This handout is for acute infectious gastroenteritis / acute diarrhoea (viral, bacterial incl. invasive/inflammatory, traveller's, toxin food poisoning, c. difficile pointer) — adult + pediatric. Your care team identified this based on: acute diarrhoea (≤14 d, usually <7) ± nausea/vomiting (idsa 2017 pmid 29053792; acg 2016 pmid 27068718).
Other reasons your team may use this plan: bloody / mucoid (dysenteric) stool ± fever ± tenesmus — invasive/inflammatory bacterial pivot (idsa 2017 pmid 29053792); fever + diarrhoea — inflammatory/invasive or systemic enteric infection (idsa 2017 pmid 29053792); vomiting-predominant short-incubation illness after shared meal — preformed-toxin food poisoning (acg 2016 pmid 27068718).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| reduced_osmolarity_oral_rehydration_salts | Reduced-osmolarity ORS — replace deficit (mild ~50 mL/kg, moderate ~100 mL/kg over 3-4 h) + ongoing losses (~10 mL/kg per stool) + maintenance | PO | continuous, frequent small volumes | Reduced-osmolarity ORS is the cornerstone for mild-moderate dehydration — fewer unscheduled IV infusions (OR 0.61, 95% CI 0.47-0.81), less stool output and vomiting vs standard ORS (Hahn BMJ 2001 / Cochrane CD002847 PMID 11869639; ESPGHAN/ESPID 2014 PMID 24739189). No single RxNorm CUI → non_pharm. |
| iv_isotonic_crystalloid_rehydration | Isotonic crystalloid (LR or NS); peds 20 mL/kg boluses to reverse shock then deficit + maintenance; adult 30 mL/kg if septic/shock then titrate | IV | bolus then maintenance | IV isotonic crystalloid for severe dehydration/shock or ORS failure (IDSA 2017 PMID 29053792; ESPGHAN/ESPID 2014 PMID 24739189) |
| early_refeeding_continue_breastfeeding | Resume age-appropriate diet within 4-6 h of rehydration; continue breastfeeding throughout; no dietary dilution/restriction | PO | continuous | Early refeeding shortens illness; do NOT withhold food or interrupt breastfeeding (ESPGHAN/ESPID 2014 PMID 24739189) |
| zinc_sulfate | 10 mg/day (<6 mo) or 20 mg/day (≥6 mo) PO × 10-14 days | PO | once daily | WHO/UNICEF — zinc reduces diarrhoea duration/severity and recurrence in children in low-resource settings (ESPGHAN/ESPID 2014 PMID 24739189) |
Plan: Acute gastroenteritis management — rehydration + selective antimicrobial + antiemetic (IDSA 2017 PMID 29053792 + ACG 2016 PMID 27068718 + ISTM/IDSA 2017 PMID 28521004 + ESPGHAN/ESPID 2014 PMID 24739189 + WHO ORS PMID 11869639)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Most: complete recovery, return precautions, hygiene/food-safety counselling, no routine test-of-cure; public-health reporting + food-handler clearance for reportable pathogens; persistent/post-infectious symptoms → reassess (post-infectious IBS — gi.ibs.core.v1; persistent → chronic-diarrhoea workup); rotavirus-vaccine context (pediatric) (IDSA 2017 PMID 29053792; ACG 2016 PMID 27068718)
Guideline: IDSA 2017 Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea (Shane, Clin Infect Dis 2017) + ACG 2016 Acute Diarrheal Infections in Adults (Riddle, Am J Gastroenterol 2016) + ISTM/IDSA 2017 Travelers' Diarrhea graded expert panel (Riddle, J Travel Med 2017) + ESPGHAN/ESPID 2014 pediatric AGE (Guarino, JPGN 2014) + WHO/UNICEF reduced-osmolarity ORS + zinc