Acute gastroenteritis is one of the most common illnesses affecting children and continues to contribute substantially to pediatric outpatient visits, emergency consultations, and hospital admissions worldwide [1,2]. Although the overall mortality associated with diarrheal disease has declined over recent decades, the burden remains high in low- and middle-income settings, where repeated enteric infections, delayed access to care, and coexisting malnutrition amplify disease severity [1,4]. In young children, even short periods of diarrhea and vomiting can rapidly lead to fluid loss, electrolyte imbalance, metabolic derangement, reduced oral intake, and the need for inpatient stabilization [2,3].

Clinically, acute gastroenteritis is characterized by the sudden onset of loose or watery stools, often accompanied by vomiting, fever, abdominal discomfort, and variable degrees of dehydration [2-5]. Viral pathogens account for a large proportion of cases in childhood, but bacterial and parasitic infections also contribute depending on age, geography, sanitation, feeding practices, and season [2,4. From a practical standpoint, the immediate clinical concern is not only the infectious etiology but also the hemodynamic and metabolic consequences of fluid loss. For this reason, careful bedside assessment of dehydration remains central to case stratification and treatment planning [3,5-7].

The severity of dehydration influences the choice between oral rehydration and intravenous fluid therapy. Evidence-based recommendations consistently support oral rehydration solution as the cornerstone of treatment for mild to moderate dehydration, while intravenous fluids are reserved for children with severe dehydration, shock, persistent vomiting, or failure of oral therapy [3,5,8]. Adjunctive therapies such as zinc, selected probiotics, and ondansetron have also been evaluated to reduce symptom burden or improve tolerance to rehydration in selected clinical settings [4,9,10,12,13]. However, the profile of hospitalized children often differs from that of community-managed cases because admitted patients are more likely to have significant vomiting, reduced intake, electrolyte abnormalities, renal dysfunction, or nutritional vulnerability [11,13].

Hospital-based data are therefore important for understanding how acute gastroenteritis presents in routine pediatric practice and how children respond to supportive management in tertiary care settings. Such information assists clinicians in anticipating complications, prioritizing early correction of dehydration, and planning resource use in pediatric wards and intensive care units. The objectives of the present study were to describe the demographic characteristics and nutritional profile of children admitted with acute gastroenteritis, assess their presenting symptoms and dehydration status, document laboratory abnormalities and treatment patterns, and evaluate short-term in-hospital outcomes at a tertiary care teaching hospital. The study also sought to provide locally relevant descriptive data that can support clinical audit and future comparative pediatric gastroenteritis research.

Study design and setting. This hospital-based observational study was conducted in the Department of Pediatrics at Prathima Institute of Medical Sciences, Karimnagar, Telangana, over a six-month period from February 2025 to July 2025. The study was designed to describe the spectrum of illness among children admitted with acute gastroenteritis and to document their management and short-term hospital outcomes in a tertiary care setting. The study setting included the pediatric ward, emergency services, and pediatric intensive care support for children requiring advanced monitoring or resuscitation.

Study population. Children aged 2 months to 12 years who were admitted with a clinical diagnosis of acute gastroenteritis during the study period were considered eligible. Acute gastroenteritis was defined as the passage of loose or watery stools of recent onset, with or without vomiting, fever, abdominal pain, or reduced oral intake, consistent with standard pediatric definitions [3-5,13]. Children with chronic diarrhea, known surgical abdomen, major gastrointestinal malformation, or incomplete inpatient records were excluded from analysis. A total of 100 eligible children were included in the final study sample.

Sampling and data collection. Eligible children were enrolled consecutively until the planned sample size of 100 was achieved. Data were collected using a structured case record format from history, physical examination, inpatient monitoring sheets, and laboratory reports. The variables recorded included age, sex, residence, nutritional status, duration of symptoms before admission, frequency of stools, associated symptoms, dehydration status, electrolyte abnormalities, treatment received, duration of hospital stay, and final outcome. Nutritional status was categorized clinically into normal nutrition, mild to moderate undernutrition, and severe acute malnutrition on the basis of routine pediatric assessment recorded at admission.

