title: Review article: the management of acute gastroenteritis in children.
abstract: BACKGROUND
  In 2008, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society of Paediatric Infectious Disease (ESPID) developed evidence-based guidelines for the management of acute gastroenteritis (AGE) in children in Europe.
  
  
  OBJECTIVE
  To summarise data published subsequently to the ESPGHAN/ESPID guidelines.
  
  
  METHODS
  MEDLINE and The Cochrane Library were searched in August 2012 for randomised controlled trials (RCTs) or their meta-analyses published after 2008.
  
  
  RESULTS
  Efforts to improve the taste and/or efficacy of oral rehydration solution (ORS) continue, and some interventions are promising. While standard (over 24 h) nasogastric rehydration is still being used, new evidence confirms that rapid (over 4 h) rehydration is also effective. For intravenous rehydration, new evidence is available regarding rapid or ultrarapid and large-volume vs. standard-volume rehydration; as the new evidence is not consistent, until more data are available, the administration of 20 mL/kg seems appropriate. Convincing evidence has accumulated showing that ondansetron reduces the risk for vomiting; however, a clearance on safety in children is needed. New evidence has reconfirmed that in Europe, where zinc deficiency is rare, there is no benefit from the use of zinc. New data, although mainly from outside of Europe, have reconfirmed that either smectite or racecadotril is an effective adjunctive therapy to oral rehydration. There is a clear effect of using certain probiotics, such as Lactobacillus GG or S. boulardii.
  
  
  CONCLUSIONS
  The update of current ESPGHAN/ESPID recommendations is warranted.
authors.affiliation: Department of Paediatrics, The Medical University of Warsaw, Dzialdowska 1, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Pieścik-Lech
authors.forename: R
authors.initials: R
authors.lastname: Shamir
authors.forename: A
authors.initials: A
authors.lastname: Guarino
authors.forename: H
authors.initials: H
authors.lastname: Szajewska
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D002675:Child, Preschool; D003681:Dehydration / Q000188:drug therapy* / Q000209:etiology; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D005440:Fluid Therapy / Q000379:methods*; D005759:Gastroenteritis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D015201:Meta-Analysis as Topic; D019936:Probiotics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D015532:Rehydration Solutions / Q000008:administration & dosage; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology; D015032:Zinc / Q000008:administration & dosage
chemical_list: D000932:Antiemetics; D015532:Rehydration Solutions; D015032:Zinc