Gastroenteritis: The Common "Stomach Bug"
Nothing is worse than feeling that rumble in your belly and the ensuing agony of a “stomach bug.” These illnesses are known as "gastroenteritis", they typically bring vomiting and diarrhea and are quite common in the spring months.
My household has recently recovered from such a visit by the virus. Harmless for the most part, a doctor’s help is usually not required with these infections. It is, however, important to watch for a few red flags, which herald more serious illness.
This blog will explore these illnesses, providing a “users guide” for supportive care and knowing when to worry.
Gastroenteritis: What It Is
What Gastroenteritis Is: Gastroenteritis is an infection that occurs in the bowel tract. Almost always, these infections are a virus.
Symptoms of Gastroenteritis: The illness begins with vomiting which usually lasts a matter of hours to a couple days.The infection then works its way down the digestive tract and eventually causes diarrhea that can last up to 12 days. Most often, the illness is brief, only lasting a few days.
Cause of Gastroenteritis: Gastroenteritis is quite infectious. It is transmitted through viral shedding in fecal matter (diarrhea) that is transmitted to hand and then to mouth. For this reason, hand washing is paramount to prevention.
Gastroenteritis: What It Is Not
The Stomach Flu: Sometimes these illnesses are commonly referred to as “the stomach flu.” but they are actually, completely unrelated to influenza.
Food Poisoning: Gastroenteritis is quite different from food poisoning. Food poisoning occurs when a food (usually a milk-based food like potato salad or cole slaw) is left in a warm environment. Bacteria grow in the food and produce a toxin that is eaten.This toxin causes vomiting and diarrhea two to six hours after consumption. Once the toxin is cleared, the illness subsides.
Home Treatment for a Stomach Bug or Gastroenteritis
Gastroenteritis does a number on the gut. Vomiting can easily scorch the esophagus with the hydrochloric acid-containing stomach contents.The infection and diarrhea cause a sloughing of the finger-like cells of the intestines which are important in absorbing nutrients.
However, as stated before, viral gastroenteritis is self-limited. The only real concern is dehydration. With vomiting and diarrhea, it can be difficult to replenish the lost fluids and electrolytes. The biggest danger comes with children.
With their smaller mass, children dehydrate easier than adults. In addition, children may not have the sense to force fluids into their system with the memory of vomiting still looming.
When to Worry About a Stomach Bug or Gastroenteritis
Dehydration can be evidenced by:
- Dry lips
- A sunken appearance to the face
- Lack of voiding (wet diapers)
If a parent gets a sense that their child is dehydrated, it is best to visit the emergency room for IV fluids. It always amazes me how a child bounces back on getting “topped off” with some IV saline. These fluids also contain lost electrolytes. For adults, some nausea medicine and Gatorade may stave off the need for IV.
Other symptoms of concern with a stomach bug:
- High fever
- Any sign of blood in the diarrhea
- Symptoms following the consumption of undercooked chicken
- Symptoms following travel to third world countries
- Diarrhea that lasts more than two weeks
Serious infections with salmonella and a special form of E. coli called OH 157 H7 can cause bloody diarrhea with a high fever.
Salmonella: usually comes from undercooked chicken. Basically, most raw chicken contains salmonella and cooking it kills the bacteria.
E. coli OH 157 H7: occasionally occurs in outbreaks from stool-contaminated foods. Outbreaks have occurred with hamburger and various vegetables in recent years.
Traveler's Diarrhea: A coinciding history of recent travel to a third world country should also prompt concern. Travelers’ diarrhea is caused by bacteria that contaminate water and fresh foods. It is easily treated with antibiotics. Finally, if the diarrhea does not resolve within two weeks, further testing should be done.
It is said that when you are hunting in the woods locally don’t expect to find zebras or rhinos. Likewise, without any unusual signs or history of travel, most everything seen is viral gastroenteritis. Testing for microbial “rhinos and zebras” is rarely needed.
In other words, the simplest explanation is usually the right one.
The BRAT Diet for Stomach Bug or Gastroenteritis
Fluids and electrolytes are the essential needs for replacement.
Food is of secondary importance. However, even after things quiet down, introduction of foods can be a bit of a challenge. Milk products for example, may not be well tolerated due to the complex sugar lactulose.
When is comes to home treatment and recovery from a stomach bug, it is really best to keep things simple.
BRAT is an acronym for reasonable introduction foods that contain simple sugars and starches.
B is for bananas. Bananas are good for a stomach bug because they contain fructose sugar, a modest amount of fiber and the important electrolyte potassium that is lost in diarrhea.
R is for rice. Rice is good for a stomach bug because it is a simple, bland starch.
A is for applesauce. Applesauce is good for a stomach bug because it is a nice, broken down source of fructose sugar and fiber.
T is for toast. Toast or bread is good for a stomach bug because it is another simple form of starch.
Why is a BRAT diet good for the stomach bug or gastroenteritis? Consumption of these “bland” foods make for easy absorption of nutrients a give the gut a rest as the brush boarder cells are built back up.
Viral gastroenteritis is a common infection that usually passes over in a matter of days. Supportive care with electrolyte-containing fluids can help to prevent dehydration. Signs of unrelenting dehydration should prompt a visit to the emergency room for IV fluids. When resolving, ease the gut back into foods with the BRAT diet. As these illnesses are quite contagious from fecal matter to hand to mouth, hand washing is important in preventing further infection.