From the Guidelines
Gastroenteritis is a self-limited illness that typically resolves within 1-3 days without antibiotics, and treatment should focus on preventing dehydration through oral rehydration solutions and maintaining adequate fluid and electrolyte intake. The symptoms of gastroenteritis include nausea, vomiting, watery diarrhea, abdominal cramps, and sometimes fever and headache, resulting from inflammation of the stomach and intestines usually caused by viral infections like norovirus or rotavirus, though bacteria and parasites can also be culprits 1.
Key Considerations
- The main risk associated with gastroenteritis is dehydration and electrolyte imbalance, as noted in a study from 1.
- Adults should drink at least 2-3 liters of fluids daily while ill to prevent dehydration.
- Over-the-counter medications like loperamide (Imodium) can help control diarrhea in adults, but should be avoided in children and cases with high fever or bloody stools.
- Anti-nausea medications such as ondansetron may be prescribed in severe cases.
- Medical attention is necessary if symptoms persist or worsen, including severe dehydration, bloody stools, persistent vomiting, high fever above 102°F (39°C), or symptoms lasting more than 3 days.
Prevention and Management
- General measures to reduce the incidence of acute infectious diarrhea include hand hygiene, proper food preparation and storage, avoidance of high-risk foods, and use of infection prevention and control measures in hospitals and public settings 1.
- The use of rotavirus vaccine in infants has been shown to significantly reduce the burden of acute gastroenteritis, not only in vaccinated individuals but also through community protection of unvaccinated individuals 1.
- Laboratory investigation is generally not warranted for most acute diarrhea episodes in previously healthy, immunocompetent people, as most cases are self-resolving and of viral or unknown etiology 1.
From the Research
Gastroenteritis Symptoms
- Gastroenteritis is characterized by rapid onset of diarrhoea with or without vomiting, nausea, fever, and abdominal pain 2
- Diarrhoea is defined as the frequent passage of unformed, liquid stools 2
- The main symptoms of gastroenteritis include:
- Diarrhoea
- Vomiting
- Nausea
- Fever
- Abdominal pain
Treatment and Management
- The mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration 2
- Oral rehydration therapy with a rehydration solution can be used to treat diarrhea in children with mild to moderate dehydration 3
- Ondansetron can decrease vomiting or help avoid the need for intravenous fluid, but it increases episodes of diarrhea 3
- Probiotics can be used to shorten the course of diarrhea 3
- A child's regular diet reduces the duration of diarrhea 3
Prevention
- Good handwashing reduces the incidence of acute gastroenteritis, but not rotavirus 3
- The introduction of two rotavirus vaccines in the United States in 2006 significantly reduced the incidence of rotavirus gastroenteritis 3
- Rotavirus vaccines have strong safety records, despite a minimal incidence of intussusception 3
Oral Rehydration Solutions
- Pedialyte and Gatorade are advocated for the treatment of dehydration in viral gastroenteritis, but there is limited evidence to support their use 4
- A new oral rehydration solution (N-ORS) seems to be as effective as Pedialyte in correcting dehydration and in improving bowel symptoms 4
- Gatorade and N-ORS may be effective in the treatment of dehydration associated with mild viral gastroenteritis 4