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Gastroenteritis

When you have diarrhea and vomiting, you may say you have the "stomach flu." These symptoms often are due to a condition calledgastroenteritis.

With gastroenteritis, your stomach and intestines are irritated and inflamed. The cause is typically a viral or bacterial infection.

Symptoms of Gastroenteritis

With gastroenteritis, the main symptoms you probably have are waterydiarrhea and vomiting. You might also have stomach pain, cramping, fever, nausea, and a headache.

Because of diarrhea and vomiting, you also can become dehydrated. Watch for signs of dehydration, such as dry skin and a dry mouth, feeling lightheaded, and being really thirsty. Call your doctor if you have any of these symptoms.

Stomach Flu and Children

Children can get dehydrated quickly, so if your child has the stomach flu, it's important that you look for signs that he is very thirsty or has dry skin or a dry mouth. If you have a baby, look for fewer, drier diapers.

Keep children with gastroenteritis out of day care or school until all symptoms are gone. Check with your doctor before giving your child any medicine. Drugs used to control diarrhea and vomiting aren't usually given to children younger than 5.

To help prevent rotavirus -- the most common cause of stomach flu for children -- there are two vaccines that can be given to infants. Talk to your doctor about the vaccines.

What Causes Gastroenteritis

There are many ways gastroenteritis can be spread:

· Contact with someone who has the virus

· Contaminated food or water

· Unwashed hands after going to the bathroom or changing a diaper

The most common cause of gastroenteritis is a virus. Gastroenteritisflu can be caused by many different kinds of viruses. The main types are rotavirus and norovirus.

Rotavirus is the world's most common cause of diarrhea in infants and young children. Norovirus is the most common cause of serious gastroenteritis and also foodborne disease outbreaks in the U.S.

Although not as common, bacteria such as E. coli and salmonella can also trigger the stomach flu. Salmonella and campylobacter bacteria are the most common bacterial causes of gastroenteritis in the U.S. and are usually spread by undercooked poultry, eggs, or poultry juices. Salmonella can also be spread through pet reptiles or live poultry.

Another bacteria, shigella, is often passed around in day care centers. It typically is spread from person to person, and common sources of infection are contaminated food and drinking water.

Parasites can also cause gastroenteritis, but it's not common. You can pick up organisms such as giardia and cryptosporidium in contaminatedswimming pools or by drinking contaminated water.

There are also other unusual ways to get gastroenteritis:

· Heavy metals (arsenic, cadmium, lead, or mercury) in drinking water

· Eating a lot of acidic foods, like citrus fruit and tomatoes

· Toxins that might be found in certain seafood

· Medications such as antibiotics, antacids, laxatives, andchemotherapy drugs

· Gastroenteritis is a very common condition that causes diarrhoea and vomiting. It's usually caused by a bacterial or viral tummy bug.

· It affects people of all ages, but is particularly common in young children.

· Most cases in children are caused by a virus called rotavirus. Cases in adults are usually caused by norovirus (the "winter vomiting bug") or bacterial food poisoning.

· Gastroenteritis can be very unpleasant, but it usually clears up by itself within a week. You can normally look after yourself or your child at home until you're feeling better.

· Try to avoid going to your GP, as gastroenteritis can spread to others very easily.

Symptoms of gastroenteritis

The main symptoms of gastroenteritis are:

sudden, watery diarrhoea
feeling sick
vomiting, which can be projectile
a mild fever

Some people also have other symptoms, such as a loss of appetite, anupset stomach, aching limbs and headaches.

The symptoms usually appear up to a day after becoming infected. They typically last less than a week, but can sometimes last longer.

What to do if you have gastroenteritis

If you experience sudden diarrhoea and vomiting, the best thing to do is stay at home until you're feeling better. There's not always a specific treatment, so you have to let the illness run its course.

You don't usually need to get medical advice, unless your symptoms don't improve or there's a risk of a more serious problem (see When to get medical advice).

To help ease your symptoms:

Drink plenty of fluids to avoid dehydration–You need to drink more than usual to replace the fluids lost from vomiting and diarrhoea. Water is best, but you could also try fruit juice and soup.
Take paracetamol for any fever or aches and pains.
Get plenty of rest.
If you feel like eating, try small amounts of plain foods, such as soup, rice, pasta and bread.
Use special rehydration drinks made from sachets bought from pharmacies if you have signs of dehydration, such as a dry mouth or dark urine – read about treating dehydration.
Take anti-vomiting medication (such as metoclopramide) and/or antidiarrhoeal medication (such as loperamide) if you need to – some types are available from pharmacies, but check the leaflet that comes with the medicine. You can also ask your pharmacist or GP for advice about whether they're suitable.

Gastroenteritis can spread very easily, so you should wash your hands regularly while you're ill and stay off work or school until at least 48 hours after your symptoms have cleared, to reduce the risk of passing it on (seePreventing gastroenteritis).

When to get medical advice

You don't normally need to see your GP if you think you have gastroenteritis, as it should get better on its own.

