Gastroenteritis and the Queen - should it be headline news?

The Queen has gastroenteritis and it's all over the headlines - is it just another slow news day or should we be concerned?

Probably neither. Her Majesty is in remarkable health for her age, and her working schedule at the age of 86 would put many 26-year-olds to shame. This story has probably been so prominent for three reasons:

Firstly, the queen hasn't been admitted to hospital since ten years ago, when she needed knee surgery. We have had a stream of royal illnesses in recent months, from the Duke of Edinburgh's urine infection to the Duchess of Cambridge's pregnancy-related vomiting. But any reminder that the most senior member of the royal family, too, is human is always going to be news.

Secondly, like the Duke of Edinburgh, Her Majesty has shown astonishing dedication to her role. She will almost certainly have resisted anything that meant cancelling her engagements, and the media are understandably concerned that only a serious medical problem would force our monarch to admit defeat. If it is gastroenteritis, she should be back on her feet in days. But could it be more?

Thirdly, this may be a reminder that while she may seem ageless, she is getting more vulnerable as she gets older. Gastroenteritis is remarkably common - about one in five Britons are affected every year - and most recover completely within days. But the very old, like the very young, are vulnerable to dehydration, the biggest complication of gastroenteritis.

Most older patients have decline in the function of their kidneys. Dehydration can cause dizziness, weakness, headache, muscle cramps and much more. In severe cases it can cause damage to the kidneys, which is much more serious in people with underlying kidney disease.

The other group particularly at risk of dehydration are pregnant women - and in just the last two months the Duchess of Cambridge has been admitted to hospital with hyperemesis gravidarum. The cause is different - in one a gastrointestinal infection and in the other probably hormonal changes of pregnancy. The big risk to health - dehydration - is the same.

Her Majesty will almost certainly be getting fluid replacement through a drip, and having regular blood tests to check her kidneys are coping. It's possible she may have other tests to exclude a more serious cause for her symptoms, but nothing the Palace has said suggests there is cause for concern.

Of course, the Queen will no doubt be all too well aware that her condition is infectious, and that she should avoid contact with anyone non-essential until at least two days after her symptoms have settled. There is every reason to believe that Her Majesty will be out of hospital in a day or two, but she is very wise to avoid public engagements for longer. Catching gastroenteritis might be one memento too many of an audience with the Queen!

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