Diarrhea and vomiting

Diarrhea is defined as the passage of three or more loose or watery stools within a 24-hour period in adults and children, and an increase in stool frequency to twice the usual number per day in infants. It can be the result of an illness, an infection or a side effect of certain medications.

Gastroenteritis is an inflammation of the lining of the stomach and intestines, resulting in digestive problems. It is a highly contagious and very common infection. The risk of contracting gastroenteritis is greater in young children, older adults and persons with immune systems weakened by medication or disease.

Causes of gastroenteritis

Gastroenteritis can be caused by a virus, a bacteria or a parasite. Viral gastroenteritis is the most common form of the illness. It is spread by touching an infected person or object or by consuming contaminated food or drink. People are contagious from the moment symptoms occur until approximately 48 hours after their symptoms disappear. Food poisoning can also cause gastroenteritis.

Symptoms of gastroenteritis

Symptoms of gastroenteritis last from 1 to 3 days, but can persist as long as 7 to 10 days in some cases. The most common symptoms are:

• diarrhea, nausea and vomiting;
• abdominal cramping;
• low-grade fever (about 38°C);
• headache;
• muscle aches;
• fatigue.

When to seek help

Most cases of gastroenteritis do not warrant a trip to the doctor's office. However, if you have one or more of the following signs or symptoms, you should consult a healthcare professional:

• diarrhea or vomiting that lasts more than 48 hours or that is frequent and profuse;
• inability to drink or to keep fluids down;
• fever (greater than 38°C) for more than 48 hours;
• bloody or black stools;
• severe abdominal pain;
• signs of dehydration (increased thirst, decreased urination or darker coloured urine, dry mouth and tongue, muscle cramps, sunken eyes, dizziness, lack of tears in a crying infant and sunken fontanelles (membrane-covered "soft spot" on the top of the head);
• weakness, drowsiness, irritability, confusion;
• diarrhea that started during or after returning from a trip abroad.

Treating gastroenteritis

When you have gastroenteritis, the body eliminates significant amounts of water and mineral salts that are essential to the proper functioning of the body. The goal of treatment therefore involves replenishing the body and avoiding dehydration. Adults can drink broths, sports drinks and diluted fruit juices. In some more severe cases, rehydration solutions may be a better option. Avoid alcohol and caffeine, as they promote the loss of water and mineral salts, as well as soft drinks and undiluted fruit juices.

Eating is important during a bout of gastroenteritis. Start by eating small portions often throughout the day, and increase your portion sizes gradually based on your tolerance. Foods such as saltine crackers, soup, rice, noodles and bananas are all good options.

In babies and young children, the approach to avoiding dehydration should take eating habits into consideration:

• Continue to breastfeed. If the child can only ingest small amounts, nurse them more often.
• If the child is not breastfed, continue to give them milk in smaller amounts, but more often.
• Children who are older should continue to eat based on their likes and tolerance. Juices, soft drinks and Gatorade-type beverages however, should be avoided.
• If a child presents signs of dehydration, offer small amounts of fluids very often. Give them more that just plain water. If the child vomits breastmilk or is not breastfed, oral rehydration solutions may be used.

Electrolyte solution for diarrhea
Commercial preparations (e.g., Pedialyte or Gastrolyte) are the best choice. They contain the proper amount of mineral salts needed by the body. If you do not have ready access to these types of preparations, you can resort, at least temporarily, to making a "homemade" version.

When preparing the solution, strict adherence to each ingredient and amount is important. Do not substitute any ingredient without first speaking to a health care professional. The following solution can be stored for 12 hours at room temperature or for 24 hours in the refrigerator:

When diarrhea is present, rehydration solutions should be started quickly, especially in children and seniors. The table below can be used as a guideline for the amount to administer a child with diarrhea who is not breastfed:

Preventing gastroenteritis

To prevent the spread of gastroenteritis, wash your hands with soap and water, especially before eating or preparing food and after using the toilet. Use bleach to clean objects that have come into contact with diarrhea or vomit, such as the toilet and sink. Lastly, avoid direct contact with an infected person as much as possible.

Other tips could be of use or more suited to your situation. Do not hesitate to contact your healthcare provider.