Generally, medication is not necessary to relieve the abdominal pain or decrease the number of bowel movements during episodes of diarrhea and/or vomiting (also known as gastroenteritis).  Good fluid intake is the most important part of treatment. 

When vomiting is present, do not give anything by mouth for 1-2 hours after a vomiting episode to let the stomach calm down.  You should then slowly introduce Pedialyte, or any commercially available electrolyte solution, in very small amounts given frequently as described below.  These electrolyte solutions are specifically formulated to maintain the normal balance of water, electrolytes (salt), and sugar in a vomiting child.  If your child does not care for the taste of these solutions you may make them taste better by keeping them very cold in the refrigerator (do not add ice) and flavoring them with a pinch of sugar free Koolaid powder, sugar-free JELL-O and/or aspartame (Equal).  Do not add sugar as this will defeat the purpose of these specially mixed salt and sugar solutions.  Also choose a flavor that is not red colored.  A child less than 2 years of age should receive 1/2 cup of solution every hour given with a teaspoon every 1-2 minutes.  A child 2 years or older should receive one cup every hour again using a teaspoon every 2-3 minutes. When this regimen has been tolerated for an hour without vomiting you may begin to slowly increase the volume you offer your child at slightly more frequent intervals.  Next try a tablespoon every 5-10 minutes, then an ounce every 10-15 minutes, then 2 oz every 15-20 minutes, slowly increasing the volume in this fashion until your child is taking a normal amount of fluid.  If vomiting recurs during this time, start the process over. After 4 hours without vomiting, other clear liquids may be introduced.  After 6 hours without vomiting, bland foods may be introduced.

In the child with diarrhea but no vomiting, there is little reason for specific treatment.  Infants who are breastfed can continue to nurse and those who are formula fed will often tolerate feedings well. Increasing intake helps to prevent dehydration.  Food restriction is not indicated as a treatment for diarrhea. It has been proven that calorie restriction slows the intestine's healing process.  Instead, offer your child bland, high fat, easy to digest solids.  If your child has had these foods before, try cereal, pasta, milk, eggs, potatoes, bread, rice, clear soup, crackers, toast, applesauce or mashed bananas for the first day.  If well tolerated, liberalize her diet.  Prolonged periods without food will actually worsen the diarrhea by slowing the body's healing process. 

In most cases, your child need only stay home, rest, and follow these instructions and the vomiting and diarrhea will resolve.  Please call us if any of the following occur:

1. Vomiting is severe or persists for longer than 8 hours in infants less than one year of age or 18-24 hours in older children despite the appropriate use of electrolyte solution.

2.  Abdominal pain or back pain which is severe or worsens with jumping up and down.

3.  Recovery is not progressing as you expect.

4.  Extreme drowsiness or irritability is noted.

5.  Blood or mucus is found in the stool.

6.  Your child has pain on urination.

7.   Your child has pain with walking, jumping up and down or going over bumps in the car.

8.  Blood or bile (a green colored substance ) appears in the vomitus.

9.  Your child won't drink.

10.  Your child's abdomen is markedly distended.

11.  Signs or symptoms of dehydration develop (dry mouth, sunken soft spot, absent tears, or urination less than every 8 hours.

12.  Diarrhea persists for longer than a week.