Clinical assessment and management variables. Dehydration severity was classified as no dehydration, some dehydration, or severe dehydration using accepted clinical criteria based on general appearance, oral intake, urine output, mucous membrane dryness, and other bedside signs routinely used in pediatric practice [5-7]. Laboratory evaluation was performed as indicated by the treating pediatrician and included serum electrolytes, renal function tests, blood glucose, and acid-base assessment where clinically required. Treatment variables documented in the study included oral rehydration solution, intravenous fluid therapy, zinc supplementation, antiemetics, probiotics, antibiotics, and pediatric intensive care unit admission. Rehydration practices followed standard pediatric principles, with oral rehydration preferred whenever feasible and intravenous fluids used for severe dehydration, persistent vomiting, or poor oral tolerance [3,5,8,9].

Outcome measures and statistical analysis. The primary outcomes assessed were clinical recovery during admission, duration of hospital stay, need for pediatric intensive care, referral, discharge against medical advice, and death. All data were entered into a spreadsheet and analyzed using descriptive statistical methods. Continuous variables are presented as mean ± standard deviation, whereas categorical variables are summarized as frequency and percentage. The results are displayed in four tables for clarity and to facilitate journal presentation.

Ethical considerations. Institutional ethics approval number and date were not available in the source material used for drafting this manuscript and should be inserted before submission. Parent or guardian consent language should also be added in the final submission copy in accordance with the approved institutional protocol.

A total of 100 children admitted with acute gastroenteritis were included in the study and analyzed. The age of the participants ranged from 2 months to 12 years, with a mean age of 3.9 ± 2.8 years. Most children belonged to the 1–3 years age group (36.0%), followed by 4–6 years (24.0%). Males constituted 58.0% of the study population, while females accounted for 42.0%. The majority of children were from rural areas (64.0%). Most participants presented within 1–3 days of symptom onset, and 38.0% had some degree of undernutrition. The baseline characteristics are shown in Table 1.

Table 1. Baseline characteristics of children admitted with acute gastroenteritis [N = 100]

Diarrhea was present in all children. Vomiting was the most common associated symptom (78.0%), followed by poor oral intake (58.0%), fever (46.0%), and abdominal pain (34.0%). Decreased urine output and lethargy were noted in 29.0% and 26.0% of children, respectively. Blood in stool was present in 12.0% of cases. On assessment of dehydration, 54.0% had some dehydration and 26.0% had severe dehydration. Clinical features and dehydration status are presented in Table 2.

Table 2. Clinical profile and dehydration status of the study participants [N = 100]

Laboratory evaluation showed that hypokalemia was the most frequent electrolyte abnormality (22.0%), followed by hyponatremia (18.0%). Metabolic acidosis was documented in 28.0% of cases. Raised serum creatinine and hypoglycemia were observed in 9.0% and 5.0% of participants, respectively. All children received rehydration therapy, while 68.0% required intravenous fluids. Zinc supplementation was administered in 94.0% of children, antiemetics in 58.0%, probiotics in 52.0%, and antibiotics in 24.0%. Six children required pediatric intensive care unit admission. Laboratory abnormalities and treatment details are shown in Table 3.

Table 3. Laboratory abnormalities and treatment profile of the study participants [N = 100]

The mean duration of hospital stay was 3.4 ± 1.8 days. Most children (62.0%) were discharged within 3 days, while 28.0% stayed for 4–5 days and 10.0% required hospitalization for more than 5 days. Overall, 96.0% of children improved and were discharged, 2.0% were referred, 1.0% left against medical advice, and 1.0% died during hospital stay. The hospital stay and final outcomes are shown in Table 4.

