avoid fruit juice in viral gastroenteritis

  • fluid rehydration
    • if PO rehydration, use hypo-osmolar solution with electrolytes and small amount of glucose
    • avoid water alone
    • avoid fruit juice until sx improves
      • Excessive consumption of juice high in fructose (eg, apple juice) or sorbitol increases osmotic load and leads to fructose malabsorption in the small intestine. In addition, a mild, transient lactase deficiency with dairy intake can result from gastroenteritis due to inflammation and damage to the intestinal epithelium.

Children who can tolerate oral intake can resume a normal, age-appropriate diet. This should consist of a balance of complex carbohydrates, proteins, and healthy fats. The previously popular BRAT (bananas, rice, applesauce, toast) diet is no longer recommended as it is unnecessarily low in calories and protein. Sugary foods (eg, bananas, applesauce) increase the osmolarity of stool in the intestinal lumen, and excessively fatty foods increase gastric acid secretion. Both can worsen gastroenteritis symptoms.