Strength Recovery Stage

Even after the child feels better, the body still needs time to fully regain its strength:

Proper nutrition
Drinking plenty of fluids
Rest
⏱️ Duration: 1–2 weeks

How to Diagnose Gastroenteritis in Children

To determine if a child really has gastroenteritis, the doctor follows a few simple but precise steps, including questions, examination, and tests. Here are the main diagnostic methods:

1. Asking the Mother About Symptoms

The first step is for the doctor to ask questions about:

When did the symptoms start?
Type of diarrhea (watery? bloody?)
Number of vomiting episodes per day
Presence of fever
Whether the child attends daycare or was exposed to another sick child

Why it’s important:
These answers help the doctor identify the type of infection: viral, bacterial, or parasitic.

2. Clinical Examination of the Child

The doctor examines the child and looks for:

Signs of dehydration (dry mouth, low urine output, lethargy)
Body temperature
Abdomen: swollen or tender?
Child’s activity and responsiveness

3. Stool Analysis

One of the most important tests to determine the cause:

Detects presence of bacteria, viruses, or parasites
Checks for blood or mucus in the stool
Helps the doctor determine the appropriate treatment accurately

4. Blood Tests (for severe cases)

The doctor may order blood tests if:

The child has persistent fever
Signs of severe dehydration appear
The condition is not improving quickly

Blood tests show:

Levels of inflammation in the body
Electrolyte or mineral deficiencies
Overall impact of the infection on the body

5. Urine Analysis

May be requested if:

The child is not urinating normally
Dehydration is suspected
To rule out other causes of vomiting or fever, such as a urinary tract infection

Do all children need tests?
Not always!
If the case is mild, symptoms are clear, and the child was exposed to another sick child, the doctor may rely on questions and physical examination without tests.

Best Foods for Children with Gastroenteritis

Proper nutrition is an important part of treatment. The right foods can calm the stomach and prevent dehydration and energy loss.

Allowed Foods:

Boiled white rice – easy to digest, soothes the stomach, reduces diarrhea
Boiled or mashed potatoes – provides energy and gentle on a sensitive stomach
Ripe bananas – rich in potassium, helps restore electrolyte balance
Cooked or grated apples – reduces diarrhea and soothes the digestive system
White toast or dry biscuits – light on the stomach, prevents irritation
Carrot or potato soup – rich in fluids and minerals, easy on the stomach
Plain yogurt – contains probiotics to help restore gut balance
Rice water or rice soup – helps replenish fluids and calm the stomach

Beneficial Drinks:

Oral rehydration solution (ready-made or homemade)
Clean water
Light herbal teas (mint or anise)
Diluted natural apple juice
Warm, fat-free soup

Foods and Drinks to Avoid:

Fried or fatty foods
Cow’s milk (especially for infants or children with allergies)
Citrus juices (orange, lemon)
Sweets or chocolate
Soft drinks
Spicy or heavily seasoned foods

Important advice for mothers:
Serve small portions at intervals. Don’t force the child to eat if they’re unwilling. Focus on fluid replacement first, then gradually return to normal foods.

Treating Gastroenteritis in Children with Medications

Treatment depends mainly on the cause—whether viral, bacterial, or parasitic. The choice of medication must always be supervised by a doctor, as every case is different.

Medications for Treating Gastroenteritis in Children

Here are the main types of medications doctors use to treat gastroenteritis in children:

1. Rehydration Solutions (Most Important First Step)

Diarrhea and vomiting make the child lose a large amount of fluids and electrolytes.

Best options for children:

Oral Rehydration Solution (ORS) – ready-made or powder
Given in small spoonfuls every 5–10 minutes
Can be given slowly according to the child’s tolerance

Tip: This is the most important treatment in the first 1–2 days to prevent severe dehydration complications.

2. Fever Reducers and Pain Relievers

If the child has fever or abdominal cramps:

Paracetamol (Cetal, Fevadol, Adol)
Ibuprofen (if approved by the doctor and no stomach issues)

Important: Never give any painkiller without the doctor’s recommended dose.

3. Anti-Vomiting Medications (Severe Cases Only)

If the child cannot keep any fluids down:

Domperidone (Motilium)
Ondansetron (Zofran)

Important: Only used under medical supervision, especially for young children.

4. Anti-Diarrheal Medications (Rarely Used in Children)

Since the body expels the infection through diarrhea:

Anti-diarrheal drugs are generally not recommended for children
However, the doctor may prescribe them in special cases

5. Antibiotics (Depending on the Cause)

Not every case requires antibiotics!

Viral infections: No antibiotics needed
Bacterial infections: The doctor may prescribe:
- Cefixime (Suprax)
- Azithromycin
- Metronidazole (for Giardia or other parasites)

6. Probiotics (Beneficial Bacteria)

Help reduce diarrhea duration and restore gut balance:

BioGaia
Lacteol Fort
Enterogermina
Bifidus

Important Tip: Any medication, even simple probiotics, should be given only with a doctor’s prescription for your child’s safety.

Light Exercises for Gastroenteritis (After Recovery)

Although exercises are not essential for treating gastroenteritis, some gentle, safe exercises can help:

Relieve cramps
Expel gas
Improve digestion

Important: Start exercises only after vomiting and fever symptoms have decreased.

"Knee-to-Stomach" Exercise (Frog Pose)

Method: Child lies on their back, gently bends the knee toward the stomach.

Parents can help guide the movement gently.
Benefit: Reduces gas and relieves abdominal cramps
Duration: 5 repetitions per leg, slowly

Abdominal Massage in Circular Motions

Not a strict exercise, but very useful.

Massage the child’s belly gently clockwise with the palm of your hand.
Optional: use warm oil (olive oil or baby oil)
Benefit: Relieves cramps and helps release gas
Duration: 5 minutes, 2–3 times daily

Deep Breathing Exercise (For Children Over 4 Years)

Encourage the child to take a deep breath through the nose and exhale slowly through the mouth.
Can be done as a playful activity or relaxation.
Benefit: Reduces tension and soothes the stomach, especially after vomiting or cramps
Repetitions: 5 times every hour or as needed

Light Walking at Home

Once the child starts recovering, gentle walking for 5–10 minutes after meals can help digestion
Benefit: Aids digestion, reduces bloating, and prevents constipation after diarrhea

Important Notes for Mothers: