Last reviewed: 23 Aug 2023
Last updated: 04 Jul 2023
Summary
Definition
History and exam
Key diagnostic factors
- age <5 years
- exposure to people with gastroenteritis
- lack of immunization against rotavirus
- vomiting
- nonbloody diarrhea
- hyperactive bowel sounds
More key diagnostic factors
Other diagnostic factors
- abdominal pain
- low-grade fever
- evidence of dehydration
- decreased body weight
- nondistended abdomen
- abdominal tenderness
- mucus in stool
Other diagnostic factors
Risk factors
- age <5 years
- poor personal hygiene
- exposure to people with gastroenteritis
- daycare attendance
- winter months
- poverty
- lack of immunization against rotavirus
- lack of breast-feeding
- immunodeficiency
More risk factors
Diagnostic investigations
1st investigations to order
- clinical exam
More 1st investigations to order
Investigations to consider
- serum electrolytes, BUN, creatinine
- CBC
- blood cultures
- stool microscopy
- stool culture
- enzyme immunoassay (EIA) for detection of viral antigen
- stool electron microscopy
More investigations to consider
Treatment algorithm
ACUTE
no dehydration
mild dehydration (<5%)
moderate dehydration (5% to 10%)
severe dehydration (>10%)
Contributors
Authors
Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP

Clinical Professor of Pediatrics
The University of Calgary
Calgary
Alberta
Canada
Disclosures
AKCL is an author of a guideline and a number of references cited in this topic.
Peer reviewers
Saul Greenberg, MD
Associate Professor
Department of Paediatrics
University of Toronto
Ontario
Canada
Disclosures
SG declares that he has no competing interests.
Y.L. Lau, MBCBhB, MD, FRCP, FRCPCH, FRCPS, FHKAM, FHKCPaed
Professor
Faculty of Medicine
University of Hong Kong
Hong Kong
Disclosures
YLL declares that he has no competing interests.
Differentials
- Bacterial gastroenteritis
- Protozoal gastroenteritis
- Food poisoning
More DifferentialsGuidelines
- Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2023
- Recommendations for the use of rotavirus vaccines in infants
More GuidelinesPatient leaflets
Diarrhea in children
Rotavirus vaccine
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer