Acute Gastroenteritis Shouldn’t Be Winter’s Fate

In two thirds of the cases, gastroenteritis is due to an infection by a virus such as a rotavirus, a norovirus, an adenovirus … In a third of the cases, it is a bacterium.

What is acute gastroenteritis?

Acute gastroenteritis is essentially a sudden diarrhea that is usually accompanied by nausea, vomiting, stomach pain (“abdominal pain”) like cramps, usually against a background of fever or even dehydration.

What is acute diarrhea?

Diarrhea is defined by stool emissions, liquid or pasty, of various colors which are above all “daily, too frequent and too abundant” (weight greater than 300 g / d in adults).

This diarrhea is the immediate and effective response that our body has to quickly get rid of the virus. It should not be feared and considered as the best “natural remedy” for the disease. While understanding that, whatever the diarrhea, the body loses a lot of water which must be replaced.

In practice, we speak of diarrhea when there are more than three loose or liquid stools per day. Acute diarrhea usually lasts less than 8-10 days. It is preceded by a normal transit and does not recur in the short term.

What are the causes of acute gastroenteritis?

The main causes of acute gastroenteritis are viral (rotavirus most often), bacterial (the bacterium itself or its toxin), parasitic or medicinal (antibiotics).

More than 10% of people who take antibiotics may suffer from diarrhea. This is most often benign, scarce and transient. It is most often due to a decrease in the fermentation capacity of the colon. It is only if it is prolonged that one must look for the selection of a dangerous bacterium in the colon, especially Clostridium difficile.

How do you get gastroenteritis?

The transmission of gastroenteritis of infectious origin occurs by direct contact with a sick person or indirectly by ingestion of food or water contaminated by a sick person, or by contact with objects or hands on which are deposited fine particles of stool from sick people (“manual infection”).

Gastroenteritis is therefore favored by community life and collective catering. Epidemics of rotavirus gastroenteritis occur each year in December-January-February.

Can it get complicated?

Viral gastroenteritis usually lasts less than three days and does not recur in the short term. Bacterial diarrhea can last up to two weeks. During acute diarrhea, especially if it is accompanied by vomiting, complications such as dehydration may appear. This risk is particularly common in infants, the elderly, or those with chronic illnesses.

A rare complication in infants and very young children in case of viral gastroenteritis is the occurrence of an “acute intestinal intussusception” which corresponds to an intestinal obstruction: it occurs when intestinal loops collapse and an intestinal segment penetrates in the downstream intestinal segment. It’s a surgical emergency.

When should you consult a doctor?

The diagnosis of banal acute gastroenteritis does not generally require the doctor and the pharmacist can provide the products necessary for its management.

However, you must consult a doctor during the day if it is a baby under 3 months and if the baby repeatedly vomits and no longer takes his bottle, and especially in the event of dehydration: mouth and tongue dry, feeling thirsty, weight loss, appearance of a skin fold (when it is slightly pinched, the skin keeps the fold and is slow to regain its initial appearance), low emission of concentrated urine, dull look and sunken eyes and, finally, if the diarrhea lasts more than 2 days, if it is accompanied by a high fever and if there is blood or mucus in the stools.

When should you see a doctor urgently?

It is necessary to consult a doctor in emergency if the dehydration causes a weight loss which exceeds 5% of the body weight and is accompanied by a marked skin fold and disturbances of consciousness (malaise, dizziness…) and behavior (agitation or on the contrary prostration and apathy). It is then a case of severe dehydration and it is urgent to consult.

If the diarrhea occurs after returning from a trip to a tropical country, you should also consult an emergency doctor to find a malaria attack that can lead to acute diarrhea.

What to do in adults with gastroenteritis?

In most cases, acute diarrhea can be managed at home, especially if the condition is recent and does not prevent drinking.

To relieve pain and limit diarrhea, it is possible to take medicines available without a prescription, such as intestinal dressings (clay, etc.) or transit retarders.

There are a few dietary measures that need to be associated with it: you should drink more than usual, especially drinks containing sugar and salt (sugar water, vegetable broths) to compensate for the water and salt losses linked to diarrhea. It is necessary to take smaller but more frequent meals, consisting of salty foods, rich in sugars and without residues (rice, pasta, cooked carrots). With the exception of bananas, it is better to avoid raw fruits and vegetables, frozen drinks. Sodas are not really contraindicated but are often poorly tolerated. It is less difficult to tolerate them by removing the gas a little.
Acute diarrhea is, most of the time, viral in origin and does not require antibiotics. Antibiotic treatment is only justified if the bacterial cause of diarrhea has been established by a laboratory stool examination or in the event of a complication.

What to do in case of gastroenteritis in children?

In infants, you should avoid giving baby formula during diarrhea, however, it is possible to breastfeed. In the absence of breastfeeding, only give rehydration fluids for six hours (ad libitum).

There are balanced rehydration solutions in pharmacies that are adapted to the needs of infants. The prepared solution should be stored in the refrigerator for up to 24 hours. It can be given cold because it calms vomiting.

You should start by administering 5 to 15 ml each time, several times an hour, in small sips or with a spoon. In babies from 0 to 6 months, we typically give between 30 to 90 ml per hour. From 6 months to 2 years, 90 to 120 ml per hour. If the child starts vomiting again, take a 30-60 minute break and start the sequence over again (always giving 5-15 ml each time).

When the baby is better, it is then possible to use lactose-free milk for a few days.

When a child 2 years of age or older, suffers from diarrhea, the most important thing is to avoid dehydration and the loss of mineral salts. Therefore, never rehydrate a child with pure water, as he could not tolerate it well: you must ensure that he drinks regularly and more than usual drinks containing sugar and salt (sugar water, vegetable broths or rehydration fluids) to compensate for water and salt losses linked to diarrhea.

It is then necessary to give him smaller, but more frequent meals, composed of salty foods, rich in sugars and without residues which have an anti-diarrheal effect (rice, pasta, cooked carrots). With the exception of bananas, it is better to avoid raw fruits and vegetables, frozen drinks.

Sodas are not really contraindicated but are often poorly tolerated. When traveling, when you have nothing else, you can use them by improving their tolerance by removing a little gas.

Intestinal dressings (clays, etc.) or transit retarders can be given in older children (8 years old for loperamide but without limitation for rececadortil). Acute diarrhea is, most of the time, viral in origin and does not require antibiotics.
When the diarrhea stops, you should reintroduce the usual food gradually, in three to four days.

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