Savvy parents can manage most cases of intestinal diseases that occur away from home and recognize the rare case needing immediate medical attention.
Here’s how to be a savvy parent:
1. Do not treat intestinal illnesses with only clear or sugary liquids.
Vomiting and diarrhea eliminates vital nutrients from the body, mainly sodium and chloride (salt). Water, juice, and cola drinks do not contain them. Sugary liquids such as juice worsens diarrhea by drawing additional nutrients out of the blood stream into the intestine. 
2. Continue feeding.
Food does not worsen diarrhea – it supplies calories for needed energy and helps restore the intestine. Starchy substances are best but any food that is tolerated is OK to give. The only time to stop feeding is in the presence of severe vomiting. (See below.)
3. Use oral rehydrating solutions (ORS) when available.
These replace salt and other substances lost with vomiting and diarrhea. ORS comes in powder in small packets, especially convenient for travel. Dissolve in clean water. Carry an electrical coil, current converter, and plug for boiling water, where necessary. Use purifying tablets for camping. All these items are available at camping and travel supply stores. Many advertise on the web.
4. Make your own ORS when necessary.
There are two ways to do this: (1) Give plain water and juice along with pretzels, salted crackers and potato chips. (2) Mix 1 quart (liter) of safe water, six level teaspoons of sugar and one level teaspoon of salt.
5. Avoid common remedies.
Some are counterproductive, others have side-effects. Kaolin-pectate products, for example, do reduce the number of stools, but do so by retaining fluids in the intestine, further worsening the salt imbalance, and giving a false sign that diarrhea is improving. Bismuth-containing substances (Pepto-Bismol) and loperamide (Imodium) are not recommended for young children.
Sports drinks (Gatorade) are designed to replace fluids lost by perspiration, not for fluids lost from the intestinal tract. Products bought overseas may contain substances banned in the U.S.
6. Start treatment with ORS at first signs of vomiting or diarrhea.
Don’t wait to see whether the illness will be severe. In the majority of cases, ORS is the only treatment necessary. Continue regular feedings, including milk.
7. Treat vomiting with small amounts of fluids.
Large amounts tend to be vomited. Three ounces or less are usually retained. For severe vomiting, give a tablespoon every 10 minutes. (Six tablespoons equal one ounce.) Fluids retained for 30 minutes are generally absorbed from the intestines and effective. If vomiting occurs more often, further reduce the amount given to a teaspoon or dropper full.
Ideally, in infants and young children, give about 3 ounces for every loose stool or bout of vomiting. Avoid food as long as vomiting continues, which is rarely more than 12 hours. Continue breast-feeding, formula, or milk during vomiting.
8. Recognize dehydration.
This results when the body loses more fluids than it is able to replace. Signs of impending severe dehydration in children include continuous uncontrollable vomiting and diarrhea, refusal to take or inability to retain fluids, listlessness, lack of urination, no smiling, not playful, blood and mucus in the stool, and high fever. Children with these symptoms require immediate medical attention.
9. Diarrhea may continue for many days.
ORS helps prevents dehydration; it does not necessarily stop diarrhea immediately. The number of stools is not an accurate indicator of the severity of the disease. Children taking fluids, urinating, and who are active and happy, are not dehydrated, even if the diarrhea continues for many days.
10. Carry an antibiotic for visits to remote areas.
Rarely, an antibiotic helps speed recovery, especially in developing countries where such illnesses may be more serious, last longer, and spread to other family members, especially from infants in diapers.
Antibiotics are effective against intestinal disease caused by susceptible bacteria, not all cases. Most effective for infants and small children is Azithromycin. It is available in liquid form, does not require refrigeration, and has a long shelf life. Ask you pediatrician for a prescription and instructions for taking it.
