Treatment for Stomach Virus
The primary treatment for viral gastroenteritis is oral rehydration therapy (ORT) to prevent and treat dehydration, as the illness is typically self-limited and resolves within a few days without specific antiviral treatment.1
General Management Principles
- Viral gastroenteritis is a self-limited illness typically lasting a few days, with virus replication restricted to the gut mucosa. The main risk is dehydration and electrolyte imbalance.1
- The cornerstone of treatment is maintaining adequate hydration through oral rehydration therapy (ORT).1, 2
- Most patients can be managed at home with appropriate fluid replacement.1
Rehydration Strategies
Oral Rehydration Therapy (ORT)
- ORT is the first-line treatment for both children and adults with mild to moderate dehydration.1, 2
- Commercial oral rehydration solutions containing appropriate glucose and electrolyte concentrations are effective.2, 3
- For adults, maintenance of good hydration is particularly important, especially among elderly patients and those on diuretic medications.1
- In a comparative study, solutions like Pedialyte, Gatorade, and other oral rehydration solutions were found to be effective in treating dehydration in adults with viral gastroenteritis.2
Intravenous Fluids
- Hospitalization and intravenous fluid therapy are only required for cases with severe dehydration or when the patient/caretaker cannot provide adequate oral rehydration.1
- Children with severe dehydration may require serum electrolyte, creatinine, and glucose measurements.3
Symptomatic Management
Anti-emetics
- For persistent vomiting that interferes with oral rehydration, ondansetron may be considered.4, 3
- Judicious use of ondansetron can increase the success of ORT and minimize the need for intravenous therapy and hospitalization.4, 3
- In one study, bismuth subsalicylate reduced the duration of Norwalk virus infection from 27 to 20 hours in adults.1
Nutritional Management
- Continue feeding during the illness - "feed through" approach.1
- Breast milk has a protective effect against enteric infections and should be continued in infants.1
- A mild, easily digestible diet can be offered as tolerated.2
- Temporary lactose intolerance may occur following rotavirus infection (typically lasting 10-14 days), but most infants completely recover.1
Special Considerations
Children
- Children have a higher risk of dehydration and respond well to ORT.1
- Lack of access to medical care, rather than disease virulence, is a principal risk factor for death from gastroenteritis.1
Elderly and Immunocompromised Patients
- Elderly patients require careful monitoring for dehydration.1
- Immunocompromised patients may experience more severe or prolonged illness and may require specialized care.1
Prevention Measures
- Vigorous handwashing with soap is necessary to control the spread of enteric pathogens.1
- Thorough cleaning of environmental surfaces contaminated with feces or vomitus is required.1
- Persons with symptoms should avoid preparing food for others and should be excluded from contact with susceptible individuals for at least 2 days after resolution of symptoms.1
- Soiled linens should be handled minimally and washed with detergent in hot water.1