Sunday, February 01, 2004
Stomach flu by any other name is still rotten
Ask anyone who has had the "stomach flu" recently about how it compares with a cold, and most would say they would take a cold any day over the nausea, vomiting and diarrhea that often accompanies a stomach virus.
Young children are often bewildered and scared when they have a stomach virus, unsure why they keep getting sick, while parents may not know whether to hold off on giving their kids milk, fruit juice or food when they are nauseous.
Gastroenteritis means inflammation of the stomach and small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses that results in vomiting or diarrhea.
It is commonly called the "stomach flu," although it is not caused by the influenza viruses, according to the Centers for Disease Control and Prevention.
But whatever it is called, it is still not easy for children. In fact, it's dangerous. Infants and young children are at risk for dehydration from loss of fluids through viral gastroenteritis. They can continue to drink breast milk, if nursing, and can have Pedialyte and water, but should not have milk or dairy products because they are harder to digest, pediatricians say.
The American Academy of Pediatrics guidelines are:
• For diarrhea with no dehydration, feed the child normally and give supplemental commercial rehydration fluids, such as Pedialyte, within four to six hours after a diarrheal episode. If the diarrhea persists, call the child's doctor.
• For diarrhea with mild dehydration-you can recognize mild dehydration if the child has a lack of tears, difficulty swallowing or a lower-than-normal number of wet diapers-take the child to a physician. In the doctor's office, the child should be given fluids orally to rehydrated them. Food and fluids should be continued at home.
• For moderate or severe dehydration, your child should go to a hospital. Symptoms could include a bloated stomach, convulsions, fainting, rapid breathing, muscle contractions, sunken eyes with few tears and a lack of elasticity of the skin.
Moderate dehydration may be treated orally, but severe dehydration requires intravenous fluids.
The old advice to let the intestine "rest" after a bout with diarrhea is no longer recommended by the American Academy of Pediatrics. Food can help the intestines absorb more water, which helps slow down the diarrhea.
Mild foods such as crackers, rice and plain unbuttered toast are good for a child to eat within an hour of vomiting or diarrhea, says Dr. Aaron Michelfelder, a family physician and assistant professor of family medicine, bioethics and health policy at Loyola University Medical Center.
"It's better to attempt to eat a small amount of food on the very first day when you have a stomach virus because it helps stimulate the body to heal," he says. "The digestive tract begins to lose the ability to absorb nutrients if you don't eat anything."
Stomach viruses, which peak in the fall and winter, can be transmitted either through the air-when someone who is sick passes on a virus by sneezing or coughing-or by someone who has had contact with feces through changing a diaper or not properly washing their hands. A stomach virus sometimes can turn up at the tail end of a bad cold and cough, pediatricians say.
Food also may be contaminated by the virus by food preparers or handlers who have viral gastroenteritis, especially if they do not wash their hands regularly after using the bathroom.
People who wash their hands well can catch a virus by simply drying their hands on a hand towel that has been touched by someone with germs on their hands. Even used facial tissues left on a night stand can send viruses through the family, as can coughing without covering your mouth.
Preventing stomach viruses comes down to good hygiene, physicians say. Regularly scrubbing hands for one minute in warm, soapy water is the No. 1 way to prevent transmitting viruses.
If someone in your family has had a stomach virus and you're hoping to prevent others in the household from coming down with it, use a bleach-based solution or wipes to clean countertops, doorknobs and handles on cabinets.
A disinfectant spray can also help to fight germs on surfaces in a child's room, pediatricians say.
Even when people are infected with a stomach virus, they might not know it yet because they haven't experienced symptoms. Once people do have symptoms, the virus can remain in their system three to seven days
If your children-or you-aren't getting any better after about a week or your symptoms worsen, you should see a doctor. A viral infection can lead to a bacterial infection.
In children, a fever that causes listlessness is a sign they should be taken to the emergency room or seen by a pediatrician or family physician. Kids who refuse to eat for several days, hold their ears or stomach or wheeze also should be seen by a doctor.
Susan Dodge is Ben's mother and a writer living in northwest Indiana.