When should I seek medical advice?
Seek medical advice in any of the following situations, or if any other symptoms occur that you are concerned about:
- If you suspect that you are becoming lacking in fluid in the body (dehydrated).
- If you are being sick (vomiting) a lot and unable to keep fluids down.
- If you have blood in your diarrhoea or your sick (vomit).
- If you have severe tummy (abdominal) pain.
- If you have severe symptoms, or if you feel that your condition is getting worse.
- If you have a persisting high temperature (fever).
- If your symptoms are not settling - for example, vomiting for more than 1-2 days, or diarrhoea that does not start to settle after 3-4 days.
- Infections caught abroad.
- If you are elderly or have an underlying health problem such as diabetes, epilepsy, inflammatory bowel disease, or kidney disease.
- If you have a weakened immune system because of, for example, chemotherapy treatment, long-term steroid treatment, or HIV infection.
- If you are pregnant.
What options are there for treatment of gastroenteritis?
Symptoms often settle within a few days or so as your immune system usually clears the infection. Occasionally, admission to hospital is needed if symptoms are severe, or if complications develop.
The following are commonly advised until symptoms ease.
Fluids - have lots to drink
If you suspect that you are dehydrated, you should contact a doctor.
- As a rough guide, drink at least 200 mls after each bout of diarrhoea (after each watery stool).
- This extra fluid is in addition to what you would normally drink. For example, an adult will normally drink about two litres a day but more in hot countries. The above advice of 200 mls after each bout of diarrhoea is in addition to this usual amount that you would drink.
- If you have been sick (vomited), wait 5-10 minutes and then start drinking again but more slowly. For example, a sip every 2-3 minutes but making sure that your total intake is as described above.
- You will need to drink even more if you are dehydrated. A doctor will advise on how much to drink if you are dehydrated.
For most adults, fluids drunk to keep hydrated should mainly be water. It is best not to have drinks that contain a lot of sugar as they can sometimes make diarrhoea worse.
Rehydration drinks are recommended for people who are frail, or over the age of 60, or who have underlying health problems. They are made from sachets that you can buy from pharmacies. (The sachets are also available on prescription.) You add the contents of the sachet to water. Rehydration drinks provide a good balance of water, salts and sugar.
The small amount of sugar and salt helps the water to be absorbed better from the gut (intestines) into the body. They do not stop or reduce diarrhoea. Home-made salt/sugar mixtures are used in developing countries if rehydration drinks are not available but they have to be made carefully, as too much salt can be dangerous. Rehydration drinks are cheap and readily available in the UK and are the best treatment.
Antisecretory medicines are designed to be used with rehydration treatment. They reduce the amount of water that is released into the gut during an episode of diarrhoea.
Eat as normally as possible
It used to be advised to not eat for a while if you had gastroenteritis. However, now it is advised to eat small, light meals if you can. Be guided by your appetite. You may not feel like food and most adults can do without food for a few days. Eat as soon as you are able - but don't stop drinking. If you do feel like eating, avoid fatty, spicy or heavy food at first. Plain foods such as wholemeal bread and rice are good foods to try eating first.
Antidiarrhoeal medicines are not usually necessary. However, you may wish to reduce the number of trips that you need to make to the toilet. You can buy antidiarrhoeal medicines from pharmacies. The safest and most effective is loperamide. The adult dose of this is two capsules at first. This is followed by one capsule after each time you pass some diarrhoea up to a maximum of eight capsules in 24 hours. It works by slowing down your gut's activity. You should not take loperamide for longer than five days.
Note: do not give antidiarrhoeal medicines to children aged less than 12 years. Also, do not use antidiarrhoeal medicines if you pass blood or mucus with the diarrhoea or if you have a high temperature (fever). People with certain conditions should not take loperamide. Therefore, read the leaflet that comes with the medicine to be safe. For example, pregnant women should not take loperamide.
As explained, if symptoms are severe, or continue for more than several days, your doctor may ask for a sample of the diarrhoea. This is sent to the laboratory to look for infecting microbes (bacteria, parasites, etc). Sometimes an antibiotic or other treatments are needed if certain bacteria or other infections are found to be the cause. Antibiotics are not needed for gastroenteritis caused by viruses and may even make things worse.
Further reading and references
Freeman MC, Stocks ME, Cumming O, et al; Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Health. 2014 Aug19(8):906-16. doi: 10.1111/tmi.12339. Epub 2014 May 28.
Acute diarrhoea in adults: racecadotril; NICE Evidence Summary New Medicine, March 2013
Gastroenteritis; NICE CKS, July 2015 (UK access only)
Here are my symptoms:Gas and frequent burping Burping and tasting food eaten hours before Bloating and distension that's lasts a while Gurgling noises in abdomen Indigestion - upset stomach, diarrhea...farah41194
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