Viral gastroenteritis Health Article

Definition

Viral gastroenteritis is inflammation of the stomach and intestines caused by a virus. The infection can lead to diarrhea and vomiting. It is sometimes called the "stomach flu."

Alternative Names

Rotavirus infection; Norwalk virus; Gastroenteritis - viral; Stomach flu

Causes, incidence, and risk factors

Viral gastroenteritis is a leading cause of severe diarrhea in both adults and children. Many types of viruses can cause gastroenteritis. The most common ones are:

• Astrovirus
• Enteric adenovirus
• Norovirus (also called Norwalk-like virus). It is common among school-age children.
• Rotavirus, the leading cause of severe gastroenteritis in children. It can also infect adults exposed to children with the virus. Outbreaks may also occur in nursing homes.

These viruses are often found in contaminated food or drinking water. Symptoms of viral gastroenteritis usually appear within 4 - 48 hours after exposure to the contaminated food or water.

Those with the highest risk for severe gastroenteritis include the young, the elderly, and people who have suppressed immune systems.

Symptoms

• Abdominal cramping
• Abdominal pain
• Diarrhea
• Nausea
• Vomiting

Additional symptoms may include:

• Chills
• Clammy skin
• Excessive sweating
• Fever
• Joint stiffness
• Leakage (incontinence) of stool
• Muscle pain
• Poor feeding
• Vomiting blood (very rare)
• Weight loss

Signs and tests

Your health care provider will look for signs that your body does not have enough water (dehydration). These include:

• Dry or sticky mouth
• Lethargic or comatose (severe dehydration)
• Low blood pressure
• Low or no urine output; concentrated urine appears dark yellow
• Markedly sunken soft spots (fontanelles) on the top of an infant's head
• No tears
• Sunken eyes

Tests that examine stool samples may be used to identify the specific virus. This is usually not needed for virus gastroenteritis. A stool culture may be done to identify a bacterial cause for diarrhea.

Treatment

The goal of treatment is to prevent dehydration by making sure the body has as much water and fluids as it should. Fluids and electrolytes (salt and minerals) lost through diarrhea or vomiting must be replaced by drinking extra fluids. Even if you are able to eat, you should still drink extra fluids between meals.

• Older children and adults can drink sports beverages such as Gatorade, but these should not be used for children. Instead, use the effective electrolyte and fluid replacement solutions or freezer pops available in food and drug stores.
• Do NOT use fruit juice (including apple juice), sodas or cola (flat or bubbly), Jell-O, or broth. All of these have a lot of sugar, which makes diarrhea worse, and they don't replace lost minerals.
• Drink small amounts of fluid (2-4 oz.) every 30-60 minutes, rather than trying to force large amounts at one time, which can cause vomiting. Use a teaspoon or syringe for an infant or small child.
• Breast milk or formula can be continued along with extra fluids. You do NOT need to switch to a soy formula.

Food may be offered frequently in small amounts. Suggested foods include:

• Cereals, bread, potatoes, lean meats
• Plain yogurt, bananas, fresh apples
• Vegetables

People with diarrhea who are unable to drink fluids because of nausea may need intravenous (directly into a vein) fluids. This is especially true in small children.

Antibiotics do not work for viruses.

Drugs to slow down the amount of diarrhea (antidiarrheal medications) should not be given without first talking with your health care provider. They may cause the infection to last longer. DO NOT give these anti-diarrheal medications to children unless directed to do so by a health care provider.

People taking water pills (diuretics) who develop diarrhea may be told by their health care provider to stop taking the diuretic during the acute episode. However, DO NOT stop taking any prescription medicine without first talking to your doctor.

The risk of dehydration is greatest in infants and young children, so parents should closely monitor the number of wet diapers changed per day when their child is sick.