The following symptoms and complaints may indicate enteritis (inflammation of the small intestine) or gastroenteritis (stomach flu) or enterocolitis (inflammation of the small intestine and large intestine):
- Diarrhea (diarrhea; usually watery diarrhea: stool frequency: > 3 stools/day or at least 2 stools more than usual).
- Crampy abdominal pain
- Blood in the stool (hematochezia)
- Mucus in the stool
- Vomiting* , nausea (sickness)
- Fever*
* Vomiting and fever may precede, follow, or be absent from diarrhea. If the vomiting is gushing and occurs in the winter months, think of norovirus gastroenteritis (gastrointestinal infection caused by norovirus)!
Rare complications – which occur especially in infants and young children and are accompanied by appropriate clinical symptoms – are:
- Invaginations (invagination of one section of intestine into another).
- Toxic shock
- Volume deficiency shock*
- Prerenal renal failure as an expression of severe dehydration* (fluid deficiency).
- Cerebral spasms as a result of the water or electrolyte shifts or hypoglycemia (hypoglycemia).
- Encephalitis (inflammation of the brain).
Infants and young children
Dehydration and shock
The following children are at increased risk:
- Infants with low birth weight
- Infants, with signs of malnutrition
- Children under one year of age, especially children under 6 months.
- Children who have had > 5 diarrheal stools within the last 24 hours
- Children who have vomited more than twice within the past 24 hours
- Children who have not previously received supplemental fluids or have been unable to tolerate them
- Children in whom breastfeeding has been discontinued during the disease.
Warning signs (red flags) in children (= possible indicators of other diagnoses) [NICE recommendations; 1, 2 ]
- Fever > 38 °C in children younger than 3 months of age.
- Fever > 39 °C in children over 3 months of age
- Shortness of breath or tachypnea (“rapid breathing“).
- Changes in consciousness
- Meningismus (painful stiffness of the neck)
- Bulging fontanelle in infants
- Rash that can not be pushed away
- Blood or mucus accumulation in the stool
- Bilious (greenish) vomiting
- Severe or localized abdominal pain
- Distended abdomen or pain on release
