For some reason, this winter your Personal Trainer Sydney CBD has noticed that gastro has been rampant amongst his clients.
People ask, what can I do?
The short answer is, not a lot. Acute viral gastroenteritis is usually self-limited and is treated with supportive measures (fluid repletion and unrestricted nutrition). No specific antiviral agents are available.
Fluid maintenance and repletion
For most adults who suffer with acute viral gastroenteritis, dehydration will be a major concern but generally fluid levels can be maintained with sport drinks and broths. For adults presenting with mild to moderate dehydration, the evidence suggests oral rehydration solutions may be superior to sports drinks in maintaining electrolyte balance along with hydration. Patients with severe dehydration require intravenous fluids. Soft drinks and fruit juices that are high in sugar content should be avoided.
In adults with acute viral gastroenteritis, we do not recommend adherence to any restricted diet. Patients should be encouraged to eat as tolerated. Smaller meals may be less likely to induce vomiting than larger ones. Bland, low residue foods may also be better tolerated than others. For healthy adults with acute viral gastroenteritis without signs of dehydration, sport drinks, diluted fruit juices, and other flavored soft drinks augmented with saltine crackers and broths or soups can meet the fluid and salt needs in almost all cases. Broiled starches/cereals (potatoes, noodles, rice, wheat, and oat) with some salt are excellent foods to consider. In addition, crackers, bananas, yogurt, soups, and boiled vegetables can also be consumed.
While the BRAT diet (bananas, rice, applesauce, and toast) is often recommended, the evidence to support it is weak. Similarly, while many authorities advise patients to exclude milk and dairy products from their diet during the episode of diarrhea and for several weeks after symptoms resolve, the evidence to support this is weak.
The value of oral probiotics in acute viral gastroenteritis is not well established, and further research is needed to determine the optimal type, dose, and regimen of probiotics before they are recommended for routine use.
The effect of zinc supplementation on duration of diarrheal illnesses in adults has not been studied, and its use is not the standard of care.
Antimotility agents (drugs that stop you pooping)
In adults younger than 65 years of age with acute viral gastroenteritis and with moderate to severe diarrhea or signs or symptoms of severe dehydration, a one- to two-day course of loperamide (4 mg orally, followed by 2 mg after each episode of diarrhea, up to 8 mg/day) may be appropriate. For adults ≥65 years of age, loperamide is not recommended for self-medication, and patients should be closely monitored if taking it under the guidance of a physician.
Antiemetics (drugs that stopyou vomiting)
Although studies in adult populations are lacking, for patients who cannot tolerate oral rehydration due to excessive vomiting, I suggest treating with an antiemetic (eg, prochlorperazine or ondansetron) as needed for one to two days to facilitate oral fluid repletion.
In adults who clearly have acute viral gastroenteritis (eg, outbreak with known etiology), I do not recommend the empiric use of antibiotics. In general, empiric therapy for community-acquired acute diarrhea (of unclear etiology) may be beneficial but does not appear to dramatically alter the course of illness in unselected populations. If patients initially treated with supportive measures do not improve after seven days or symptoms worsen, then they should be reevaluated and possibly treated for other causes of gastroenteritis.
When to hospitalize
Potential indications for hospitalization include the presence of alarm symptoms or signs, or individuals at risk for complications (eg, dehydration), including:
●Abnormal electrolytes or renal function
●Excessive bloody stool or rectal bleeding
●Severe abdominal pain
●Prolonged symptoms (more than one week)
●Age 65 or older with signs of hypovolemia
●Comorbidities (eg, diabetes mellitus, immunocompromised)
Personal trainer Sydney CBD really hopes you don't get gastro this winter but if you do, see your local doctor for further advice.