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Management of diarrhoea in children is centred on prevention and treatment of dehydration. Oral Rehydration Solution is effective even in severe dehydration and should be used. Parents will need encouragement to persist as the combination of salt and sugar in the solution can make children reluctant to drink it. However if given little and often this can often be overcome.
There is no place for anti-motility drugs in infective gastroenteritis. As soon as diet is tolerated it should be restarted. Breast feeding should continue alongside rehydration solution. It is rarely necessary to withhold lactose in the recovery phase and normal formula should be reintroduced as soon as children can take it.
Most gastroenteritis in childhood is viral and the use of antibiotics will prolong symptoms. If stool samples reveal a bacterial or parasitic cause, discuss with a microbiologist before commencing antimicrobials. Inappropriate use of antibacterials may result in long term carriage e.g. Salmonella.
For chronic loose stools loperamide may be of value. Toddler diarrhoea is a benign condition and should not be treated with medication.
Refer to NICE CG84 Management of acute diarrhoea and vomiting due to gastroenteritis in children under 5 (April 2009)
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