Prevention is the best option

Upset stomach in children

Mal de panxa en nens a Vall d'Hebron

Not all upset stomachs are the same. There are two types: organic, with a clear cause, and functional or recurrent. This advice is focused on the former. The causes of upset stomach vary greatly. The most frequent cause is associated with gastroenteritis, constipation or indigestion. Often children express their physical discomfort (fever, sore throat, etc.) or emotional discomfort (stress situations above all) in the form of stomach pain. Other factors that pull the wool in front of our eyes are appendicitis, urinary infections, intussusception and a long list of diseases that cannot be overlooked, which have a significant impact on children because they make them feel ill.

Description

Upset stomach appears when viruses, parasites or bacteria damage the cells in the mucous membrane in the intestine. Normally, this membrane absorbs fluids, but when it is damaged it can no longer do it as effectively. The body therefore loses fluid through vomiting and diarrhoea.

Diarrhoea causes loss of fluids and salts. Children are more vulnerable to loss of fluids than adults; as they are smaller, they become dehydrated more quickly. Vomiting may lead to difficulties retaining the fluids consumed. Smaller children may deteriorate if they lose more fluids than they take in. This is why it is important that they drink from the onset of the stomach infection.

Vomiting and diarrhoea are the most common symptoms of upset stomach caused by a virus in children. The illness almost always cures itself and disappears in a couple of days. It is very important for children to drink fluids, especially if they have diarrhoea, which is particularly relevant in children under one year.

 

Symptoms

When children are suffering from upset stomach they may present different symptoms, including: vomiting, diarrhoea, discomfort, tummy ache, fever, tiredness and loss of appetite.

The symptoms normally appear all of a sudden, a couple of days after being infected, and disappear after a few days. Diarrhoea may last up to a week. Upset stomach is more common in winter, when children spend longer indoors. Although it may also be caused by bacteria, parasites or viruses, eating food that has gone off or travelling abroad.

 

When should I seek medical assistance?

You should go to your doctor or call 061 CatSalut Respon (Catalan Health Service care line) in the following cases:

  • If the child is younger than six months and is vomiting or has diarrhoea
  • There is no improvement after 24 hours
  • Watery stools continue to appear two weeks after the upset stomach
  • The child has a chronic illness
  • If the child is vomiting or not retaining fluid and also has heavy diarrhoea, as the risk of dehydration is serious. The smaller the child, the more vulnerable they are.

You should seek urgent medical assistance if the child has diarrhoea, vomiting and any of these symptoms:

  • unable to drink and urinating more than normal
  • tired, does not want to play and shows no interest in their surroundings
  • upset stomach that does not stop or gets worse
  • blood in vomit or faeces

 

What can I do?

Children need fluids. They need to drink often. They can drink a bit at a time, in small quantities given to them with a spoon or bottle. Offer them water occasionally. It is important that they drink a bit at time, as if they drink too much in one go they may start vomiting again.

Avoid sweet drinks such as fizzy drinks or strong juices. They should also avoid diet drinks, as although they do not contain sugar, they may contain other products that cause diarrhoea. Infants may drink what they like, the most important thing is that they drink fluids.

If the child does not want to drink, try giving them ice lollies. You still need to offer them fluids. Even if they are eating ice lollies, they need to drink fluids to rehydrate themselves.

If the child is breast or bottle feeding, they should keep doing so, only more often, even if they vomit. If they do not want to breastfeed, you can also extract milk and feed them from a spoon.

A special syringe for medication is a good solution for oral rehydration. Make sure the liquid does not land directly on their palate, as this may cause nausea.

If vomiting is continuous, the child needs to drink two spoonfuls of liquid every five minutes, which is the equivalent of about 10 ml. An infant needs approximately 1 litre of liquid every 24 hours.

 

Sometimes an oral solution will need to be given

Oral solutions contain the amounts of salts and sugars required to help restore the body’s water balance. When children vomit often and have serious diarrhoea, it is a good idea for them to drink oral rehydration solutions. The infant may not want to drink the solution. If that is the case, try adding sugar.

You can find these solutions in pharmacies.

 

When vomiting stops, but diarrhoea continues

In most cases, it may be that the child stops vomiting but the diarrhoea continues for a while. Breastfeeding babies can continue feeding and babies drinking from a bottle can eat different types of preparations: rice, corn, formula milk, etc. depending on their age. You can find these preparations in pharmacies. You should start with small quantities.

If the child is older than six months, they may eat carrot soup.

When they are ready to start eating, it is better for them to eat normal foods. It is better to start with small quantities of food and avoid fruits and foods that have a fibre content.

 

If the child starts vomiting again

If the child starts vomiting again and is more tired than usual, does not have enough energy to play or loses their interest in their surroundings, see a paediatrician.

 

Can upset stomach be prevented?

Often, upset stomach is caused by a viral infection that is highly contagious. It is normal for people in the same family to be ill at the same time.

To prevent it from being passed on:

  • Wash your hands with soap before meals and after going to the toilet
  • Use your own towel
  • Keep the bathroom dry and clean
  • Put dirty nappies in plastic bags before throwing them in the rubbish
  • Clean the changing table and wash your hands after changing the baby’s nappy

It is advisable for the child not to go back to nursery or school until two days after the symptoms disappear.

 
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Rodrigo Gonzalo de Liria
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Dr. Quique
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