A young mother called one morning to tell me her 5 year old son was vomiting, and asked what she could do. I suggested the standard of rest, sips of Pedialyte® or Gatorade®, and time.
Later that day,when the vomiting hadn’t stopped, the mother called her pediatrician and was told to take the child to Urgent Care for some Zofran – a drug used to stop nausea and vomiting. The wisdom of motherhood stepped in and it was decided to visit Urgent Care the next day if things weren’t getting better.
The nurse and the pediatrician reassured the mother that the drug is safe and there are no side effects. That advice is contradicted by the drug maker’s own list of possible side effects. Current literature about the drug states, “Zofran is not for preventing nausea or vomiting that is caused by factors other than cancer treatment or surgery.” Ironically, “nausea or vomiting that is new or worse” is also on the list of contraindications. That means using Zofran to stop vomiting could actually make it worse – but not to worry because experts in pediatrician’s office ignored or disagreed with the published information – or perhaps hadn’t read it
At the time of the first call the child had been ill for a total of about five hours. A simple stomach “bug” or food poisoning commonly resolves in 24 to 48 hours – not five. It is fully understandable to want instant relief – and an immediate resolution to an uncomfortable sickness. Being real, it usually doesn’t work that way. When the vomiting is relentless – and caused by something far more serious, such as cancer, a drug such as Zofran will be ordered to block the symptoms. It is understood, too, that blocking the symptom of vomiting is not expected to cure the underlying problem.
Vomiting is what a body often does to rid itself of a noxious substance (i.e., food poisoning, toxic substances, and flu bugs). It has always been a bad idea to block a natural body action, yet the first inclination is do something right now. It reminds me our collective mania to block a fever – another common reaction that demonstrates how our body works to build its immune defense system. A symptom informs the body that something is happening, which doesn’t always mean we should do something to put a stop to it – especially with drugs that pose health risks themselves.
I didn’t openly refute the advice from the doctor’s office, but I tried to assure the mom to relax and be prepared to wait out the problem – and offer sips of Pedialyte®.
I was informed a few days later that all symptoms had resolved by supper time that evening.
There is a place for drugs like Zofran, especially in people who are seriously nauseous. Without a powerful reason, it remains highly unlikely that a child who has been sick for five hours needs a toxic drug to stop vomiting.
As predicted, time, rest, and electrolytes were all that was needed. The little guy was ready to roll the next day.