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Child gastroenteritis ORS — GPhC CRA MCQ

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ModerateGastrointestinal TherapeuticsChild gastroenteritis ORSGPhC CRA

A 3-year-old has had watery diarrhoea for 18 hours, remains alert, is drinking and passing urine, and has no blood, bilious vomiting or severe abdominal pain. What is the best initial advice?

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Correct answer: D — Give frequent ORS, continue milk feeds and provide dehydration safety-netting

Give frequent ORS, continue milk feeds and provide dehydration safety-netting: The child has no current red flags; oral rehydration, continued feeding and clear escalation advice are recommended, while antidiarrhoeal medicines are not. Give age-adjusted loperamide, pause milk feeds and continue clear fluids: Antimotility treatment is not recommended in young children and routine milk withdrawal is unnecessary. Use diluted fruit juice as replacement fluid and continue normal feeds: High-osmolality sugary drinks can worsen diarrhoea and are not a substitute for balanced ORS. Start empirical oral antibiotics and continue frequent oral rehydration solution: Most acute childhood gastroenteritis is viral, and unsupervised antibiotics are inappropriate. Withhold food for six hours and then begin oral rehydration solution: Early small frequent ORS is preferred; fasting delays replacement and nutrition.

Reference: NICE CG84: diarrhoea and vomiting in children under 5: https://www.nice.org.uk/guidance/cg84/chapter/Recommendations