Gastroenteritis,or inflammation of the stomach and intestine, is a very common reason for a consultation at this time of year, especially in families with children
The cause may be infectious (viral) or from food poisoning after eating poorly prepared food. Most of the time the cause is viral, however, in bacterial gastroenteritis, Campylobacter is the most common bacterial cause in our country. The bacteria are transmitted as a result of eating chicken, eggs or dairy produce, or, less frequently, it can be transmitted from person to person or in water.
- General malaise
- Frequent liquid stools
- Vomiting
- Fever
- Stomach cramps
- Dehydration in severe cases
Those who have it should avoid very little, eating whatever they can tolerate. The sooner you begin to eat, the more quickly the intestinal mucosa recovers.
You should only avoid ultra-processed foods, sweets and high-sugar juices or cola-type soft drinks. These drinks make diarrhoea worse due to something called “osmotic diarrhoea,” this is when the body pushes water into the digestive tract to dilute the fluids we have consumed with a high sugar content, making diarrhoea worse.
Unless medically directed, stopping your intake of lactose is not recommended. This practice causes the lactase enzyme in the intestine that digests lactose to stop working, when lactose is then reintroduced rebound diarrhoea is triggered.
Children should be rehydrated very slowly, giving small amounts (sips of water or from a spoon) so as not to trigger vomiting.
In most cases, treatment is symptomatic:
- Paracetamol for discomfort, fever and abdominal pain.
- Probiotics to restore intestinal microbiota.
- Oral rehydration solutions: these contain all the salts and sugars our body needs in the correct amounts. They can be used to prevent dehydration if diarrhoea and vomiting are severe. Sports drinks should not be used.
- Antiemetics such as domperidone or metoclopramide, only if vomiting is very frequent and when medically prescribed.
- Anti-diarrhoea drugs such as loperamide: these are not recommended except in specific situations and may cause complications.
- Most patients do not benefit from taking antibiotics except in specific cases: when there is a bacterial cause requiring treatment, in patients who have poor general health or, in those who are immunocompromised.
If symptoms persist over time and there is a deterioration in general health, it may be necessary to undergo laboratory tests to rule out complications such as dehydration or involvement of organs such as the kidneys.
Stool analysis (stool culture) may also be required to rule out a bacterial cause or intestinal parasites.
Warning signs that should alert you to seek medical attention include a fever that is difficult to control at home, deterioration in general health, difficulty tolerating fluids, dry skin and mouth, sunken eyes with dark circles or passing less urine.
Special caution must be taken with young children and the elderly who are at a higher risk of dehydration.
How is it prevented?
- Correct hand washing: most of these infections are spread by our hands!
- Proper handling and washing of food (especially fruit and vegetables).
- Do not drink straight from rivers or sources of water unsuitable for drinking.
- We currently have an oral vaccine for one of the viruses that most commonly cause gastroenteritis, rotavirus. The vaccine is given at the age of two months and four months.
Dra. Cristina Garrido
Family Medicine
July 1, 2022
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