Viral gastroenteritis - Diagnosis, Treatment, Complications and Prevention

Diagnosis, treatment, complications and prevention of viral gastroenteritis or stomach flu.

Gastroenteritis is the inflammation of the gastrointestinal tract lining, and is characterised by diarrhea or vomiting. Worldwide, gastroenteritis affects 3 to 5 billion children every year, and accounts for 1.5 to 2.5 million deaths per year or 12% of all deaths among children less than five years of age.[1] Aged persons, as well as individuals having a weak immune system are also vulnerable to the condition.

Viruses are responsible for most episodes of acute gastroenteritis in infants and children. Viral gastroenteritis, commonly known as stomach flu, is a highly infectious disease. It spreads via contaminated food and water, improper hygiene and sharing personal belongings like towels, handkerchief, etc. of the affected person. Many species of the virus cause viral gastroenteritis. Stomach flu in children is most commonly caused by rotavirus, while norovirus is the most common causative organism in adults.

Diagnosis

Diagnosis of viral gastroenteritis is based on symptoms and a physical examination. Viruses are suspected to be the causative organisms of acute gastroenteritis when the vomiting is prominent, and there is a presence of mild fever and non-bloody, watery diarrhea. An epidemic in the community is also an indication of the condition. A stool test may be advised in some to rule out a bacterial or parasitic infection. A stool test can also help detect rotavirus or norovirus.

Treatment

Viral gastroenteritis is usually self-limiting. It gets better within a week without medications. Mild to moderate dehydration is treated with oral rehydration therapy. Oral rehydration solution (ORS), a mixture of water, sugar and salt, helps replace the lost fluids and electrolytes. Antiemetics are not routinely recommended, but if vomiting prevents the use of oral rehydration, antiemetics may be prescribed. Intravenous fluid therapy may be advised in patients with severe dehydration, shock, and decreased consciousness. A nutrient-rich diet must be continued to be given. Breastfeeding must be continued in breast-fed infants. The World Health Organisation recommends zinc supplements for acute gastroenteritis. It helps reduce the duration and severity of diarrhea.[2]

Some self-care measures can help control the situation and aid early recovery. Let the stomach settle. Stop consuming solid foods for a few hours. Gradually start to eat easy-to-digest foods. Avoid dairy products, caffeine and fatty foods. Drink plenty of water and get plenty of rest.

Complications

Viral gastroenteritis is often self-limited. But excessive diarrhea can lead to dehydration. Children in developing countries are particular at risk of severe dehydration that can result in hospitalisation or even death. Malnourished children and people with impaired immunity are most at risk of complications.

Prevention

Interventions to prevent viral gastroenteritis include the following:

• Maintain personal and food hygiene
• Wash your hands with soap after using a toilet and also before having meal
• Avoid sharing personal items like towels
• Avoid close contact with an infected person
• Have access to safe drinking-water
• Avoid raw or undercooked food like salads
• Cook meat, poultry and fish thoroughly before consumption
• Get your child vaccinated for rotavirus

References:

1. Chow CM, Leung AK, Hon KL. Acute gastroenteritis: from guidelines to real life. Clinical and experimental gastroenterology. 2010;3:97-112.

2. Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD005436. doi: 10.1002/14651858.CD005436.pub4. Review. PubMed PMID: 23440801.