Table 4. Hospital stay and outcomes of children admitted with acute gastroenteritis [N = 100]

Overall, acute gastroenteritis in the present study predominantly affected younger children, particularly those below 3 years of age. Vomiting and poor oral intake were common accompanying symptoms, and most children had some degree of dehydration at admission. Although electrolyte disturbances were seen in a considerable proportion, the overall outcome was favorable, with a high recovery rate and low mortality.

The present study demonstrates that acute gastroenteritis requiring hospital admission was concentrated largely in younger children, with the highest proportion occurring in the 1–3 year age group. This age pattern is clinically plausible because younger children have greater exposure to contaminated food and water during weaning, limited physiological reserve, and a higher risk of rapid dehydration during diarrheal illness [14]. The mild male predominance observed in the present cohort has also been described in several hospital-based pediatric series, although sex itself is unlikely to be a major determinant of disease severity [13].

Vomiting, poor oral intake, and fever were frequent presenting features in our study, and together they likely contributed to the high burden of dehydration at admission. Nearly four out of five children had some or severe dehydration, emphasizing that hospitalized patients represent the more symptomatic end of the disease spectrum. This observation is consistent with established pediatric guidance, which identifies dehydration as the key clinical determinant of treatment intensity and admission need [5-8]. The present findings therefore reinforce the importance of early clinical assessment, especially in children presenting after more than 24 hours of illness, recurrent vomiting, or decreased urine output.

Biochemical abnormalities were also notable in the present study. Hypokalemia, hyponatremia, and metabolic acidosis were the most common derangements, reflecting ongoing gastrointestinal electrolyte losses and reduced intake. These findings parallel prior work showing that electrolyte and renal abnormalities become more frequent with increasing dehydration severity in children with acute diarrhea [11]. From a practical standpoint, this supports the selective use of laboratory testing in admitted children, particularly those with lethargy, oliguria, persistent vomiting, or severe dehydration at presentation [11,13].

The management profile in this study was broadly aligned with contemporary recommendations. All children received rehydration therapy, while intravenous fluids were required in more than two-thirds of cases, which is understandable in an inpatient cohort with substantial vomiting and moderate to severe dehydration [8]. Zinc was prescribed in most children, consistent with its continued role in pediatric diarrheal management, particularly in resource-limited settings [13]. The use of antiemetics, especially ondansetron-based strategies, has been shown to improve oral rehydration success in selected children with vomiting [9,12,13]. Probiotics were also used in about half of the cohort; however, evidence supports only selected strains, and benefits are modest and context-specific [10,12,13].

The overall outcome was favorable, with short mean hospital stay, high recovery rate, low referral rate, and only one in-hospital death. These findings suggest that timely inpatient rehydration and supportive care remain highly effective for most admitted children with acute gastroenteritis. At the same time, the presence of severe dehydration, electrolyte imbalance, and pediatric intensive care requirement in a subset of patients indicates that acute gastroenteritis continues to impose a meaningful burden on tertiary pediatric services [14].

Limitations

This study was conducted at a single tertiary care hospital and included a modest sample of 100 children, which limits wider generalizability. Etiological testing for viral, bacterial, and parasitic pathogens was not available in the dataset, preventing organism-specific analysis. Socioeconomic factors, feeding practices, immunization status, and post-discharge follow-up were not assessed, restricting broader interpretation of determinants and longer-term outcomes across settings.

Acute gastroenteritis in the present study predominantly affected younger children and was commonly associated with vomiting, poor oral intake, dehydration, and electrolyte disturbances. Most admitted children required active rehydration, and a substantial proportion needed intravenous fluids because of illness severity at presentation. Hypokalemia, hyponatremia, and metabolic acidosis were the most frequent biochemical abnormalities, underscoring the need for careful inpatient monitoring in selected cases. Despite this clinical burden, short-term outcomes were favorable, with most children improving and being discharged within a few days. Early recognition of dehydration, appropriate fluid therapy, zinc supplementation, and timely supportive care remain central to reducing complications and improving hospital outcomes in pediatric acute gastroenteritis.

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