Acute gastroenteritis: from guidelines to real life

Abstract

Acute gastroenteritis is a very common disease. It causes significant mortality in developing countries and significant economic burden to developed countries. Viruses are responsible for approximately 70% of episodes of acute gastroenteritis in children and rotavirus is one of the best studied of these viruses. Oral rehydration therapy is as effective as intravenous therapy in treating mild to moderate dehydration in acute gastroenteritis and is strongly recommended as the first line therapy. However, the oral rehydration solution is described as an underused simple solution. Vomiting is one of the main reasons to explain the underuse of oral rehydration therapy. Antiemetics are not routinely recommended in treating acute gastroenteritis, though they are still commonly prescribed. Ondansetron is one of the best studied antiemetics and its role in enhancing the compliance of oral rehydration therapy and decreasing the rate of hospitalization has been proved recently. The guidelines regarding the recommendation on antiemetics have been changed according to the evidence of these recent studies.

Epidemiological profile and genetic diversity of sapoviruses (SaVs) identified in children suffering from acute gastroenteritis in Pune, Maharashtra, Western India, 2007–2011

“…Rotavirus (RV) is the foremost causative agent of viral gastroenteritis [1]. Sapovirus (SaV), a member of the family Caliciviridae, is known to cause diarrhoea in humans and animals.…”

Impacto da vacina oral de rotavírus Humano nas taxas de hospitalizações em crianças

“…(3) In the analysis of the likelihood of hospitalization for acute diarrhea, a sharp drop for children under one year of age was observed before the introduction of oral human rotavirus vaccine, possibly related to other protective factors, such as the use of oral rehydration therapy, and the improvement of factors such as socioeconomic status, maternal education, breastfeeding and nutritional status of children. (1,10) Age has been a risk factor for diarrheal disease, the severity of these episodes increased in both developing and developed countries. The attributable risk for children under one, and for one-year olds, showed a higher vaccine protection, but the OR revealed the frailty of this group regarding acute diarrhea.…”

“…In developing countries, it is the leading cause of hospitalization and death among children under five, and mortality is higher in their first year of life. (1,2) In developed countries, the frequency of acute diarrhea in infants is up to two episodes/ year, whereas in developing regions it can reach ten episodes/year. Basic sanitation and drinking water almost eliminated bacterial and parasiticinfections in developed countries, but rotavirus infections are still comparable between developed and developing countries.…”

High circulation of non-polio enteroviruses among hospitalized children with acute gastroenteritis in Belém, Pará State, Northern Brazil

“…Worldwide, it has been estimated about 3-5 billion of acute gastroenteritis (AGE) cases per year and about 1.4-2.5 million deaths gastroenteritis related disease annually 1,2 . It is estimated that about 30-40% of diarrheal cases remain unknown etiology although more sensitive molecular methods are available 3,4 .…”

“…Several enteric pathogens, viruses, bacteria and protozoa have been associated with AGE cases 1 . Many viral pathogens, rotaviruses (RVs), noroviruses (NoVs), astroviruses (AstVs), and enteric adenoviruses (AdVs) have been recognized as the major enteropathogens of gastroenteritis in children 3,5 .…”