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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
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Experience:  GP in the United States
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On 29 Dec my son, 2 years and 7 months old, went to Bangladesh,

Resolved Question:

Hi
On 29 Dec my son, 2 years and 7 months old, went to Bangladesh, South East Asia, with mom for a long holiday(9-12 months). My wife and me are Bangladeshi by birth.
On 1st Dec, he started vomiting. Vomited 10-12 times. Food intake that day, SMA, Nido, homemade boiled rice with vegetable/meat.
On same day my wife took him to a doctor in the evening, he examined and prescribed Don A15 ( to be given through the path of stool passing). On first dose the vomiting reduced so stop giving it as advised by the doc.
He also prescribed Ofran 6 ml 3 times a day for three days. Still continuing this medicine.
On 2nd Dec diarrhea started, passed liquid stool 15 times, vomited 2-3 times.
Food intake, Saline Solution, Nido, Small portion of boiled rice with vegetable/meat.
On 3rd Dec Vomitted 5 times and liquid stool passing 7 times.
Can you please suggest what is happening to my son, what can be done to stop vomiting and diarrhea, how long will take?
What group of medicine can be given to help him in Bangladesh.
I will highly appreciate your response.
Junaid Akhtar
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, Thanks for your question. Your son is likely suffering from infectious gastroenteritis. Most cases of acute gastroenteritis are due to viruses, hence antibiotics are generally not indicated. The goal of therapy in such cases is to avoid dehydration and also to treat the symptoms. Please continue with the ondansetron to stop the vomiting. You need to continue the oral rehydration solution (ORS). ORS should be given slowly using a teaspoon, or syringe, or medicine dropper and if tolerated by your son the rate of ORS delivery can be increased slowly over time. Your son has already hopefully was seen by a pediatric specialist. If not then please consult a pediatrician who will look for signs of dehydration and if severe dehydration is present he may need intravenous fluids. Also investigations may be ordered by his doctor to look for complications of dehydration and to know the cause of the gastroenteritis. Also you may ask his doctor about probiotics which are live microbial feeding supplements commonly used in the treatment and prevention of acute diarrhea. These are available OTC and also in some yogurt brands. The World Health Organization (WHO) also recommends zinc supplementation (10-20 mg/day for 10-14 days) for all children younger than 5 years with acute gastroenteritis especially in developing countries. Lastly the child needs to monitored for the various signs of dehydration such as change in mental status, decreased urine output, sunken eyes, absence of tears, dry mucous membranes, and slow return of abdominal skin pinch.He needs emergency medical attention if dehydration returns, or if oral intake is inadequate, or if the child develops worsening abdominal pain, fever >101°F, or prolonged diarrhea lasting longer than 14 days. Take care.
Expert:  DrRussMD replied 1 year ago.
HiThis is a different expert.I think you mean the 29th of November that this started?That makes this 4 days.Most gastroenteritis is viral, and resolves within this amount of time, or is vastly better.If not, the very next step here is stool samples to identify a possible bacterial infection.That should be done today in my view.Continuing home treatment without hands on re-assessment at this point, in my view is not the correct follow up after 3 days of continuous diarrhea.The child needs to be reassessed hands on, today, and stool samples should be sent to the lab.This especially given the travel history, as in such cases antibiotics often are needed.If, on the other hand, the child acts better, the diarrhea and vomiting are stopping, and the child can take plenty of fluids, then a phone call to the doctor might be adequate.However, if it were my child and I had any concern at all that things are not improving promptly, I would ask for analysis of stool samples [bacterial cultures and sensitivity]. And, parasite analysis. I am a double board certified clinical doctor.let me know if you have further questions. Or information.Please click a positive rating. We are paid per positive rating.Find Dr. Thomas by request any day of the week, in medical. I specialize in customer safe, comprehensive, accurate and precise answers. I can cover conventional and integrative medicine.
Customer: replied 1 year ago.
Dear Ravoof
Thanks for your response.
In addition to what I mentioned in my earlier post, my son has got two shots on thigh from gp as travel vaccine and also beginning of last months we gave him winter vaccine.
Can you please suggest for how many days we can continue to give ondansetron and how many dozes per day.
Can you please recommend any name for probiotics which i can buy OTC in UK. How often and for how many days can i give it to my son.
Junaid
Expert:  Dr. Phil, MD replied 1 year ago.
Thanks for this reply.You can give zofran indefinitely4 mg three times a day is fine but watch out for constipationAlso, good probiotics are culturelle or lactobacillus
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 54123
Experience: GP in the United States
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