Better Out Than In: Medications to Avoid in Diarrhea and Vomiting
- kaitlinrstockton
- Oct 11, 2024
- 2 min read
Updated: Apr 16
In general, viral gastroenteritis (the stomach flu) resolves on it's own with diligent oral rehydration: frequent small sips of fluids, for example 10mL every 5-10 minutes. If you let your child drink or eat a large amount at once when they have recently vomited, this will most likely result in more vomiting. In most cases, no medication is needed—just several loads of laundry.
Don't be tempted by the promise of instant relief from familiar over-the-counter medications, which generally don't help rehydrate your child and have common and serious side effects.
Generally, popsicles or some dilute (50:50) apple juice will help your child much more than over-the-counter medications.
Medications to Avoid:
1) Dimenhydrinate (trade name Gravol, Dramamine, etc.) is a first generation antihistamine which causes sedation and sometimes paradoxical agitation in children (think toddler after 3 shots of espresso!). It is not overly effective at treating vomiting associated with the stomach flu in children or facilitating rehydration. Furthermore, giving your child this medication at home can lead to the delayed diagnosis of more serious (and less common) causes of vomiting including meningitis, appendicitis, pneumonia, and urinary tract infections (UTIs). Children with severe illnesses may need admission to hospital and intravenous hydration, and this should not be delayed by attempting to manage the child at home with over-the-counter medications. Studies have also failed to demonstrate dimenhydrinate's efficacy in treating motion sickness in children.
2) Loperamide (brand name Imodium, Diamode) is marketed for the acute treatment of diarrhea in adults. However, its use in children has been discouraged by the World Health Organization and the American Academy of Pediatrics owing to concerns over safety and efficacy in young children. Serious adverse events have been reported with the use of loperamide in children, including bowel obstruction, lethargy, and death. It will not facilitate rehydration, nor will it kill the infectious organisms responsible for the condition.
If your child is displaying any of these danger signs, you should seek emergent medical care:
Severe abdominal pain
Inability to tolerate any liquids even in small amounts
Signs of dehydration: no urine output for 12 hours or more, sunken eyes, dry lips, Excessive sleepiness
Trouble breathing
Confusion
Seizures
Blood in vomit or diarrhea
No improvement after 48 hrs of illness
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