by Sue Mathews

Gastric health issues

The word 'gastro' is enough to send most people running

Suffering from gastro is no funny business

Don't want your boss to ask too many questions when you call in sick? Say you have gastro, the joke goes. After all, a detailed description of vomiting or diarrhoea is something no one wants to hear.

But for those afflicted, it's far from funny – especially when you throw in fever, headache, abdominal cramps and muscle aches. And the resulting dehydration can be serious – or even fatal – for young children and the elderly.

While gastroenteritis is nothing new, the last few months has seen it reach epidemic proportions on a global scale, with serious outbreaks reported. 

The outbreaks are mostly caused by infection with viruses, usually norovirus or rotavirus, explains Dr Jeremy McAnulty, director of health protection with NSW Health.

Professor Bill Rawlinson, senior medical virologist from the University of NSW, says these viruses are very easily spread from person to person.

"A kid vomits or has a bit of diarrhoea and they have incompletely washed hands, so the virus gets transmitted to someone else's mouth." This could be through person-to-person contact such as shaking hands, or by touching contaminated objects, for example a door handle.

But extra vigilance is required to stop noroviruses because they can spread in the air in droplets, causing much wider contamination of surfaces. The airborne virus may also reach the gut by being inhaled into the back of the throat.

"We think it's not a classic aerosol spread like you see with respiratory viruses," he says. You probably need to be in quite close proximity, "like a parent cleaning up a child's diarrhoea or vomit".

Dr McAnulty says: "The best way to reduce your chances of getting viral gastroenteritis is to wash your hands thoroughly with soap and running water for at least 10 seconds before handling and eating food, and always wash your hands after using the toilet.

"It is vital that if you or your family contract gastroenteritis, you stay home from work or keep a child home from school if they are sick."

If you are a parent with a young child in a childcare centre where other children have had gastro, Prof. Rawlinson advises being proactive. "Be extra careful with your own child, that they're not sharing spoons and food with their brother or sister or you because they may well be incubating it."

He says outbreaks occur every two to three years when viruses mutate in ways that make them better able to infect people.

There is no specific treatment for viral gastroenteritis except rest and drinking plenty of fluids. Replacing lost electrolytes, salts and minerals is also important. Previous advice, which recommends keeping children off solid foods for some time after gastro, is no longer the case.

The ideal way to replace lost fluid is a commercial rehydration drink, available from a pharmacy. It has the correct amounts of electrolytes such as sodium and potassium, as well as glucose for energy. This can help with two of the major gastro symptoms: headache and fatigue.

Be sure to use at the recommended strength because if it's too concentrated, it can actually promote further diarrhoea and dehydration.

"People think, 'oh it says one teaspoon per cup, I'll put in two – that'll be better'," Prof. Rawlinson says.

The loss of as little as 10% of a child's bodyweight by fluid loss can be fatal (this equates to just one litre for a 10 kilogramme child).

Older people are more prone to dehydration because their kidneys "aren't quite as good at handling changes in salt and fluid," prof. Rawlinson says. Elderly people often have other health conditions such as hardening of the arteries – thick and inflexible arteries caused by a buildup of fats and cholesterol. In those cases, a sudden drop in fluid levels in the body can trigger a heart attack or stroke, he says.

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