By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

FLU SHOTS DON’T PREVENT “STOMACH FLU”; TRY REST AND FLUIDS

Question: Several people at work, including me have had the stomach flu this winter. Most of us have missed three or four days of work. Can you tell me more about how to treat the stomach flu? Also, I had a flu shot this year, but I still got the stomach flu. Why?

Answer: It sounds to me like you and your coworkers have viral gastroenteritis. While this disorder is commonly referred to as the stomach flu, it is not caused by the influenza virus. That’s why the standard flu shot offers no protection from it. In fact, viral gastroenteritis can occur at any time during your life, and it can occur many times.

The actual viruses that cause gastroenteritis have gone by several different names in past, including Norwalk-like viruses and caliciviruses. According to the Centers for Disease Control and Prevention, the term norovirus has been approved as the official name for this group of viruses.

The symptoms of a norovirus infection are nausea, vomiting, diarrhea, fever and stomach cramps. You also feel tired, achy and can have a mild headache. The illness usually starts very suddenly, after which you typically feel very ill.

In infants and young children viral gastroenteritis is most frequently caused by a different virus altogether. It’s called a rotavirus. This form of the disease can lead to severe, dehydrating diarrhea and may require hospitalization.

In healthy adults, however, viral gastroenteritis is usually self-limiting; in other words, your immune system response will get rid of it without medical intervention. While your body is recovering, you should try to get plenty of rest and keep well hydrated.

Assuming that you and your coworkers are all otherwise healthy, you should be able to treat this illness at home. It usually lasts one to four days. To keep hydrated try clear liquids once the nausea and vomiting has stopped. You might find that slowly melting crushed ice in your mouth is a good way to reintroduce fluids. Depending on the severity of your symptoms, you might also want to take acetaminophen and over-the-counter antidiarrheal medications.

If you develop bloody diarrhea, high fever and severe abdominal pain, then the cause may be bacterial and needs prompt medical attention. Also, if you are elderly or have other medical problems -- like diabetes or heart disease -- you should contact your doctor for advice on managing your symptoms. Ask him or her what would warrant a trip to the doctor’s office or the hospital emergency department. For the elderly, the major concern is usually dehydration.

I frequently see people in the office who continue to have diarrhea for several days after the vomiting has stopped. Commonly this is due to resuming their regular diet too quickly. When you have had diarrhea, it is important to let the intestinal tract “rest” for a few days by limiting the amounts and types of solid food that you eat. Emphasis is on fluid replacement with clear, mostly water-based foods. The BRATT diet is appropriate for a couple of days in adults as well in older children whose gastroenteritis is resolving. This stands for Bananas, Rice, Applesauce, Tea and Toast. These foods are easy on the intestines, tend to not commonly cause diarrhea in most people, and will satisfy your hunger.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.