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Overview

Viral gastroenteritis is an infection of the stomach and intestines that is caused by a variety of viruses. Because it results in vomiting and diarrhea it is often called the "stomach flu" although it has nothing to do with influenza. It is a very common illness and for most people it is not serious. People who get viral gastroenteritis almost always recover completely without any long-term problems.

Many different viruses can cause gastroenteritis including rotaviruses adenoviruses caliciviruses astroviruses Norwalk virus and a group of Noroviruses. Each gastrointestinal virus has a season when it's most active. In Ontario and the rest of Canada you're more likely to get rotavirus or the Norwalk virus between October and April.

Viral gastroenteritis is not caused by bacteria (such as Salmonella or Escherichia coli) or parasites (such as Giardia) or by medications or other medical conditions although the symptoms may be similar. Your doctor can determine if the diarrhea is caused by a virus or by something else.

The viruses that cause gastroenteritis are spread through close contact with infected people (for example by sharing food water or eating utensils). You may also become infected by eating or drinking contaminated foods or beverages. Food may be contaminated by food preparers or handlers who have viral gastroenteritis especially if they do not wash their hands regularly after using the bathroom. Shellfish may be contaminated by sewage and persons who eat raw or undercooked shellfish harvested from contaminated waters may get diarrhea. Drinking water can also be contaminated by sewage and be a source of spread of these viruses.

Intestinal infections can flourish anywhere people congregate · from schools and dormitories to campgrounds and luxury cruise ships. Adults whose resistance is low · often because their immune systems are compromised by HIV AIDS or other medical conditions · are especially at risk as are children in child-care centers and older adults living in nursing homes.

The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. The affected person may also have headache low-grade fever and abdominal cramps ("stomach ache"). In general the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days depending on which virus causes the illness.

If you're an adult and can't keep liquids down for 24 hours if you're vomiting for more than two or three days or if you vomit blood or become dehydrated see your doctor. In addition seek medical care if you notice blood in your bowel movements or have a fever above 100 F.

Take your child to see a doctor immediately if he or she:

• has a temperature of 102 F or higher
• is lethargic or extremely irritable
• is in pain
• has bloody diarrhea
• is dehydrated

Take your baby to see a doctor immediately if he or she:

• hasn't had a wet diaper in three hours
• has bloody stools or severe diarrhea
• has a dry mouth or cries without tears
• is unusually sleepy drowsy or unresponsive

The most important goal of treating viral gastroenteritis in children and adults is to prevent dehydration the severe loss of water and essential salts and minerals. In extreme cases dehydration can be fatal.

Signs of dehydration include:

• excessive thirst
• dry mouth
• deep yellow urine or little or no urine
• severe weakness dizziness or lightheadedness

Healthy adults who drink enough water to replace fluids lost from vomiting and diarrhea are less likely to become dehydrated. Older adults those with suppressed immune systems and infants are most vulnerable.

Your doctor can give you specific instructions about what kinds of fluid to give to a patient. For infants and young children he may suggest oral rehydration solution (ORS) which will help replace electrolytes something that water alone will not do. Some parents keep this in their medicine chest at all times so they can give it to their child when diarrhea first occurs. ORS is available at pharmacies without a prescription. Follow the written directions on the ORS package and use clean or boiled water. Avoid giving your child apple juice for rehydration · it can make diarrhea worse.

Avoid medications including antibiotics (which have no effect on viruses) and other treatments unless specifically recommended by a healthcare professional.

• To help keep yourself more comfortable and prevent dehydration while you recover:
• Don't eat or drink for a few hours until your stomach has settled.
• Try sucking on ice chips or taking small sips of water. Once their stomach has settled adults should try to drink at least eight to 16 glasses of liquid every day taking small frequent sips.
• When you begin to eat again start with bland foods that are easy to digest for example soda crackers toast and bananas. Avoid dairy products and alcohol. Stop eating if your nausea returns.
• Get plenty of rest.

Use medications such as ibuprofen (Advil Motrin others) sparingly if at all. They can make your stomach more upset and make it harder for the body to eliminate the virus. Use acetaminophen (Tylenol others) cautiously. It sometimes can cause liver toxicity especially in children. Never give children or teenagers aspirin. It may cause Reye's syndrome a rare but potentially fatal disease. Avoid giving your child over-the-counter antidiarrheal medications such as Imodium unless advised by your doctor.

There is no vaccine or medicine currently available that prevents viral gastroenteritis. However you can reduce the risk of infection by:

• Washing your hands and your children's hands thoroughly.
• Not sharing eating utensils glasses and plates.
• Using separate towels in the bathroom.
• Avoiding close contact with anyone who has the virus if possible.
• Making sure child-care centers have separate rooms for changing diapers and preparing or serving food.

When you're traveling in other countries you can become sick from eating contaminated food or drinking water. To help reduce your risk:

• Drink only well-sealed bottled or carbonated water.
• Avoid ice cubes because ice cubes may be made from contaminated water.
• Use bottled water to brush your teeth. Avoid raw food · including peeled fruits raw vegetables and salads · that has been touched by human hands.
• Avoid undercooked meat and fish.

Additional Resources

It's In Your Hands

Water Tips

Travelers' Diarrhea (Health Canada)