Management of acute gastroenteritis in children

Acute gastroenteritis remains one of the leading causes of death in the under 5-age group in the developing world. Over 2 million deaths per year occur in this group which is much improved compared to the 1980’s when there were in the region of 4.5 million deaths per year. In the UK, gastrointestinal illness is rarely fatal but in 2007, it accounted for almost 32,000 admissions to hospital in the under 5-age group and so is a major economic burden. There is still a huge variation in practice and the NICE guidelines were published in April 2009 to develop a more unified approach to the management of acute gastroenteritis. In this article, I have tried to identify some of the key points from the NICE guidelines with regard to history taking, assessment of dehydration and fluid management. The NICE guidelines also looked at therapeutic options such as probiotics and antiemetics but were unable to find evidence to recommend them. More recent references were sought for further proof of efficacy of these agents. Adherence to guidelines for acute gastroenteritis in the past has been poor and variation related to institution. Data on adherence to the NICE guidelines is limited.