11.FEB.2021 5 MIN READ | 5 MIN READ

Gastroenteritis or ‘stomach flu’ is unpleasant, especially so when it happens to the little ones but quick action can prevent complications from arising.

Gastroenteritis, more commonly known as the ‘stomach flu’, is a viral or bacterial infection that causes irritation and inflammation of the stomach and intestines. Although it’s known as the ‘stomach flu’, gastroenteritis is not the same as influenza, which affects your nose, throat, and lungs. In fact, gastroenteritis attacks your intestines, and is commonly contracted through contact with an infected person or by eating or drinking contaminated food or water. Healthy adults would usually recover without complications, but gastroenteritis can be deadly to infants, the elderly, and people with compromised immune systems.

Rotavirus is one of the most common causes of stomach flu in infants and children whereas norovirus causes serious gastroenteritis and foodborne disease outbreaks. Bacteria such as E. coli and salmonella can also cause stomach flu.

Signs and symptoms of stomach flu

Gastroenteritis symptoms
The usual symptoms for stomach flu include watery diarrhoea, stomach cramps, nausea, vomiting and sometimes fever. In children, a stomach flu can cause dehydration very quickly so it’s important to be on the lookout for symptoms such as dry skin, dry mouth or being very thirsty. For babies, do look out for fewer and drier diapers, which could point to dehydration.

Stomach flu is highly contagious and in addition to spreading via contact with an infected person and contaminated food or water, it can also spread from not washing your hands after using the bathroom or changing a diaper.

Another bacteria called Shigella can cause stomach flu as well. It’s often spread in schools and day care centres via contact with infected toys, bathroom fixtures, changing tables, diaper pails, changing the diaper of a child with a Shigella infection, then touching your mouth.

Self-care measures in kids and babies

There isn’t a fixed, medical treatment for stomach flu other than supportive measures. The most important thing is to replace lost fluids and salt especially in children. Help them rehydrate with oral rehydration solutions, which are available over the counter at pharmacies. Do note that plain water isn’t the best replacement in children with stomach flu so it’s best to stick to oral rehydration solutions which replace lost electrolytes.

Slowly transition your child back to a normal diet to help settle their little tummies. Introduce bland, easy-to-digest foods like rice, bananas and potatoes. Avoid dairy and sugary food as they can make diarrhoea worse. Ensure that your child gets lots of rest as being ill and dehydrated can definitely weaken and tire them out.

For babies, after a bout of vomiting or diarrhoea, let their stomach rest for 15 – 20 minutes before trying to give them small amounts of liquid. If you are breastfeeding your baby, allow them to nurse and if they’re bottle-fed, offer them a small amount of oral rehydration solution or milk formula. There’s no need to dilute the formula.

Make it a point to disinfect all hard surfaces if anyone at home has the stomach flu. This includes counters, faucets, doorknobs, and switches. Wash and disinfect all toys that your infected child comes in contact with to prevent reinfection or spreading it to another person in the house.

Bacterial stomach flu

Gastroenteritis can also be caused by a bacterial infection such as E. coli or Salmonella which are commonly spread via undercooked poultry, eggs or unpasteurised milk and raw vegetables or juices.

Always check to make sure that the chicken and eggs your child is about to consume is properly cooked through. For those who like runny eggs, choose pasteurised eggs. To protect against E. coli and salmonella, ensure that you wash your hands and utensils with hot soapy water before and after preparing food or eating. Make it a habit to disinfect kitchen surfaces especially if you’ve prepared raw chicken on it. Use separate storage compartments, knives and chopping boards for storage and preparation of raw meats.

Wash your fruits and vegetables thoroughly especially those with firm surfaces with a vegetable brush while rinsing. After coming back from the grocery store, refrigerate or freeze your perishables as quickly as you can.

Precautions and prevention

Gastroenteritis precaution and prevention
Keep your children out of school, kindergarten, or nursery until all of their symptoms are gone. Always check with a doctor before giving your children any medicine because certain drugs to control diarrhoea and vomiting aren’t usually given to kids younger than 5 years old.

As with most illnesses, it’s better to prevent gastroenteritis rather than treat it. Wash your hands and ensure your children wash theirs too, especially after using the bathroom. Additionally, vaccinate your children against the rotavirus to prevent severe symptoms of stomach flu.

Complications

The main complication from stomach flu is dehydration. In healthy adults who drink enough fluids to replace what’s lost from vomiting and diarrhoea, dehydration can be resolved easily. However, infants, the elderly, and immunocompromised people could easily become severely dehydrated if they lose more fluids than they can replace. This will require hospitalisation for intravenous fluids.

Head to the Accident & Emergency (A&E) department if your child:

  • has a fever of 38.9 degrees Celsius or higher
  • is lethargic or very irritable
  • is in a lot of pain or discomfort
  • has bloody diarrhoea

For babies, parents should bring them to the A&E right away if they have been vomiting for more than a few hours, haven’t had a wet diaper in 6 hours, severe or bloody diarrhoea, sunken soft spot (fontanelle) on the top of their head, cries without tears or are unusually sleepy or less responsive.

Stomach flu in children can escalate very quickly and cause severe dehydration requiring hospitalisation. Once your child displays symptoms of a stomach flu, it’s best to take them to the A&E for quick treatment.

 

Article reviewed by Dr Mohana Rajakulendran, paediatrician at Parkway East Hospital

References

(October 2018) Viral gastroenteritis (stomach flu). Retrieved on 15 December 2020 from https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/diagnosis-treatment/drc-20378852

(January 2020) How can I tell if a food is contaminated with E. coli? Retrieved on 16 December 2020 from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/e-coli/faq-20058034

(May 2020) Gastroenteritis ("Stomach Flu"). Retrieved on 15 December 2020 from https://www.webmd.com/digestive-disorders/gastroenteritis#1

11.FEB.2021
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Mohana D/O Rajakulendran
Paediatrician
Parkway East Hospital