Regardless of what causes gastroenteritis, patient care is the same, with most cases improving without any specific treatment.
The most important aspect of treatment is to maintain hydration, which can usually be done at home.
Use an oral rehydration solution instead of large amounts of plain water. That’s because plain water is not absorbed as well as water that contains sugar and salt. Another reason to use rehydration solutions is because dehydration also results in the loss of salts. These need to be replaced to avoid causing a disruption in the salt and pH (acid) balance in your system.
Commercial rehydration solutions are available from pharmacies.
You can however, also mix your own solution. Dissolve ½ level teaspoon (2.5ml) salt and eight level teaspoons (40ml) sugar in one litre of clean boiled water.
Before you mix your own solutions, check with your doctor that the ingredients are not harmful to the health of the person with gastroenteritis.
Babies: If your baby has mild gastroenteritis, continue with her normal milk feeds, but add rehydration fluids by cup or bottle.
Adults: Fruit juice, bottled drinks such as lemonade, rooibos tea and home-made clear soups are suitable. Avoid drinks that contain caffeine.
If rehydration attempts result in vomiting, try to:
- Give liquids in smaller quantities (as little as a teaspoon at a time)
- At intervals of fifteen minutes or more,
- Increase intake gradually
- Try to at least match urine output (or other fluid loss) with fluid intake to ensure that the patient is well rehydrated.
Once the symptoms settle, you can start with a normal diet.
Antibiotics may help if you have established that the gastroenteritis has a bacterial cause. However, using antibiotics is seldom advisable as it is usually difficult to determine the exact cause of gastroenteritis. Note also that some antibiotics can cause or even worsen diarrhoea.
- There is no evidence that adsorbents such as chalk and kaolin mixtures are effective for “binding” diarrhoea.
- Medications that reduce gut contractions, such as diphenoxylate (Lomotil) or loperamide (Imodium), can be useful to control diarrhoea in adults, but should only be used for a limited time.
- Their use their use in the treatment of infectious diarrhoea is generally not recommended and they should not be used in young children.
- Probiotics such as lactobacillus are live microbes that may reduce the symptoms and duration of diarrhoea in mild to moderately ill patients.
- Try to give education and intervene where possible to improve the patient's environment in order to avoid worsening gastroenteritis, reinfection or infection of others living near them.
Mild cases of gastroenteritis will settle within days and require only attention to hydration. More severe cases require active management.
When to call the doctor
Call a doctor or take the patient to a clinic if someone:
- Has not urinated for six hours or more
- Is unable to take or keep down even clear liquids
- Is becoming listless or lethargic
- Has a persistently dry mouth or the eyes are becoming sunken (this is particularly common in children who are dehydrated)
- There is any sign of bleeding from the gut.
If needed, a doctor will give fluids intravenously until the vomiting and diarrhoea resolve.
In very severe cases where the patient is shocked through loss of fluids, admission to an intensive care unit may be required.
What is gastroenteritis?
How to prevent gastroenteritis
How gastroenteritis is diagnosed
Reviewed by Dr Karin Richter, MMed Path (Medical Virology), FC Path(SA) Viro, Dip HIV Man (SA), Dip Obst (SA), MBChB , Clinical Virologist, Senior Lecturer, Department of Medical Virology, University of Pretoria, Faculty of Health Sciences, and Consultant Pathologist, Tshwane Academic Division, National Health Laboratory Services (NHLS)
Previously reviewed by Dr EftyhiaVardas BSc (Hons), MBBCh, DTM&H, DPH, FC Path (Virol), MMed (Virol), Clinical Virologist, Director HIV AIDS Vaccine Division.