Acute viral gastroenteritis is a common disease occurring worldwide. It is an inflammation of the gastrointestinal tract, which mainly affects the stomach and intestine.

“During the months when low temperatures prevail, there is an increase in the frequency of occurrence and transmission, due to the crowding of people in closed spaces.

People who live, work or generally spend time in nurseries, schools, hospitals, elderly care facilities, etc. they are more likely to get sick from viral gastroenteritis”, explains o Dr. Konstantinos X. Delis MD, FEBG, Doctor of Medical School of the University of Athens, Director Gastroenterologist at Metropolitan Hospital.

What causes acute gastroenteritis?

Acute gastroenteritis is usually caused by viruses and less commonly by bacteria and parasites. In adults, the most common cause is norovirus infection, while in children, rotavirus. It is noted that a vaccine against rotavirus is available in the current national vaccination program for children. Bacterial gastroenteritis is mainly caused by Campylobacter and Escherichia coli.

Viral gastroenteritis is the most common cause of diarrheal disease. Gastroenteritis is mainly due to the consumption of improperly prepared or preserved food and/or contaminated water. But it can also be transmitted after close contact with an already infected person. Patients with norovirus gastroenteritis are contagious from the time they start feeling sick until at least three days after they recover. Norovirus infections, although they occur year-round, tend to occur more frequently in the colder months (late fall and during winter).

What are the common symptoms of an acute viral gastroenteritis

“Symptoms usually begin 12-72 hours after infection with the infectious agent. The infection usually appears with diarrhea, vomiting and abdominal pain often in the form of cramping but also a feeling of weakness. In more severe cases, there may be fever and dehydration.

Also in some viral infections, easy fatigue, headache and muscle pain can be observed. Viral gastroenteritis usually resolves within a week. In the majority of cases the symptoms are mild and go away without requiring a visit to the doctor. In modern, Western-style societies, the disease is usually self-limiting. In underdeveloped countries, however, gastroenteritis can be an important cause of death, especially in infants,” points out Dr. Cowardly.

How does dehydration manifest itself?

Dehydration during a gastroenteritis can occur due to vomiting and diarrhea. Extreme age groups, namely the elderly and children, are most at risk. It usually manifests itself with a feeling of thirst, dizziness, confusion, fatigue and weakness. The skin becomes dry while the urine is thick with a dark yellow color.

How long does a gastroenteritis last?

In an acute viral gastroenteritis, the symptoms usually last less than a week and, most of the time, subside within the first three days. Elderly or immunocompromised patients (oncology patients, people taking cortisone, etc.) usually take longer to fully recover.

What tests should I do?

Usually no special tests are needed. When there are severe symptoms, we should go to the doctor who will probably recommend a series of tests to assess the seriousness of the situation. These tests can be blood, urine or stool tests.

When should I see a gastroenterologist?

Call your gastroenterologist if you notice signs of severe dehydration, persistent diarrhea or vomiting that lasts more than 2 days, when you cannot tolerate liquids for several hours, when there is bloody diarrhea, unbearable abdominal pain, or when, during the day, you have no urine for over 6 hours.

What is the treatment?

“The most important goal of treatment is to keep the patient hydrated and, in the event of dehydration, to effectively treat fluid and electrolyte loss. Treatment initially involves drinking plenty of fluids. In mild or moderate conditions, hydration can usually be achieved by giving special oral salt and sugar solutions.

Antiemetic drugs such as e.g. metoclopramide may be used to help control the symptoms of nausea and vomiting, but only on medical advice. Antidiarrheal drugs are usually not recommended by doctors, especially for elderly patients. Some even believe that if the patient can maintain a good level of hydration, antidiarrheal therapy should not be initiated. Probiotics have not been shown to help with treatment.

In more severe cases, when there is significant dehydration and the patient cannot tolerate oral fluids, when there is a high fever, or when vomiting persists, hospitalization for intravenous fluids and careful monitoring of the level may be necessary of electrolytes. Viral gastroenteritis rarely requires antibiotics,” emphasizes the doctor.

Is there a special diet?

There are no specific dietary recommendations that are universally applicable to patients with viral gastroenteritis. After all, not everyone has the same severity of illness. A diet of rice, banana, apples, tea, toast, or a well-boiled chicken fillet is often recommended in mild cases. Several studies have failed to show any significant difference in the course and final outcome of the disease comparing special and normal diets. What is certain is that foods with a lot of vegetable fiber should be avoided.

Hygiene measures

To reduce the chance of contracting acute viral gastroenteritis we should wash our hands thoroughly with soap and warm water before eating and after using the toilet. Also, we should not consume suspicious foods that have not been adequately prepared and preserved and also poorly preserved liquids.

If we have contracted viral gastroenteritis it is recommended to stay at home until it has run its course. By resting, we speed up recovery but also prevent the transmission of the virus to other people, since the viruses are excreted in the feces and vomit of patients. Viruses can survive on surfaces for up to 72 hours, while even a small amount of them is enough to infect someone in the same area.

“The risk of transmission of a viral gastroenteritis is greater in places where many people are together and/or proper hygiene conditions are not observed during the preparation and consumption of food. Examples of such places can be daycare centers, camps, schools, camps, elderly care facilities, health facilities, cruise ships, etc. In these areas, increased vigilance is required from those in charge.

People with viral gastroenteritis both during symptoms and for the next 48 hours should limit direct contact with their loved ones and not participate in food preparation or providing health care to other people.

Sick children or students should stay away from nurseries and schools or sports activities areas (e.g. swimming pool), as well as sick workers in these areas. Also, patients working in food handling areas in hospitals, nursing homes or other institutions, where people belonging to vulnerable population groups are accommodated, must refrain from their work”, concludes the gastroenterologist Konstantinos X. Delis.