Doc, Do I Have the “Stomach Flu”?

Two days before he came in for an office visit, my patient Jake (not his real name) started having stomach cramps and a low-grade fever (under 102°F). He also had a total of 9 episodes of vomiting and/or diarrhea. Although he didn’t have diarrhea after the first day, he was still feeling nauseous. He had been trying to keep down sips of water and oral rehydration solution. He told me he felt very weak, tired, and achy. My nurse had checked Jake’s temperature and noted that he didn’t currently have a fever.

Jake is a 23-year-old man who is generally in good health. He said he decided to make an appointment because he thought he had the “stomach flu.” He works at a restaurant where he comes in contact with food. Before returning to work, he wanted to be sure he wasn’t contagious. He mentioned that one of his coworkers had been sick with similar symptoms the previous week.

After asking Jake about his symptoms and giving him a physical exam, I diagnosed him with a very common condition called gastroenteritis. Many people call it the “stomach flu,” but gastroenteritis is not the same as the flu (influenza). The flu is a respiratory illness. Gastroenteritis is the medical term for an inflammation and irritation of your stomach and intestines.

Viruses called norovirus and rotavirus are the most common causes of gastroenteritis. It can also be caused by bacteria, parasites, or toxins. To rule out these other causes, I asked Jake whether he had recently traveled outside of the area, eaten any undercooked (raw or partially raw) meat or fish, or used an antibiotic. He hadn’t done any of these things recently. I told him that his symptoms were most likely caused by a virus.

Gastroenteritis caused by a virus is highly contagious. It’s easy to get a stomach virus from an infected person, surface, or object. Symptoms usually go away on their own in 2 to 7 days. There is no medicine that can cure a stomach virus. Simple home treatment includes proper hand washing, rest, and hydration.

I advised Jake to do the following:

• Prevent the spread of the virus by washing his hands frequently with soap and water, especially before meals and after using the bathroom.
• Rest at home until he had been completely symptom-free for 48 hours.
• Stay hydrated.
• Stay on a clear liquid diet for 24 to 48 hours. Then, slowly add a few bland solid foods (for example, plain toast or saltine crackers) before returning to a normal, healthy diet. (Learn more about what to eat when you’re recovering from a stomach virus.)
• Avoid alcohol, caffeine, and dairy products for a few days.

Jake’s medical record showed that he was not currently taking any prescription or over-the-counter (OTC) medicines. I told him that he could take an OTC antiemetic medicine to help relieve nausea and vomiting (2 brand names: Kaopectate, Pepto-Bismol), if necessary. For fever or body aches, he could take OTC acetaminophen (one brand name: Tylenol). He should not take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen. These medicines might irritate his stomach.

For healthy adults like Jake, the symptoms of gastroenteritis are usually mild. In most cases, you don’t need to see a doctor when you have a stomach virus. I told Jake that he should call my office if his symptoms lasted longer than a week or got worse. He followed my instructions and started to feel better. Within a few days, he was back on his normal diet and returned to work.

Quick Tip

When you have gastroenteritis, repeated vomiting and diarrhea can cause dehydration. This is the loss of too much fluid from your body. You can usually treat mild dehydration at home by drinking more fluids. Water, ginger ale, and sports drinks without caffeine are good options.

Learn more about the signs of dehydration, how to stay hydrated, and when to seek medical attention.