Stomach Flu (Gastroenteritis )

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What is the treatment for the stomach flu (gastroenteritis)?

Most people with the stomach flu require no formal treatment. The key to a rapid and safe recovery at home (home remedy) is proper hydration. If dehydration occurs, the patient should be evaluated by a doctor. Many health care professionals choose to begin IV fluids, the treatment of choice for rapid rehydration.

Other medications may be prescribed to reduce the symptoms of gastroenteritis. To reduce vomiting, promethazine (Phenergan), prochlorperazine (Compazine), or ondansetron (Zofran) are often used. Some physicians suggest using these agents only as a suppository or rapidly disintegrating tablet on the tongue since patients may vomit the pills up. Others may prescribe diphenoxylate and atropine (Lomotil) or lopermadine (Imodium) to slow diarrhea while others do not as the drugs may prolong the disease in some individuals. Many doctors recommend no medical treatment for gastroenteritis symptoms as all of the drugs have side effects and if the patient stays well hydrated, the symptoms usually stop soon anyway.

As the gastroenteritis symptoms abate, especially vomiting, doctors may recommend a BRAT diet (bananas, rice, apples and toast) for a day or two before returning to the patient's regular diet. Potatoes, lean meat like chicken and whole grains can help replace nutrients and electrolytes lost with diarrhea.

Patients who have more serious symptoms or other symptoms in addition to gastroenteritis need to be evaluated, diagnosed, and treated by a physician because the patient will likely have a specific disease that will need treatment. The treatment will depend on the cause of the illness (for example, salmonellosis or Clostridium difficile toxin). Antibiotics and other treatments may not be recommended for some of these diseases so an accurate diagnosis of the disease is important. For Clostridium difficile infected patients, antibiotic sensitivity testing may need to be done to determine the most effective antibiotics to use.

Which specialties of doctors treat the stomach flu (gastroenteritis)?

Most individuals with viral or mild bacterial caused gastroenteritis require no treatment or can be treated by the patient's primary care provider or pediatrician. For more patients with more severe gastroenteritis, such infectious disease specialists, gastroenterologists, emergency medicine specialists, allergists, critical-care physicians, and hematologists may be consulted.

When should I call my doctor for stomach flu (gastroenteritis)?

If gastroenteritis symptoms last more than about 5 days, increase in severity (fever of 101 F or 38.33 C or higher), or a person develops bloody diarrhea, dehydration, constant abdominal pain or other symptoms see a physician. The patient may have some gastroenteritis symptoms but may have a disease more serious than self-limiting gastroenteritis. Signs and symptoms of dehydration may include decreased or no urine production, dry mucus membranes, dry mouth or skin, no tears, weakness, lightheadedness and low blood pressure, while children may show little or no urination, become lethargic, have skin that "tents up" when pinched. Signs of dehydration in anyone are good reasons to see a doctor immediately.

What are complications of stomach flu (gastroenteritis)?

Most patients who get gastroenteritis have no complications and will completely recover. The major complication for some patients is dehydration; infants, children, the elderly and immunosuppressed are at higher risk for this complication. In many third world countries, hydration of infants is difficult at best so there are many infant deaths worldwide due to dehydration caused by gastroenteritis.

Can you prevent from getting the stomach flu (gastroenteritis)?

There is no diet that will prevent gastroenteritis but food preparation plays a strong role in preventing gastroenteritis. In general, there are some actions people can do to prevent or reduce the chance of getting gastroenteritis, including:

  • Hand washing, especially before eating and after any close association with an infected person or items (clothing, bedding, toys) they have touched
  • Launder items daily that infected persons wear
  • Avoid direct contact with infected individuals when possible
  • Do not eat undercooked foods, especially meats
  • Do not eat raw foods or drink untreated water
  • Do not drink untreated or unpasteurized fluids, especially milk
  • Thoroughly wash any produce, especially in third world countries, before eating
  • While traveling, avoid all raw foods and ice; drink only from sealed bottled products and use bottled water for tooth brushing

There is a vaccine available against rotavirus that has reduced this infection in children. Also, there is a vaccine available against cholera-causing bacteria (Vibrio), but it is not widely available. A clinical trial of a Norovirus vaccine was done with some success. It is likely in the near future commercial vaccines against some causes will be available.

What is the prognosis for a person who gets the stomach flu (gastroenteritis)?

The prognosis (outlook) for complete recovery is excellent in most people infected with viral and bacterial caused gastroenteritis, as long as the person keeps well hydrated. Because infants, children, pregnant women, and adults that are elderly or immunosuppressed, usually dehydrate faster than healthy adults and sometimes are more difficult to rehydrate orally, their prognosis can range from excellent to poor. Their prognosis depends on how dehydrated they become and how effective are the attempts to rehydrate the patient.

The prognosis for those patients that develop gastroenteritis symptoms as part of a specific disease process (for example, shigellosis) vary from good to poor, depending on the severity of the specific disease process.

REFERENCES:

Churgay , C.A., MD., et al. "Gastroenteritis in Children: Part II. Prevention and Management." Am Fam Physician. 2012 Jun 1;85(11):1066-1070.
<http://www.aafp.org/afp/2012/0601/p1066.html>

Diskin, A., MD. "Emergent Treatment for Gastroenteritis." Medscape. Updated: Jan 02, 2015.
<http://emedicine.medscape.com/article/775277-overview#a0199>

Hall, A.J., et al. "Norovirus." Centers for Disease and Prevention; Yellow Book; Chapter 3.
<http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/norovirus>

Tablang, M.V.F., MD. "Viral Gastroenteritis." Medscape. Updated: Dec 14, 2014.
<http://emedicine.medscape.com/article/176515-overview>

Medically Reviewed by a Doctor on 11/21/2016
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