vomiting

Vomiting (emesis - EM-uh-sis) is a common symptom of illness in childhood. The most common cause for vomiting is by far viral gastroenteritis. Other common causes include gastroesophageal reflux, especially in the young infant. Much more rare are conditions such as pyloric stenosis, intussusception or other bowel obstruction, or inborn metabolic disturbances.

Basically, the best treatment for the usual sudden onset of vomiting in children is

  • bowel rest - nothing by mouth for the first three or four hours for new onset vomiting, then
  • clear fluids - frequent sips of Pedialyte®, Rehydralyte®, Ricelyte® - meaning a teaspoon or two every few minutes
  • observation - watch for signs of dehydration, especially if the child
    • is less than three or four years old
    • has diarrhea
    • has high fever

Assume that the vomiting will pass fairly quickly - in 8-12 hours or so - and report to your doctor if it seems to go on longer, or particularly if there is something else going on with the child that makes you worried - diarrhea, high fever, anything abnormal in the stool (for instance blood or excessive mucus), or if there is severe abdominal pain. Medications are generally discouraged. The over-the-counter medicines such as Emetrol® are safe but pretty ineffective. Suppositories such as Phenergan® (promethazine) are often prescribed but discouraged by the experts, because of possible side effects and the potential for masking serious illness with dangerous delay in diagnosis.



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