Système gastro-intestinal et digestif

Abstrait

Management of Acute Gastroenteritis in Children below Five Years by General Practitioners : An Egyptian Consensus

Hamed EL-Khayat, Moustafa El-Hodhod

Objective: Acute Gastroenteritis (AGE) is a major public health problem, especially in developing countries. Therefore, we aim to update the Egyptian clinical practice by providing consensus statements regarding the diagnosis and management of AGE.

Methods: The present consensus was developed to address the current practice regarding the management of AGE among the pediatric population in Egypt. In order to address the current challenges and to reach a national consensus in the management of AGE in children below 5 years old The “Egyptian Consensus Guideline for Management of Pediatric AGE” was formulated based on the panel recommendations from two meetings held in Cairo in July and December 2018.

Results: Laboratory investigations have no role in the diagnosis of AGE. However, Lab investigations are highly indicated in the presence of red flags and should be individualized according to the case. Primary care physicians should evaluate the hydration status of patients and identify patients at risk of developing severe dehydration. The physician should search for signs of hypovolemic shock in children with severe dehydration. In addition, it is important to recognize early signs of hypernatremia. Cases with no or minimal dehydration can be managed at home with fluid therapy and a regular diet. The fluid administration is indicated for patients with severe dehydration or non-response to rehydration therapy, shock, impaired consciousness, severe metabolic abnormalities, persistent vomiting despite appropriate fluid administration, and/or severe abdominal distension and ileus. 

Conclusion: AGE is a major health problem in developing countries. The management lines for AGE include assessment of hydration status, treatment or prevention of dehydration, and reducing the severity and duration of symptoms. Children with no dehydration can be managed safely at home. However, children with a high risk of developing dehydration or other complications should be hospitalized for the proper care.