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Stomach Flu (Gastroenteritis) Overview

Viral gastroenteritis (stomach flu) is a highly contagious intestinal infection that causes watery diarrhea, stomach cramps, and vomiting. It is usually due to a norovirus or rotavirus and transmits via contact with others or contaminated food or drink.

Stomach flu usually develops after contact with a person carrying the infection or consuming contaminated food or water. Often, a person can let the infection run its course. However, home remedies can relieve symptoms.

In the United States, many people recover from stomach flu within a few days without any complications. However, for people in high-risk categories and those with reduced access to healthcare facilities, it can be a severe condition and a significant cause of death.


Symptoms of Stomach Flu (Gastroenteritis)

Although people refer to viral gastroenteritis as flu, it is not the same as influenza . It only affects the respiratory system, including the nose, throat, and lungs. Stomach flu affects the stomach and intestines.

Symptoms of stomach flu can include:

Anyone with symptoms of stomach flu should not go to school or work as the condition is usually contagious.


Causes of Stomach Flu (Gastroenteritis)

Different viruses can cause stomach flu, including:

  • Adenovirus: Infection with this virus can present with a wide range of symptoms
  • Norovirus: It is the most contagious form
  • Astrovirus: This mostly affects weaker immune systems
  • Rotavirus: This virus peaks between December and April

Symptoms generally appear following contact with someone who has the infection. They can also occur after eating or drinking contaminated food or water.

Doctors can offer help for some symptoms and make sure that they are not due to another illness. Some bacterial infections cause the same symptoms as stomach flu.

How long Stomach Flu (Gastroenteritis) Lasts?

Stomach flu can last from days up to 2 weeks, depending on which virus causes the condition.

The symptoms of each type begin at different times after contact with the virus and last for varied periods:

  • Astrovirus: Symptoms usually begin 4–5 days after contact and last 1–4 days
  • Norovirus: Symptoms usually begin 12–48 hours after contact and last 1–3 days
  • Adenovirus: Symptoms usually begin 3–10 days after contact and last 1–2 weeks
  • Rotavirus: Symptoms usually begin 48 hours after contact and last 3–8 days

Norovirus is more contagious when a person has symptoms or during the first days after recovery. However, the virus can continue to spread for over 2 weeks after symptoms ease.

Norovirus affects people at any age. Rotavirus, adenovirus, and astrovirus are more likely to affect children and infants, but adults can contract them too.

Remedies for Children

A parent should consult a doctor if their infant has symptoms for more than 1–2 days and is dehydrated. This can have particularly severe effects on their health.

Signs of mild to severe dehydration include:

  • Decrease in urination
  • Excessive sleepiness
  • Dark colored urine
  • Fewer tears when crying
  • Dry lips and mouth 
  • Sunken soft spots on the heads of infants

Hydration

If possible, encourage the child to take sips of fluids. Parents can help their children stay hydrated with the following:

  • Juice
  • Milk, including breast milk
  • Oral and intravenous rehydration solutions
  • Their regular diet once tolerated
  • Water

Also, doctors do not recommend electrolyte solutions or infants. These solutions contain a high level of artificial ingredients, which are not optimal to keep a child well hydrated.

However, experts recommend oral rehydration solutions made of sugar and sodium as an alternative. People can administer these for children using a syringe, spoon, or cup.

Treatment of Stomach Flu (Gastroenteritis)

There are no drugs that can cure stomach flu. Doctors do not prescribe antibiotics because a virus usually causes it.

However, there are medications that can help control symptoms:

  • Acetaminophen: This is a common treatment option that has fewer side effects than ibuprofen. However, this drug carries the  risk of liver damage.
  • Ibuprofen: This can help with fever and aches, but people should use it cautiously as it can upset the stomach and give the kidneys extra work to do when they are already dehydrated.
  • Antiemetics: These can relieve feelings of nausea. Doctors may prescribe promethazine, ondansetron, metoclopramide, or prochlorperazine.
  • OTC antidiarrheals: These include subsalicylete  (Pepto-Bismol) and loperamide hydrochloride (Imodium). Parents should consult a doctor before giving these medications to children, as they can be harmful to children of certain ages.


Home Remedies of Stomach Flu (Gastroenteritis)

The virus usually passes on its own, but home remedies can control symptoms and provide the best relief.

Stay Hydrated

People with stomach flu often lose their appetite. The body also loses a lot of fluids through diarrhea, vomiting, and sweating. This lack of food and liquids can cause dehydration.

Dehydration is when the body does not have enough water to work properly. Signs of dehydration include extreme thirst, a dry mouth, tiredness, dizziness, and headache.

People with stomach flu should drink plenty of liquids such as clear soda, diluted fruit juices, or caffeine-free sports drinks, taking slow sips to help to keep fluids down. People who cannot keep food or drink down can snack on ice chips to maintain hydration. Electrolyte solutions, such as Pedialyte, can also help replace lost fluids.

Doctors recommend avoiding coffee as it can unsettle the stomach and disrupt sleep, which is important for recovery. People should also avoid alcohol because it is a diuretic, which means it reduces water content in the body.

