To characterize the pain experienced by children with acute gastroenteritis in the 24-hours prior to emergency department (ED) presentation. Secondary objectives included characterizing ED pain, discharge recommendations, overall analgesic use, and factors that influenced analgesic use and pain severity.
A prospective cohort was recruited from two pediatric EDs (December 2014 -September 2017). Eligibility criteria included <18 years of age, acute gastroenteritis (≥ 3 episodes of diarrhea or vomiting in the previous 24 hours), and symptom duration < 7 days at presentation.
We recruited 2136 patients, median age 20.8 months (IQR 10.4, 47.4) and 45.8% (979/2136) female. In the 24-hours prior to enrolment, most caregivers reported moderate [28.6% (610/2136, 95% CI 26.7, 30.5)] or severe [46.2% (986/2136, CI 44.0, 48.3)] pain for their child. In the ED, they reported moderate [31.1% (664/2136, 95% CI 29.1, 33.1)] or severe [26.7% (571/2136, 95% CI 24.9, 28.7)] pain; analgesia was provided to 21.2% (452/2131). The most common analgesics used in the ED were acetaminophen and ibuprofen. At discharge, these were also most commonly recommended. Factors associated with greater analgesia use in the ED were high pain scores during the index visit, having a primary-care physician, earlier presentation to emergency care, fewer diarrheal episodes, presence of fever, and hospitalization at index visit.
Most caregivers of children presenting to the ED with acute gastroenteritis reported moderate or severe pain, both prior to and during their visit. Future research should focus on the development of effective, safe, and timely pain management plans.

Copyright © 2020. Published by Elsevier Inc.