Acute gastroenteritis is a common yet potentially serious condition where the real danger is dehydration not diarrhea itself. While most cases are viral and self-limiting, proper classification and timely management are crucial to prevent complications.
Clinical Summary
Definition: ≥3 loose stools/day or change from baseline (<14 days)
Watery - usually viral
Bloody (dysentery) - bacterial
Persistent (>14 days) - consider parasites
Core Principle of Treatment : Correction of dehydration (NOT stopping diarrhea)
Essential triad:
ORS
Zinc
Continued feeding
Key Management Points
Assess dehydration (WHO) - guides Plan A, B, C
ORS is life-saving (works via glucose–Na⁺ co-transport)
IV fluids (Ringer lactate) for severe dehydration. Use NS if RL is not available.
Continue feeding early (do NOT stop feeds)
Antibiotics: Use very selectively
Indicated: dysentery, cholera, severe infection
Avoid: viral or uncomplicated watery diarrhea
Adjuncts (Optional)
Ondansetron : for vomiting
Probiotics
Racecadotril : reduces stool output
Prevention
Safe water & sanitation
Hand hygiene
Exclusive breastfeeding for babies (first 6 months)
Rotavirus vaccination of babies
Safe food practices
One-Line Takeaway
Most AGE is viral so treat with ORS + Zinc, continue feeding, and remember: dehydration is what kills, not diarrhea.
MBH/PS
