Vomiting and Diarrhoea

Symptoms

Vomiting and diarrhoea cause the loss of body fluids and can result in dehydration. There are many causes, for example, microbes in the stomach can cause gastroenteritis, which has the symptoms of vomiting and diarrhoea; these symptoms can also be caused by a reaction to particular medicines or medical conditions. In gastroenteritis, the bowel motions are watery, frequent and can be greenish-brown or tan in colour. Vomiting usually settles quickly, but diarrhoea can last for a week or more. Other symptoms of gastroenteritis can include fever, nausea, headache, loss of appetite, and cough or sore throat. Gastroenteritis can be bacterial or viral in origin. In bacterial gastroenteritis:

• fever tends to be persistent and high (>38°C)
• stomach pains are often quite severe
• there can be blood and mucus in the bowel motion.

You should seek medical attention if you have symptoms of bacterial gastroenteritis.

Dehydration

Losing a large amount of body fluids can cause dehydration which has the following symptoms:

• increased thirst and dry mouth
• passing very small volumes of dark coloured urine
• skin is inelastic and stays up when lightly pinched
• feeling listless, dizzy, tired or restless
• breathing can become faster or slower, or laboured
• the soft spot (fontanelle) on a baby’s head becomes sunken.

Young babies and the elderly can become dangerously dehydrated very quickly. If an individual is dehydrated, see your doctor or ask your pharmacist for advice immediately.

Causes

Gastroenteritis (‘gastro’) is a common illness for both young children and adults that is caused by bacteria, viruses, toxins or parasites, although viruses are the most common cause and occurs through:

• close personal contact with an infected person, or their faeces, or by touching contaminated surfaces such as taps, toilet flush handles, children’s toys and nappies
• eating contaminated food (food poisoning)
• drinking contaminated water
• inhaling airborne viruses from infected people vomiting, coughing and sneezing near you
• handling pets and other animals.

People and animals can carry the microbes in their faeces and pass the disease on to others without having any symptoms.

Lifestyle options

To avoid getting gastroenteritis always wash your hands:

• thoroughly with soap and water. Hand sanitisers can be used if there is no water
• before preparing food
• between touching raw and ready-to-eat food
• before eating
• after going to the toilet or changing nappies
• after smoking
• after using a tissue or handkerchief
• after playing with pets.

If you or your baby have gastroenteritis:

• Do not go to work until the symptoms have totally cleared especially if your work involves food handling, child care or health care.
• If your baby is bottle-fed, give clear fluids instead of formula for 12–24 hours. Re-introduce once the symptoms have improved and your child seems to be hungry again.
• If you are breastfeeding do not stop breastfeeding.

If there are signs of dehydration
It is essential that you replace the fluid lost through vomiting and diarrhoea. Sip fluids, preferably water, slowly and frequently – try a teaspoon of fluid every five minutes, or 30 mls every half an hour. Frequent small amounts of fluid are easier to tolerate than a large glass of water.

Pharmacy Options

Always inform pharmacy staff if you are taking any other medicines, or if you have any other health conditions, because some over-the-counter medicines may not be suitable for you. People who are moderately dehydrated will feel better more quickly if they take specially formulated oral rehydration solutions (ORS) rather than drinking plain water.

Oral rehydration solutions are available as dispersible tablets, liquids and ice blocks and are specially formulated to replace the lost fluid and body salts (electrolytes). They are an effective early treatment for gastroenteritis. Follow the product instructions carefully to correctly prepare and store the solution. Giving oral rehydration solutions that are cooled can make it more palatable. Replacement fluids will not stop the vomiting or diarrhoea, but will help prevent dehydration. If a child refuses rehydration solution, try diluted lemonade or very diluted unsweetened pure fruit juice (dilute 1 cup with 4 cups of water). Avoid ‘diet’ soft drinks. Do not give full strength fruit juice or fizzy drinks as they can worsen the diarrhoea and dehydration.

Loperamide is a medicine which may provide symptomatic relief from diarrhoea and might be recommended by your doctor or pharmacist in some circumstances.

Talk to your pharmacist or see a doctor if:

• you have blood or bile in your vomit or bowel motions
• you are losing weight
• you have a compromised immune system or have a medical condition
• you recently started a medicine and the vomiting or diarrhoea may be a side effect
• the vomiting is severe
• you are pregnant
• the patient is a young baby, a young child or is elderly, because these patients are at high risk of dehydration.

If vomiting or diarrhoea continues for more than 12 hours (even with adequate hydration), talk to your pharmacist or seek immediate medical advice. Ask your pharmacist for advice on the most suitable treatment for you.

More information

Health Direct: www.healthdirect.gov.au
NPS MedicineWise: www.nps.org.au or phone 1300 MEDICINE (1300 633 424)
Disclaimer: The information provided is a guide only, is current at time of publishing, and is not intended to replace the advice of your pharmacist or doctor. 

IN EMERGENCIES DIAL 000.