What to Eat

Stomach flu often reduces or eliminates the appetite. It can help to eat slowly and simply while appetite is low to aid recovery.

Doctors recommend that people rehydrate with fluids before transitioning to soups and broths, then try eating small meals.

Experts suggest following a bland diet to manage gastrointestinal complaints. Recommended foods include rice, pasta, or eggs. People should avoid excess fiber as it loosens the bowels. Tomato-based, fatty, and spicy dishes can also worsen diarrhea.

Rest

Stomach flu can be exhausting. The body needs as much energy as possible to fight off the infection and repair damage. For this reason, it is important to rest, allowing the immune system to work and cells to repair as quickly as possible.

Anyone with stomach flu should rest during the day and get a good night’s sleep each night.

Ginger

Ginger helps reduce inflammation and promote digestion by relieving nausea and vomiting. It may also offer some relief from stomach cramps and bloating.

To make ginger tea:

  1. Add 1 teaspoon (tsp) of powdered ginger or ½ tsp of fresh ginger root to 1 cup of water.
  2. Boil for 5 minutes and let steep for 10 minutes.
  3. Strain the tea when using fresh ginger root.
  4. Drink 2–3 times daily to get relief.

Ginger can be a spice in meals. People with stomach flu can consume ginger by taking ginger capsules, drinking ginger ale, or chewing a piece of ginger.

Peppermint

Mint, such as peppermint, may also help soothe an upset stomach and treat gas and bloating. The most effective way to use mint for an upset stomach is to drink it as tea.

To make mint tea, a person can take a few fresh mint leaves, boil them in water, then strain the infusion.

However, there is limited data available to determine the benefit of mint in humans.

Acupressure

Some research has demonstrated that acupressure can reduce nausea.

Measure three finger-widths down from the bottom of the palm and apply pressure with your thumb to the soft part between two tendons, then massage for a couple of minutes.

Chamomile

Chamomile is a plant that can be helpful as a stomach flu remedy. It relaxes the muscles and has anti-inflammatory properties.

This plant may help relieve diarrhea, stomach cramping, bloating, nausea, and gas in some individuals. Experts suggest it can help in minor cases of gastrointestinal distress.

To make chamomile tea:

  1. Add 2–3 tsp of dried chamomile flowers to a cup of hot water.
  2. Cover and let it steep for 10–15 minutes.
  3. Strain, and then add some lemon juice and honey to taste.
  4. Drink this tea three or four times a day for 2–3 days.

Rosemary, red, and fennel tea may also have anti-inflammatory properties and aid digestion.

Prevention of Stomach Flu (Gastroenteritis)

Norovirus is the most common form of stomach flu. According to the Centers for Disease Control and Prevention (CDC), every year in the U.S., it causes 19–21 million illnesses, around 109,000 hospitalizations, and 900 deaths of adults over 65 years of age.

It is the most common cause of foodborne disease outbreaks in the U.S., causing 58% of cases.

Measures of Prevention

A few simple measures can reduce the risk of catching stomach flu:

  • Always wash hands before handling or preparing food and after using the toilet or changing a diaper
  • Disinfect countertops and surfaces, and wash clothes and bedding
  • Wash all fruits and vegetables and thoroughly cook seafood before eating
  • People who begin to feel ill should not prepare food for others
  • Sick family members should self-isolate, for instance, by restricting themselves to one bathroom
  • Wipe shopping cart handles before use
  • Use the dishwasher rather than washing dishes by hand

Vaccination for Children

Rotavirus was previously the most common cause of stomach flu, causing around 440,000 deaths worldwide each year in children under 5.

However, since 2006, rotavirus vaccination has become available for children. Since the vaccination scheme, cases have dropped by 58–90% each year.

Seeking Medical Attention

A person should seek immediate medical assistance if they or a child in their care experiences the following:

  • A fever above 104 degrees Fahrenheit, or any fever in infants
  • Blood or pus in the stool, or black or tarry stools
  • Alteration in mental state
  • Being unable to keep liquids down for 24 hours
  • Dehydration
  • Diarrhea that lasts more than two days
  • Producing at least six loose stools in a day
  • Severe pain in the rectum or abdomen
  • Persistent vomiting

Additionally, a parent or caregiver should seek medical advice if a child cannot consume enough fluids or if liquids are not helping with symptoms. Prolonged bouts of diarrhea are considered a dangerous symptom, especially in newborns, as it can lead to severe dehydration.

Stomach Flu vs. Food poisoning

The symptoms of stomach flu and food poisoning are very similar but food poisoning is more common.

One major difference is the duration of illness. Food poisoning tends to clear up within a couple of days, but stomach flu can last for almost 2 weeks.

Stomach Flu vs. COVID-19

Symptoms of stomach flu can overlap with those of COVID-19. However, the most common feature of COVID-19 is respiratory symptoms, which do not occur with gastrointestinal conditions.

Outlook

For people who are not at high risk and have access to healthcare facilities, stomach flu often passes on its own without causing complications. Home remedies and general good hygiene can help prevent or ease symptoms.

However, stomach flu can have strong, negative implications in some cases in people of all ages. A person should consult a doctor if they are experiencing severe symptoms or dehydration.

Biospecimens

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