Stomach flu is here- What you Need to Know

Stomach flu is here- Vomiting is usually OK

The community is, right now, experiencing a massive epidemic of stomach flu.

Kids with stomach flu typically vomit, have diarrhea, and fever.

Stomach flu is a miserable experience but it rarely presents any danger.

The way it works is that a virus is caught, like any virus, but in the case of stomach flu the virus goes to the gut.

The first stop is the stomach where it causes lots of swelling and inflammation.  Once this hits you will see vomiting.  As the virus goes along the gut the intestine gets red, swollen, and inflamed and this causes diarrhea.

Stomach flu is overwhelmingly harmless in a healthy populatoin, in the sense that nearly everyone who gets it recovers without the need for medical interventions.   The main risk faced is dehydration, which is discussed below.  But even in the unlikely event that should occur, the treatment for the mild dehydration seen in stomach flu is very effective.

On the vomiting
The vomiting from stomach flu lasts about 2-6 days and often frightens parents.
Sometimes the vomiting can be quite intense.  So bad that nothing is kept down and what appear to be great quantities of fluid keep getting vomited all day and all night.

The most helpful thing to do for intense vomiting is to retreat to giving small amounts of fluid, about one teaspoon, every five minutes.  One teaspoon every five minutes over 8 hours is 16 ounces of fluid a day, plenty to prevent dehydration.   Why one teaspoon?  Because that's a small enough amount it might be absorbed in the mouth and esophagus, before it hits the stomach, so you can drink it, absorb it, and not vomit it.

We would recommend resorting to the one teaspoon every five minutes approach only if the vomiting is so severe it is clear that your child is not able to stay hydrated.  Once the vomiting eases off and your child can hold meals down, no restrictions on eating or drinking what they can.

On the diarrhea
The diarrhea usually lasts longer than the vomiting.  Where vomiting might go on for a few days, diarrhea can to on for a few weeks.  As long as there is on blood or mucus in the stool, it is likely viral diarrhea, not a dangerous or worrisome event.  It tends to cause less dehydration than vomiting because you can drink enough water to match the water lost in diarrhea.

How do you know when you are dehydrated?
Nearly everyone with stomach flu gets dry, but that's different than dehydrated.  You are dehydrated when you have lost so much more water than you take in that functions begin to suffer.    Signs of dehydration include markedly reduced or cessation of urination, dry and cracked lips, sunken eyes, and marked lethargy.
Dehydration leads to not peeing, looking very sagged and tired, and a sallow-sunken-dry-cracked face.

There is no drug that cures stomach flu.

Water is the best treatment as it resolves the only danger stomach flu can pose- dehydration.

The most frequently used drug used for nausea and vomiting is Zofran, or odansetron.  This is a powerful drug, and does present risks, so we recommend it not be used for any but the most severe stomach flus.  To use it with every stomach flu vastly increases the chance some serious harm could occur from uncommon side effects.

There are no drugs that can stop the diarrhea, like a runny nose with a cold, it simply has to run its course.

1.  Stomach flus, like colds, are a universal human experience.
2.  They can happen anytime of the year, but the community experiences waves of them.  We are in one now.
3.  The stomach flu is not the flu of the flu vaccine, so that vaccine does not prevent it.  There is a vaccine for one cause of stomach flu, the rotavirus, but as that vaccine has been used, the noravirus has simply taken its place, so there is still plenty of stomach flu around.
4.  Stomach flu is a viral infection, typically starting with 1-3 days of heavy vomiting followed or also including a week or so of diarrhea, with fever often.
5.  Drugs for nausea and vomiting should not be used for every stomach flu as this would greatly increase the harm from such drugs.
6.  The best treatment is water as it treats the only real danger from uncomplicated stomach flus- dehydration.  Water can be give orally, but if that fails, there is always the IV route which can always quickly and safely restore water.
7.  We at Advanced Pediatrics are happy to help if your child comes down with a stomach flu, particularly if you need help knowing if dehydration is appearing.

To your health,
Dr. Arthur Lavin

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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