Gastroenteritis is an infection of the gut. It causes diarrhoea, and may also cause vomiting, abdominal pain and other symptoms. In most cases the infection clears over several days, but sometimes takes longer. The main risk is dehydration. The main treatment is to have lots to drink which aims to avoid dehydration. You should also eat as normally as possible. See a doctor if you suspect that you are dehydrating, or if you have any worrying symptoms such as those which are listed below.
Gastroenteritis is an infection of the gut (intestines). The severity can range from a mild tummy upset for a day or two with some mild diarrhoea, to severe diarrhoea and vomiting for several days or longer. Many viruses, bacteria and other microbes (germs) can cause gastroenteritis.
A virus is the most common cause of gastroenteritis. For example, infection with noroviruses and adenoviruses are common causes of gastroenteritis in adults in the UK, but other viruses can also be the cause. Viruses are easily spread from one person to another by close contact. This is often because of the virus being present on people's hands after they have been to the toilet. Surfaces or objects touched by the infected person can also allow transmission of the virus. The virus can also be passed on if the infected person prepares food. Outbreaks of a virus causing gastroenteritis in many people can occur - for example, in schools, hospitals or nursing homes.
Food poisoning (eating food infected with microbes) causes some cases of gastroenteritis. Many different types of microbes can cause food poisoning. Common examples are species of bacteria called Campylobacter, Salmonella and Escherichia coli (usually shortened to E. coli). Toxins (poisons) produced by bacteria can also cause food poisoning. Another group of microbes called parasites can also be a cause. Water contaminated by bacteria or other microbes is another common cause, particularly in countries with poor sanitation. See separate leaflet called 'Food Poisoning in Adults' for further details.
This is a general leaflet about gastroenteritis. There are also other leaflets that give more details about some of the different microbes that cause gastroenteritis.
Gastroenteritis is common. About 1 in 5 people in the UK will develop a gastroenteritis in a year. Most people have a mild form of gastroenteritis and do not need to seek medical advice or to visit their doctor.
If vomiting occurs, it often lasts only a day or so, but sometimes longer. Diarrhoea often continues after the vomiting stops and commonly lasts for several days or more. Slightly loose stools may persist for a week or so further before a normal pattern returns. Sometimes the symptoms last longer.
Diarrhoea and vomiting may cause dehydration (a lack of fluid in the body). Consult a doctor quickly if you suspect you are becoming dehydrated. Mild dehydration is common and is usually easily reversed by drinking lots of fluids. Severe dehydration can be fatal unless quickly treated because the organs of your body need a certain amount of fluid to function.
Dehydration in adults with gastroenteritis is more likely to occur in:
Most people with gastroenteritis recognise this from their typical symptoms and they do not usually need to see a doctor or to seek medical advice. Symptoms are often quite mild and commonly get better within a few days without any medical treatment.
However, in some circumstances, you may need to see a doctor when you have gastroenteritis (see below about when to seek medical advice). The doctor may ask you questions about recent travel abroad, if you have been in contact with someone with similar symptoms, or if you have recently taken antibiotics or been admitted to hospital. This is to look for possible causes of your gastroenteritis. The doctor will also usually check you for signs of dehydration. They may check your temperature, pulse and blood pressure. They may also examine your abdomen to look for any tenderness.
Tests are not usually needed. However, if you are particularly unwell, have bloody stools, have recently travelled abroad, are admitted to hospital, or your symptoms are not getting better, then your doctor may ask you to collect a stool sample. This can then be examined in the laboratory to look for the cause of the infection.
Seek medical advice in any of the following situations, or if any other symptoms occur that you are concerned about:
Symptoms often settle within a few days or so as your immune system usually clears the infection. Occasionally, admission to hospital is needed if symptoms are severe, or if complications develop (see below).
The following are commonly advised until symptoms ease.
The aim is to prevent dehydration, or to treat dehydration if it has developed. (Note: if you suspect that you are dehydrated, you should contact a doctor.)
For most adults, fluids drunk to keep hydrated should mainly be water, Also, ideally, include some soup. It is best not to have drinks that contain a lot of sugar, such as cola or pop, as they can sometimes make diarrhoea worse.
Rehydration drinks are recommended for people who are frail, or over the age of 60, or who have underlying health problems. They are made from sachets that you can buy from pharmacies. (The sachets are also available on prescription.) You add the contents of the sachet to water. Rehydration drinks provide a good balance of water, salts, and sugar. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea. Do not use home-made salt/sugar drinks, as the quantity of salt and sugar has to be exact.
Anti-secretory medicines are designed to be used with rehydration treatment. They reduce the amount of water that is released into the gut during an episode of diarrhoea.
It used to be advised to not eat for a while if you had gastroenteritis. However, now it is advised to eat small, light meals if you can. Be guided by your appetite. You may not feel like food and most adults can do without food for a few days. Eat as soon as you are able - but don't stop drinking. If you do feel like eating, avoid fatty, spicy or heavy food at first. Plain foods such as wholemeal bread and rice are good foods to try eating first.
Antidiarrhoeal medicines are not usually necessary. However, you may wish to reduce the number of trips that you need to make to the toilet. You can buy antidiarrhoeal medicines from pharmacies. The safest and most effective is loperamide. The adult dose of this is two capsules at first. This is followed by one capsule after each time you pass some diarrhoea up to a maximum of eight capsules in 24 hours. It works by slowing down your gut's activity. You should not take loperamide for longer than five days.
Note: do not give antidiarrhoeal medicines to children under 12 years. Also, do not use antidiarrhoeal medicines if you pass blood or mucus with the diarrhoea or if you have a high temperature. People with certain conditions should not take loperamide. Therefore, read the leaflet that comes with the medicine to be safe. For example, pregnant women should not take loperamide.
Paracetamol or ibuprofen is useful to ease a high temperature or headache.
As explained above, if symptoms are severe, or persist more than several days, your doctor may ask for a sample of the diarrhoea. This is sent to the laboratory to look for infecting microbes (bacteria, parasites, etc). Sometimes an antibiotic or other treatments are needed if certain bacteria or other infections are found to be the cause. Antibiotics are not needed for gastroenteritis caused by viruses, and may even make things worse.
Complications are uncommon in the UK. They are more likely in the very young, pregnant women, or the elderly. They are also more likely if you have a chronic (ongoing) condition such as diabetes or if your immune system may not be working fully. For example, if you are taking long-term steroid medication or you are having chemotherapy treatment for cancer.
Possible complications include the following:
Gastroenteritis can be easily passed on from person to person. If you have gastroenteritis, the following are recommended to prevent the spread of infection to others:
The advice given in the previous section is mainly aimed at preventing the spread of infection to other people. However, even when we are not in contact with someone with gastroenteritis, proper storage, preparation and cooking of food, and good hygiene help to prevent gastroenteritis.
In particular, always wash your hands:
The simple measure of washing hands regularly and properly is known to make a big difference to the chance of developing gastroenteritis.
You should also take extra measures when in countries of poor sanitation. For example, avoid water and other drinks that may not be safe, and avoid food washed in unsafe water.