Q: My 5-year-old was diagnosed with enteritis, had a fever, and now refuses to eat and is constantly lying down. Should we hospitalize?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My 5-year-old child is not eating, and their energy levels are extremely low. Two weeks ago, they had severe abdominal pain and a fever of 38.5°C. An ultrasound showed swollen intestines, and they were diagnosed with enteritis. The fever spiked to 39.5°C the next day, but then they were fine without a fever for a week.

Last Friday, their condition suddenly dropped again with a 38.4°C fever. The doctor said their throat was red. Over the weekend, the fever fluctuated, but a flu test came back negative, and they were diagnosed with a swollen throat. Because they weren't eating and felt poorly, they received IV fluids on Sunday.

On Monday, we went to a larger hospital. Blood, urine, and X-ray tests all came back normal. I was worried about severe constipation, but the X-ray showed it wasn't too bad. They had almost no fever and seemed okay, possibly thanks to the IV fluids.

However, from this evening, my child has been constantly lying down and has barely eaten all day. Why can't they eat when the tests are normal? Is their low energy just from not eating? They only had one bowel movement last week and another on Sunday, so I suspect they might be constipated. Should I admit them to the hospital tomorrow? What else should I do?

Answer:

Taking care of a sick child for almost two weeks is very exhausting. Based on your description, it has been about 10 days since the enteritis started, recent tests (blood, urine, X-ray) are normal, but your child is currently very lethargic, not eating, and possibly constipated, though currently without a fever.

Red Flags for Urgent Care or ER:

Please seek immediate medical attention today if you notice any of the following signs:

• No urine for 8 hours or more (dry diapers or no trips to the bathroom).

• Extremely dry lips, a dry tongue, or crying without tears.

• Constantly lying down with weak eye contact or very low responsiveness.

• Worsening abdominal pain or a hard, swollen belly.

• Repeated vomiting, or bloody/black stools.

(If you are heading to the hospital, give 1-2 teaspoons of water or an electrolyte drink every 5 minutes on the way, keep their upper body elevated, and bring the recent test results with you.)

What You Can Do at Home Now:

1. Prioritize Hydration: This is the most important step. Offer 1-2 teaspoons (5-10 mL) of water, barley tea, or an electrolyte solution every 5-10 minutes.

2. Small, Frequent Bites: Offer a single spoonful of bland foods like porridge, bananas, or boiled potatoes. Do not force them to eat; only give what they can comfortably tolerate.

3. Assist Bowel Movements: Gently massage the belly in a clockwise direction with warm hands, ensure adequate hydration, and offer small amounts of fruit (like pears or plums). If they go more than 3 days without a bowel movement and seem uncomfortable, consult your pediatrician tomorrow about a potential enema or laxative.

4. Rest: Allow them to rest comfortably in bed without forcing any activity.

Hospitalization vs. Outpatient Visit:

• Consider Hospitalization: If there are signs of severe dehydration (decreased urine, extreme dry mouth, sudden drop in energy), an inability to eat requiring continuous IV fluids, or worsening abdominal pain.

• Outpatient Visit is Okay: If your child is still urinating, can tolerate small amounts of fluids, and maintains good eye contact and responsiveness.

Please contact your pediatrician tomorrow morning to discuss your child's condition and decide whether an outpatient visit or hospital admission is the best course of action. When you speak with the doctor, you can ask how long a loss of appetite is considered normal during enteritis recovery, whether constipation management (like a laxative) is needed now, and what the best approach is for further IV fluid treatment. Focus on frequent, small amounts of hydration for now.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

fevercoach.us

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