Complications
Dehydration is the most significant complication of viral gastroenteritis.
Volume depletion occurs as a result of loss of body fluids due to vomiting, diarrhoea, and inadequate fluid replenishment.
Treatment for dehydration accounts for an estimated 220,000 admissions to hospital per year in the US, with comparable rates in Canada.[51][82][83] The rates are appreciably much higher in developing countries.
Dehydration may be hyponatraemic, isonatraemic, or hypernatraemic, depending on the relative loss of water and sodium through vomiting and diarrhoea. Hyponatraemia may also result if plain water, carbonated drinks, or fruit juices are used solely in the oral rehydration process or hypotonic saline used for intravenous rehydration.[40][61]
Hypokalaemia may result from the loss of potassium in the urine as a consequence of increased aldosterone activity in the kidney in an attempt to conserve sodium. Hypokalaemia is a common occurrence in severe dehydration.
Often complicates acute diarrhoea, as a result of faecal losses of bicarbonate and impaired renal excretion of hydrogen ions.
The longer the child is starved, the more likely the child will become hypoglycaemic.[84]
Results from disruption and damage to the intestinal mucosa. This complication is uncommon except when the viral gastroenteritis is prolonged. As such, lactose restriction is usually not necessary in the re-feeding process.
As a result of damage to the intestinal mucosa, endogenous bacterial flora in the small intestine may occasionally invade the bloodstream with resulting bacteraemia.[85]
If severe dehydration is not corrected, end-organ hypoperfusion, circulatory collapse, and shock may result.
This complication is much more common in developing countries than in developed countries.
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