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How to manage intestinal flu

Q: Last week, I had diarrhea, which our company doctor diagnosed as intestinal flu. I got well after two days without any medications but with liberal fluid intake. What is intestinal flu? Is its cause the same as that of flu? How can it be prevented?

–Joseph J., Manila

A: Intestinal flu and stomach flu are the more popular terms for acute viral gastroenteritis, which refers to inflammation of the stomach and the intestines that is caused by a variety of viruses. The more common viruses that produce stomach flu are the noroviruses, rotaviruses, enteric adenoviruses, caliciviruses, and astroviruses. These viruses are different from the influenza virus that causes “flu.” Hence, the word “flu” is really a misnomer for viral gastroenteritis.

Intestinal flu is a fairly common condition that occurs sporadically or in epidemic proportions all over the world. It is the most commonly occurring foodborne illness and it accounts for as many as a third of all diarrheas that are due to infectious agents globally.

The intestinal flu viruses are transmitted mainly through the fecal-oral route (e.g., by eating and drinking food or water that has been contaminated when someone with the virus/es handles food without washing his/her hands after using the toilet). In addition, person-to-person transmission of the viruses can also occur.

The main signs and symptoms of intestinal flu, which usually appear one to three days after exposure to an offending virus, are watery diarrhea or loose vowel movement and vomiting. Other signs and symptoms include abdominal pain, muscle and headaches, malaise, and low-grade fever.

Intestinal flu is typically a mild and self-limiting disease that subsides spontaneously in one to six days. Thus, people who are otherwise healthy, will likely recover without complications. Restoration of water and electrolytes that have been lost through diarrhea and vomiting is the mainstay in the treatment of the illness. Most cases of the disease can be managed at home with the aid of oral rehydration solutions. Antidiarrheals and antibiotics have no place in the treatment of viral gastroenteritis. These medications will not help and may even aggravate the condition.

In rare instances, especially among infants, very young children, older adults, and people with compromised immune systems, stomach flu can present as a severe, life-threatening illness. Also, it is easy to confuse the diarrhea of intestinal flu with that of more serious gastrointestinal infections caused by bacteria such as salmonella and E. coli or parasites such as amoeba. In any case, occurrence of any of the following grave signs and symptoms should necessitate the transport of a patient with diarrhea to a hospital: presence of blood in the stool or vomit; abdominal swelling; dehydration which could manifest as severe thirst, dry mouth, sunken eyeballs, dry skin, yellow urine, or little or no urine; lethargy; severe weakness; dizziness or light headedness; high grade fever (40oC for adults; 39oC for children); and signs and symptoms that persist for more than two days.

The preventive measures that apply to diseases that are transmitted through the fecal-oral route are also applicable to viral gastroenteritis. These measures include: hand washing after going to the toilet, before handling food and before eating; meticulous cleanliness in the preparation and handling of food; sanitary disposal of human waste; drinking safe water (if you are unsure of the quality of your drinking water, boil it before drinking); protecting food from flies, cockroaches, and other insects; pasteurizing milk and dairy products; cooking food thoroughly; and refrigerating leftovers immediately.