There really are few things worse than feeling gastrointestinal distress. Nausea,
vomiting and diarrhea can easily stop the most active and symptom-refractory
person cold in their tracks. While there are numerous possible reasons behind
these unpleasant feelings, we will take a look two different etiologies that
frequently get confused: viral gastroenteritis (stomach virus) and food poisoning. Let's check out
the differences.
Viral gastroenteritis (VGE), commonly dubbed the "stomach flu", is named aptly,
as it is caused by a viral infection. Typical symptoms can include fever, vomiting,
diarrhea and abdominal cramps, and they occur about 1-2 days post-exposure to
the responsible virus.
Rotavirus and norovirus are two of the most common viral bugs that cause VGE,
and both are highly contagious. In fact, prior to the development of the rotavirus
vaccine for children, rotavirus was the leading cause of gastroenteritis in children
globally, infecting nearly all young children before their fifth birthday. Because of
their smaller size and weight, significant diarrheal losses can greatly increase risk
for death by dehydration in children, which prompted initiation of the rotavirus
vaccine. Norovirus is flagged as the offending virus in about half of all VGE
cases and is also the culprit of about 90% of diarrheal epidemics around the
world.
These viruses transmit through fecal-oral fashion, or more simply, a person
becomes sick after swallowing infected stool. If trace amounts of fecal matter
remain on a person's hands, on commonly touched objects or even on food,
there is risk for spreading infection. As could be expected, hand washing is most
critical in prevention. Also, staying away from others during the peak of your
symptoms is important, but also take note that you can pass the virus on through
stool shedding that may last up to 14 days after symptoms have resolved. And it
is recommended to vaccinate young infants with the rotavirus vaccine series,
shown to have approximately 90% efficacy in prevention of severe rotavirus
infection.
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Due to similar symptoms, food poisoning often gets lumped in with the “stomach
bug”. Interestingly, food poisoning may also be caused by a virus, but is more
frequently the result of bacterial toxins or parasites. You’ve probably heard of the
advice, don’t eat raw cookie dough, because of the uncooked eggs. Other
sources for these bugs include raw or undercooked meat products,
unpasteurized dairy as well as seafood, unwashed produce and surprisingly,
flour. So essentially, these pathogens cross over different dietary staples, and
can cause similar feelings of gastrointestinal upset, body aches and fatigue, with
or without fever.
Sometimes, certain bacterial strains, such as Shiga toxin-producing E. coli
(STEC), can cause damage to blood vessels and lead to kidney injury and
failure. The diarrhea that accompanies food poisoning typically presents after a
few hours from the time of exposure and can often be bloody as compared to a
simple viral gastrointestinal illness.
Most cases of food poisoning resolve fairly quickly, within a day or two, as the
offending bug works its way out of the system. Properly storing, washing,
handling and cooking food products are the best means of prevention.
As noted above, one of the biggest concerns with VGE and food poisoning is the
risk for dehydration. Replacing fluid loss is important, focusing on water and
electrolyte replenishment. Water is usually best, however low sugar sports drinks
and pedialyte are also good options. While vomiting is still an active symptom,
taking small sips of fluids more frequently is most helpful to keep hydration in
balance. Alternatively, for those who can’t tolerate sips well, low sugar popsicles
or ice chips can work. Once symptoms have started to subside, increasing food
intake should be done slowly and intentionally. Going to your favorite fast food
drive through the day after GI symptoms is probably not in your stomach’s best
interest, as recovery is still underway, and greasy, processed food may counter
that process. Most physicians have navigated away from a traditional bland diet,
such as the often-referred to BRAT (bananas, rice, applesauce, toast) diet that
many pediatricians once advised, due to the lack of nutrition. Concentrate on
food choices that include healthy fats and plenty of protein and fiber, which can
be found in fruits and vegetables as well as whole grains.
Both viral gastroenteritis and food poisoning are often mild and self-limiting
illnesses (meaning they do not require medical intervention to resolve).
However, symptoms that should prompt a doctor’s attention would include
changes in stool color including blood in the stool, changes in breathing patterns
or difficulty breathing, pink or red urine, severe pain, worsening fatigue or
irritability in young children, or lingering symptoms such a fever, vomiting or
diarrhea that don’t abate within a few days.
As always, if you have any concerns, the online physicians at My Virtual
Physician, make it quick and convenient to help you! An online visit is easy to
arrange and we can help with guidance as well as testing, if necessary.
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