Diarrhea, vomiting, stomach cramps: gastroenteritis is very common and almost always settles on its own. The one real danger is dehydration, above all in babies and older adults. Here is how to respond, and when to see a doctor.
What is gastroenteritis?
Gastroenteritis is an acute inflammation of the digestive tract, almost always caused by a virus — rotavirus in young children, norovirus in adults. It spreads very easily from person to person, through hands and surfaces, and through contaminated water or food.
It usually lasts two to four days. The heart of the treatment is replacing the fluid and salts that are being lost, rather than stopping the diarrhea at all costs: the diarrhea is part of how the body clears the virus.
The symptoms
- sudden diarrhea, sometimes profuse;
- vomiting, often the main problem in the first few hours;
- cramps or pain in the abdomen;
- a mild fever, chills and headache;
- tiredness caused by the loss of fluid and salts.
Black stools, mucus or blood in the stools, or a high fever that keeps going fall outside this usual picture and warrant medical advice.
Recognising dehydration
This is the thing to keep an eye on, particularly in babies, older adults and people with diabetes:
- a dry mouth and tongue, and intense thirst;
- passing little urine, or dark urine — in a baby, fewer wet nappies;
- sunken eyes, crying without tears, a sunken fontanelle in an infant;
- rapid weight loss, unusual drowsiness, difficulty getting up.
In Israel the heat speeds up dehydration considerably: a child who is vomiting on a summer day needs watching more closely than in winter.
What to do at home
Drinking small amounts often works better than a large glass all at once, especially when there is vomiting: a few sips every five to ten minutes. Oral rehydration solutions sold in pharmacies are clearly better than water alone in children, because they provide salt and sugar in the right proportions.
Food can be started again as soon as the vomiting eases off, with no strict diet: rice, pasta, banana, apple sauce, carrot, bread. In a baby, breastfeeding or the usual formula should never be interrupted. Very sweet drinks and fizzy drinks make the diarrhea worse.
Medicines that stop diarrhea are not suitable for children, nor when there is fever or blood in the stools. They should not be taken without medical advice.
When to see a doctor
- in a baby under six months, or as soon as vomiting prevents any drinking at all;
- when there are signs of dehydration, or unusual drowsiness;
- if there is blood in the stools, a persistent high fever, or severe pain fixed in one part of the abdomen;
- if diarrhea lasts more than three days in an adult, or 48 hours in a child;
- after a trip abroad, or in anyone frail, immunocompromised or elderly.
Pain that settles in the lower right side of the abdomen, particularly without diarrhea, should not be put down to a stomach bug: it needs to be examined.
Keeping the rest of the family well
Washing hands with soap and water — alcohol gels work poorly against these viruses — after using the toilet and before preparing food is by far the most useful measure. Avoid sharing towels and cutlery, and clean bathroom and toilet surfaces. Anyone who has been ill should wait 48 hours after the symptoms stop before cooking for others.
Seeing Dr Nathalie Gozlan
Dr Nathalie Gozlan, a family physician, can see you quickly for gastroenteritis — as a home visit in the Sharon region (Netanya, Kfar Saba, Raanana, Kadima-Tzoran and the moshavim and kibbutzim nearby), or by telemedicine anywhere in Israel, in French, Hebrew and English.
The main purpose of the consultation is to assess how dehydrated you are, adjust the rehydration and decide whether an examination in person or further tests are needed.
Frequently asked questions
How long does gastroenteritis last?
Vomiting usually settles within 24 hours and the diarrhea within two to four days. Tiredness and unsettled bowels can linger for a few more days, which is not a cause for concern.
Should I stop eating?
No. Going without food for long delays recovery. The priority is to drink, then to go back to simple foods as soon as possible. In a baby, breastfeeding and bottle feeds are never suspended.
When are antibiotics needed?
Almost never: the great majority of cases of gastroenteritis are viral. Antibiotics are kept for certain confirmed bacterial infections, with a high fever or blood in the stools, and only on a doctor's advice.
Can gastroenteritis be managed by telemedicine?
Yes, to assess how severe it is, guide the rehydration and prescribe if needed. In a baby, or when there are signs of dehydration, a physical examination is essential and a home visit is then offered.
This article is for information only and does not replace a medical consultation. If in doubt or in an emergency, see a doctor.