Diarrhea and vomiting
In adults and children, diarrhea is defined as noticeably softer (or even liquid) and more frequent stools than usual. In infants, who often have soft stools, diarrhea is defined as a sudden increase in bowel movements. Along with nausea or vomiting, it is a gastroenteritis.
Gastroenteritis is an inflammation of the stomach and intestines, causing digestion trouble. It is a highly contagious infection. Most at risk are young children, older adults and people with a weakened immune system due to illness or medication.
Causes
Gastroenteritis is caused by viruses, bacteria or parasites. It is spread through contact with an infected person or a contaminated object, while consuming contaminated foods or drinks. Gastroenteritis can also spread while swimming.
Symptoms
Symptoms last from 1-3 days but can persist for 7-10 days. They include:
- Diarrhea, nausea, vomiting
- Abdominal cramping
- Low-grade fever
- Headache
- Loss of appetite
- Muscle aches
- Fatigue
Treatment
Gastroenteritis causes the body to eliminate significant amounts of water and essential mineral salts. The goal of treatment is to prevent dehydration. Commercial rehydration solutions are the ideal option, but adults can also drink broths, sports drinks and diluted fruit juices. Avoid alcohol, caffeine, soft drinks and undiluted fruit juices.
Eating is important. Start as soon as you can, with small portions. Increase portions gradually based on tolerance. Crackers, rice, pasta, lean meats, fish, eggs, fruit including bananas, cooked vegetables, sugar-free whole-grain bread and cereals, and yogurt are good options.
In babies and young children, consider eating habits to prevent dehydration:
- Feed smaller amounts of milk more often.
- Older children should eat based on their likes and tolerance. Avoid all sweetened beverages.
- Offer more than just plain water.
- If the child vomits breastmilk or is not breastfed, you could use an oral rehydration solution.
Electrolytes
Opt for commercial rehydration solutions (e.g., Pedialyte®). If unavailable, make your own.
Respect the exact quantities. Do not substitute any ingredient without first speaking to a health professional. This solution can be stored for 24 hours in the refrigerator:
| Ingredients | Quantity |
|---|---|
| Cooled boiled water | 2½ cups (600 mL) |
| Unsweetened orange juice | 1½ cups (360 mL) |
| Table salt | ½ teaspoon (2.5 mL) |
| Total | 4 cups (1 L) |
In the presence of diarrhea, rehydration solutions should be started quickly. Offer 5 to 15 mL of the solution every 5 to 15 minutes at first. You can then gradually increase if well tolerated. Use the table below as a guideline:
| Age | Amount to administer |
|---|---|
| 0-6 months | 30-90 mL/hour |
| 6-24 months | 90-180 mL/hour |
| > 2 years | 180-250 mL/hour |
Prevention
Here are a few recommendations to prevent the spread of gastroenteritis:
- Wash hands frequently, with soap and water and for 20 seconds minimum
- Sanitize hands with an alcohol-based gel only if washing with water and soap is not possible, as some viruses that cause gastroenteritis are less sensitive to it
- Decontaminate surfaces with bleach (toilet, sink, handles)
- When possible, avoid direct contact with an infected person
- Avoid swimming if you think you might have gastroenteritis
There is also a prescription vaccine against the rotavirus, which is mainly responsible for gastroenteritis in young children.
When should I see a health care professional?
Most cases do not require medical attention. However, you should consult your health care provider in the following cases:
- Diarrhea or vomiting for more than 48 hours or that is frequent and profuse
- Inability to drink or keep fluids down
- Fever (higher than 38°C) for more than 48 hours
- Bloody or black stools
- Severe abdominal pain
- Weakness, drowsiness, irritability, confusion
- Diarrhea during or after a trip abroad
- Signs of dehydration:
- Great thirst
- No urination for 6 to 8 hours (children and adults)
- No urination for 4 to 6 hours (infants)
- Lack of tears in a crying infant
- Darker urine
- Dry mouth and tongue
- Muscle cramps
- Sunken eyes, dizziness