In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to deb@newfalconherald.com. It’s your chance to ask the doc.Question: My child had a sore throat recently, and I was concerned about strep throat. When should I see a doctor?Answer: Strep throat is an infection of the throat caused by the bacteria streptococcus, which gives it its name. The typical symptoms in adults with strep throat are a sore throat, fever and swollen neck glands. They usually don’t have a cough or runny nose. Children with strep throat also have a sore throat, but also may have an upset stomach, vomiting and a rash. The rash is described as a “sandpaper rash” because it has very fine, small bumps with redness and is worse under the arms and in skin creases.Not all sore throats are caused by strep. Bacteria only cause about 5 to 10 percent of sore throats, and the rest are caused by viruses, allergies or irritation. If a person has a runny nose, nasal congestion or a cough, they probably don’t have strep. In these cases, the best treatment is over-the-counter analgesics, such as acetaminophen, throat lozenges or salt-water gargles. Antibiotics will not help in these cases.If a person does have strep throat, most doctors will prescribe antibiotics. Antibiotics will reduce the bacteria in the throat and will help the sore throat get better quicker.Untreated strep throat can also lead to several significant complications, such as kidney disease, and antibiotics help to prevent these. Most doctors can do a test in their office, called the rapid strep test, or a throat swab. Strep tests are about 97 percent accurate at diagnosing strep and can be done in 5 to10 minutes.Strep throat is highly contagious and can be spread to others for up to three days. As a general rule, children with strep throat should not go back to school or day care until their fever has gone away and they have taken an antibiotic for at least 24 hours.Besides antibiotics, there are several things that can make strep throat feel better. Taking ibuprofen or acetaminophen can help with the pain, but aspirin should not be used in children. Gargling with warm salt water made from 1/4 teaspoon of salt in 1 cup (8 ounces) of warm water can help, as can sucking on throat lozenges, hard candy or pieces of ice. Eating soft foods, drinking cool drinks or warm liquids, or sucking on popsicles usually will soothe a sore throat as well, no matter the cause.With any sore throat, it is usually alright to give it a day or two with these measures before seeing a doctor. People with sore throats that continue or get worse or that come with swollen glands, fever, or the lack of cough or runny nose, should be seen by a doctor for a test or treatment.Question: My child had the stomach flu recently. What can I do to treat it at home?Answer: Vomiting and diarrhea can be caused by viruses; bacteria; parasites; foods that are hard to digest, such as too many sweets; and other things. Most illnesses are caused by viruses and will resolve on their own. Even so, vomiting and diarrhea can be harmful to children because they can cause dehydration when too much fluid is lost from the body. Signs of dehydration in children include irritability, decreased eating, weight loss, decreased urination, dry mouth and a fast heartbeat. With severe dehydration, one can see a loss of tears with crying, sunken eyes and a sunken soft spot in babies.Dehydration can be prevented by continuing to give fluids even though a child may vomit. For children over age 2, it is best to give sports drinks, juices or rehydration fluids such as Pedialyte. For younger children who breastfeed, it is usually best to continue to breastfeed while supplementing with fluids. Children do best when given small sips of fluids frequently, rather than large amounts at once.Food can be reintroduced after about 24 hours of clear fluids. Foods that are high in sugar and fat, such as ice cream, pudding and fried foods, can make diarrhea worse and should be avoided. Diarrhea will wash out the chemicals that digest milk in the intestine, so dairy products should be avoided for up to seven days after diarrhea stops. The best foods are bland ones, such as the BRAT diet (bananas, rice, applesauce, toast) or unsweetened cereals.Very few medications are effective for vomiting and diarrhea. Over-the-counter diarrhea medications will slow the diarrhea, but can prolong an illness. Nausea medications are alright for adults, but can be very dangerous for children. Therefore, aggressive fluids and bland diets are the mainstay of treatment. If dehydration becomes severe, see your doctor, as IV fluids may be necessary.Dr. Kent HerbertBoard-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
