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Vomiting and Diarrhea: Dr Zulfikar Bux shares ‘The do’s and don’ts’
We have all had the displeasure of having an episode of vomiting or diarrhea, or both. It’s not the best feeling
Dr Zulfikar Bux
in the world and can make our lives very uncomfortable. Medication, illicit drugs, pregnancy and other medical conditions are less common causes of vomiting and diarrhea, but our main focus today is on gastroenteritis caused by viruses and bacteria.
Gastroenteritis is defined as inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhea. It can be mild or more severe which can lead to dehydration and even death. It accounts for 1.4 million deaths worldwide yearly and therefore should be taken seriously. Children are more prone to the debilitating effects of gastroenteritis and most of their complications arise from dehydration. Dehydration occurs when there is too little fluid in your body causing inefficient blood circulation. When one vomits or has diarrhea, they are constantly losing fluids which if not replaced, will lead to dehydration.
By knowing what to do and what not to do, you may be able to ride out an episode of vomiting and diarrhea.
REHYDRATE YOURSELF
This is the most essential component of improving your outcome from an episode of gastroenteritis. Do not use water alone. Your body also needs essential electrolytes (potassium, sodium etc.) that you would have lost during the vomiting or diarrhea. Coconut water, Pedialyte, Gatorade, Oral Rehydration Salts etc. are alternatives for rehydration that have electrolytes. Once you have vomited, rest your stomach for an hour before you try rehydrating. Once you start drinking, start with sips and gradually increase your amounts over time. Do not drink too much fluid at once as it may make you nauseated and cause you to vomit.
AVOID SWEET AND SOUR
Sour foods tend to make your stomach more acidic and can irritate it and precipitate vomiting. Sweet foods tend to precipitate diarrhea since most of the causative virus and bacteria tend to thrive better in a sweet environment. Aerated drinks are both sweet and acidic, it is best to avoid them during this time.
DO NOT USE ANTIBIOTICS
Viruses are by far the most common cause of gastroenteritis. Antibiotics are ineffective against viruses and may even precipitate some gastroenteritis. The decision to use antibiotics during gastroenteritis should be made by a doctor who will determine if a bacterium is the cause and only then would antibiotics be warranted.
AVOID OVER-THE-COUNTER ANTI-DIARRHEAL
These may make you feel nice for a while but may complicate your gastroenteritis and make it worse. They tend to stop the diarrhea, but prevent your body from expelling the “bug” that is causing the diarrhea in the first place. This “bug” then has a chance of remaining in your intestines and multiplying and thereby re-presenting in a more severe and possibly deadlier form.
WHEN TO SEE YOUR DOCTOR
Most cases of gastroenteritis go away on their own. Visit a doctor if the vomiting and diarrhea continues for more than a day, or if you notice any signs of dehydration like:
· Not urinating or yellow and little urine
· Dry mouth
· Crying without tears (children)
· Fever over 102 F
· Lack of energy
· Irritable(children)
· Soft spot on the top of baby’s head is sunken.
· Blood in stool, or dark tarry stool
Having a bout of gastroenteritis is definitely not one of the most fun times in one’s life. Knowing what to do and what not to do may be the difference between you overcoming the bout before it overcomes you.
(Dr Zulfikar Bux is an Assistant Professor of Emergency Medicine at the Vanderbilt University and Medical Center and holds the position of Head of the Georgetown Public Hospital’s Accident and Emergency Department.)
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