Visiting your GP surgery can put others at risk, so it's best to call NHS 111 or your GP if you're concerned or feel you need advice.

Get medical advice if:

you have symptoms of severe dehydration, such as persistentdizziness, only passing small amounts of urine or no urine at all, or if you're losing consciousness
you have bloody diarrhoea
you're vomiting constantly and are unable to keep down any fluids
you have a fever over 38C (100.4F)
your symptoms haven't started to improve after a few days
in the last few weeks you've returned from a part of the world with poor sanitation
you have a serious underlying condition, such as kidney disease,inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting

Your GP may suggest sending off a sample of your poo to a laboratory to check what's causing your symptoms. Antibiotics may be prescribed if this shows you have a bacterial infection.

Looking after a child with gastroenteritis

You can look after your child at home if they have diarrhoea and vomiting. There's not usually any specific treatment and your child should start feeling better in a few days.

You don't normally need to get medical advice unless their symptoms don't improve or there's a risk of a more serious problem (see Getting medical advice for your child).

To help ease your child's symptoms:

Encourage them to drink plenty of fluids. They need to replace the fluids lost from vomiting and diarrhoea. Water is generally best. Avoid giving them fizzy drinks or fruit juice, as they can make their diarrhoea worse. Babies should continue to feed as usual, either with breast milk or other milk feeds.
Make sure they get plenty of rest.
Let your child eat if they're eating solids and feel hungry. Try small amounts of plain foods, such as soup, rice, pasta and bread.
Give them paracetamol if they have an uncomfortable fever or aches and pains. Young children may find liquid paracetamol easier to swallow than tablets.
Use special rehydration drinks made from sachets bought from pharmacies if they're dehydrated. Your GP or pharmacist can advise on how much to give your child. Don't give them antidiarrhoeal and anti-vomiting medication, unless advised to by your GP or pharmacist.

Make sure you and your child wash your hands regularly while your child is ill and keep them away from school or nursery until at least 48 hours after their symptoms have cleared

Getting medical advice for your child

You don't usually need to see your GP if you think your child has gastroenteritis, as it should get better on its own, and taking them to a GP surgery can put others at risk.

Call NHS 111 or your GP if you're concerned about your child, or they:

have symptoms of dehydration, such as passing less urine than normal, being unusually irritable or unresponsive, pale or mottled skin, or cold hands and feet
have blood in their poo or green vomit
are vomiting constantly and are unable to keep down any fluids or feeds
have had diarrhoea for more than a week
have been vomiting for three days or more
have signs of a more serious illness, such as a high fever (over 38C or 100.4F), shortness of breath, rapid breathing, a stiff neck, a rash that doesn't fade when you roll a glass over it or a bulging fontanelle (the soft spot on a baby's head)
have a serious underlying condition, such as inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting

Your GP may suggest sending off a sample of your child's poo to a laboratory to confirm what's causing their symptoms. Antibiotics may be prescribed if this shows they have a bacterial infection.

How gastroenteritis is spread

The bugs that cause gastroenteritis can spread very easily from person to person.

You can catch the infection if small particles of vomit or poo from an infected person get into your mouth, such as through:

close contact with someone with gastroenteritis – they may breathe out small particles of vomit
touching contaminated surfaces or objects
eating contaminated food – this can happen if an infected person doesn't wash their hands before handling food, or you eat food that has been in contact with contaminated surfaces or objects, or hasn't been stored and cooked at the correct temperatures (read more about the causes of food poisoning)

A person with gastroenteritis is most infectious from when their symptoms start until 48 hours after all their symptoms have passed, although they may also be infectious for a short time before and after this.

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by ingesting contaminated food or water. If you're otherwise healthy, you'll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.

There's no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defense.

Although it's commonly called stomach flu, gastroenteritis isn't the same as influenza. Real flu (influenza) affects only your respiratory system — your nose, throat and lungs. Gastroenteritis, on the other hand, attacks your intestines, causing signs and symptoms, such as:

Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
Abdominal cramps and pain
Nausea, vomiting or both
Occasional muscle aches or headache
Low-grade fever

Depending on the cause, viral gastroenteritis symptoms may appear within one to three days after you're infected and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may persist as long as 10 days.

Because the symptoms are similar, it's easy to confuse viral diarrhea with diarrhea caused by bacteria, such as Clostridium difficile, salmonella and E. coli, or parasites, such as giardia.

When to see a doctor

If you're an adult, call your doctor if:

You're not able to keep liquids down for 24 hours
You've been vomiting for more than two days
You're vomiting blood
You're dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
You notice blood in your bowel movements
You have a fever above 104 F (40 C)

For infants and children

See your doctor right away if your child:

Has a fever of 102 F (38.9 C) or higher
Seems lethargic or very irritable
Is in a lot of discomfort or pain
Has bloody diarrhea
Seems dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them

If you have an infant, remember that while spitting up may be an everyday occurrence for your baby, vomiting is not. Babies vomit for a variety of reasons, many of which may require medical attention.

Call your baby's doctor right away if your baby: