diarrhées et vomissements

The episodes of gastro, diarrhea and vomiting generate a significant risk of dehydration.

Episodes of gastroenteritis, diarrhea and vomiting cause a significant risk of dehydration.

The discovery of ORS (oral rehydration solutions) and their usefulness in epidemics:

Oral fluid administration for diarrhea is an ancient practice and was part of traditional remedies centuries ago. In fact, 3,000 years ago, an Indian doctor named Shushruta recommended that people with diarrhea drink plenty of water with salt cubes and molasses. And it was in 1975, during a cholera epidemic in India among refugees from Bangladesh, that the first significant trials of ORS were carried out, showing a significant reduction in mortality, from 30 to 3%. Since this discovery, the use of a unique initial formula of ORS based on glucose has revolutionized the management of acute gastroenteritis by allowing effective prevention and treatment of dehydration.

What is gastroenteritis?

Acute gastroenteritis is an inflammation of the digestive tract (stomach, intestines) most often linked to viruses. Twenty million episodes of "gastroenteritis" occur each year in France. The infection occurs more frequently in winter, with a peak in January.

It can, more rarely, be due to a bacterial infection, often contracted during trips to countries where hygiene is poorer: this is called "traveler's diarrhea" or "tourista". However, it is also possible in France. It generally occurs following the consumption of contaminated water or food. In most cases, it heals on its own, the main thing being to avoid dehydration.

Symptoms of a gastro episode:

Acute viral gastroenteritis is usually short-lived, lasting a few days. Vomiting usually lasts less than 24 hours, fever (when present) 2 to 3 days, and diarrhea 3 to 4 days. Diarrhea, fever, and vomiting caused by gastroenteritis can cause water loss. Be vigilant for symptoms of dehydration (feeling thirsty, dry mouth and tongue, little or no urination, drowsiness).

How to relieve the symptoms of gastroenteritis?

Rest if you feel tired. Hydrate yourself enough to compensate for your water loss. Eat, according to your appetite, foods such as rice, carrots, apples, bananas, pasta. Avoid certain over-the-counter medications, in particular: Anti-inflammatories such as ibuprofen which can increase the risk of complications. Anti-vomiting medications which are most often useless and at risk of side effects.

The only drugs recommended by the WHO are antisecretory drugs. They allow the digestive tract to release less water and limit its elimination in the stools. Antipyretics are rarely necessary. Paracetamol can be given if the fever is very high. But these drugs are really second to oral rehydration (ORS) which is the main response to compensate for water and mineral salt losses . The old reflex of reducing drinks in the belief that it will reduce the volume of diarrhea leads directly to catastrophic dehydration. You should not use: pure water, tap or bottled, because it does not contain mineral salts and risks accentuating salt deficiencies. Nor a sugary soda, too concentrated and which draws water from the blood into the intestine and even less a caffeinated soda (cola, energy drink) whose caffeine content stimulates intestinal motility.

If oral rehydration is not possible (in the case of severe vomiting, for example), the patient must go to hospital to receive an IV , i.e. intravenously hydrated .

The hydratis solution in addition to antidiarrheals:

Hydratis lozenges are based on the principle of ORS. In fact, they are composed of electrolytes (magnesium, potassium, chloride, zinc, manganese, sodium chloride) and dextrose which is a sugar and thus allow better absorption of water by the body by constituting a significant supply of electrolytes.

Thus, these lozenges provide optimal hydration during episodes of diarrhea but do not constitute a treatment for diarrhea. They can therefore be taken in addition to antidiarrheals.

Prevention based on hygiene:

Since the transmission of acute viral gastroenteritis is mainly human-to-human, prevention and control measures for these infections are essentially based on the application of hand hygiene measures and measures to be adopted when preparing meals. Firstly, hands are the major vector for the transmission of acute viral gastroenteritis. To limit the risks of transmission, careful and frequent cleaning of hands with soap is necessary.

Secondly, since some viruses (rotavirus and norovirus) are very resistant in the environment and present on surfaces, these must be cleaned carefully and regularly in places with a high risk of transmission (children's communities, institutions welcoming the elderly).

And finally, when preparing meals, applying strict hand hygiene measures before preparing food and when leaving the toilet is essential. This is particularly important in communities (institutions for the elderly, hospital services, daycare centers) where the exclusion of sick staff (kitchens, caregivers, etc.) also reduces the risk of foodborne outbreaks.

When to consult?

Consult your doctor if you have symptoms of diarrhea and:

  • You have recently stayed in a tropical country;

  • You or your child over 2 years old have diarrhea or vomiting lasting more than 2 days, a fever above 38.5°C or the presence of mucus or blood in the stool.

  • You are over 75 or have a chronic illness

  • You are immunocompromised;

  • You can't drink;

  • You have a high fever, extreme fatigue or rapid weight loss

  • You can contact the emergency services by dialing 15 or 112 if you or your child shows signs of dehydration : unusual behavior (apathy, agitation, confusion), paleness, dry tongue, little urine, and in addition in children, dark circles under the eyes, rapid breathing or weight loss of more than 5%.

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