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. This is because plain water isn’t 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 1 level teaspoon (5ml) salt and eight level teaspoons (40ml) sugar in one litre of clean, boiled water.
Before you mix your own solution, check with your doctor that the ingredients aren’t harmful to the health of the person with gastroenteritis.
A few more tips:
• Babies: If your baby has mild gastroenteritis, continue with his or 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).
• Give liquids at intervals of 15 minutes or more.
• Increase intake gradually.
• At least match urine output (or other fluid loss) with fluid intake to ensure that the person 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’s usually difficult to determine the exact cause of gastroenteritis. Note also that some antibiotics can cause or even worsen diarrhoea.
A few notes on other medications:
• There’s 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 in the treatment of infectious diarrhoea is generally not recommended and they shouldn’t 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 individuals.
Mild cases of gastroenteritis will settle within days and require only attention to hydration. More severe cases require active management.