Nausea, Vomiting and Diarrhea and dehydration – What to do about gastroenteritis

shutterstock_103672964Viral gastroenteritis is an illness that we often see in the urgent care and medical clinic in both adults and children.  It causes diarrhea and vomiting.

How do I get infected?  If you touch an infected person or an object that has been touched by someone who is infected (that has the virus on it), you could become contaminated.  If you eat foods or drink liquids with the virus you may also become infected.  It is important for people with the virus to wash their hands.

Symptoms: Possible symptoms include nausea, vomiting, diarrhea, fever, headache or muscle aches, belly pain or cramping and loss of appetite.  If your body loses too much water, you can become dehydrated.  Symptoms of dehydration include dark yellow urine, feeling thirsty, tired, dizzy or confused.  Dehydration that is severe can be life threatening.  Babies, infants, young children and the elderly are more likely to become dehydrated.

When should I call a doctor or nurse?  If you or your family member has symptoms of dehydration (mentioned above), diarrhea or vomiting that lasts longer than 24 hours, vomiting blood or have bloody diarrhea, they haven’t had anything to drink in a few hours or been able to urinate in the past 6-8 hours during the day, if a baby or young child hasn’t had a wet diaper in 4-6 hrs.

Diagnosis:  Most of the time the diagnosis can be made after obtaining a history and performing a physical exam, but sometimes your healthcare provider may obtain blood tests, urine tests or tests on a stool sample.

Treatment of viral gastroenteritis:  For severe gastroenteritis with dehydration patients are sometimes treated with IV fluids (a thin tube that goes into the vein).  We do not give antibiotics for viral gastroenteritis because they don’t help cure a viral infection.  We can give medicine in the IV to help reduce the nausea as well.   Sometimes suppositories or oral medications for nausea can be helpful.  Small sips of clear fluids at home every 15 minutes can help prevent dehydration.  We generally try to avoid red colored fluids so that if it passes right through, we don’t confuse the red color for blood in the stool.  Once vomiting has stopped for 24 hours, starting small bites of crackers can be tried.  The diet usually advances to a “BRATTY” diet at this point – ie. “Bannanas, Rice, Apples, Tea, Toast and Yogurt” are all bland foods that are easy on the stomach.

Prevention of viral gastroenteritis:  Wash your hands with soap after using the bathroom or change your child’s diaper and before you eat.  Avoid changing diapers near where you prepare food and make sure your baby gets the rotavirus vaccine.  Rotavirus is a common infection that causes severe nausea, vomiting and diarrhea in children.

Dehydration:  This is a term that medical providers use to describe when the body loses too much water.  It can be mild or severe.  Usually mild dehydration doesn’t cause problems, however severe hydration is a medical emergency and can be life threatening.  You children and babies are more at risk for dehydration because they have a small body mass and less to lose to begin with.

Causes of dehydration:  Vomiting, diarrhea, sweating/high fever, medicines called diuretics or water pills.  Also some people who have nausea or sore throat might not drink enough fluids.

Symptoms of dehydration:  With mild dehydration, patients might not notice any symptoms, however as dehydration gets worse it can cause:

1)   Feeling thirsty

2)   Urinating less often, or having dark yellow or brown urine

3)   Dry mouth or cracked lips

4)   No tears when a child cries

5)   Feeling tired or confused

6)   Feeling light headed or dizzy

7)   Eyes look sunken in the face

8)   Babies can have a sunken gap between the bones in the babies skull. This soft spot can feel/look caved in.

When to seek help:  Call your medical provider if your child has any symptoms of dehydration.  You should also call if the patient has diarrhea that lasts more than a few days, vomits blood or has bloody diarrhea, vomiting lasts more than 24 hours, urinating much more than usual, haven’t had anything to drink in many hours, hasn’t needed to urinate in the past 6-8 hours (in adults/older children) or hasn’t had a wet diaper in 4-6 hrs.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

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