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diarrhées et vomissements

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

The episodes of gastro, diarrhea and vomiting generate 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. Indeed, 3000 years ago an Indian doctor named Shushruta recommended that people with diarrhea drink plenty of water with pieces of salt and molasses. And it was in 1975, during a cholera epidemic that appeared 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 glucose-based ORS has revolutionized the management of acute gastroenteritis by allowing prevention and effective 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 "gastros" occur each year in France. 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 less high: we speak of "traveller's diarrhea" or "tourista". However, it is also possible in France. It usually occurs following the consumption of contaminated water or food. It heals in most cases on its own, the main thing being to avoid dehydration.

Symptoms of a gastro episode:

Acute viral gastroenteritis is generally of short duration, of the order of a few days. Usually, vomiting lasts less than 24 hours, fever (when present) 2-3 days, and diarrhea 3-4 days. Diarrhea, fever, and vomiting caused by gastroenteritis can cause water loss. We must remain vigilant to the symptoms of dehydration (thirst, dry mouth and tongue, urinating little or not at all, drowsiness)

How to relieve the symptoms of gastroenteritis?

Rest if you feel tired. Stay hydrated enough to make up for your water loss. Eat, according to your appetite, foods such as rice, carrots, apples, bananas, pasta. Avoid certain over-the-counter medications, including: Anti-inflammatories such as ibuprofen which can increase the risk of complications. Medications for vomiting which are most often unnecessary and at risk of side effects.

The only drugs recommended by the WHO are anti-secretory drugs. They allow the digestive tract to release less water and limit its elimination in the stool. Antipyretics are rarely needed. Paracetamol can be given if the fever is very high. But these drugs are really in the background compared to oral rehydration (ORS) which is the major response to compensate for the loss of water and mineral salts . The old reflex of reducing drinks in the belief that it reduces the volume of diarrhea directly leads to catastrophic dehydration. Do not use: pure water, tap or bottled, as it does not contain mineral salts and risks accentuating salt deficits. Neither 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 motricity.

If oral rehydration is impossible (in case of severe vomiting for example), the patient must go to the hospital in order to be perfused , that is to say hydrated intravenously.

The hydratis solution in addition to antidiarrheals:

Hydratis lozenges are based on the principle of ORS. Indeed, 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 an important contribution. in electrolytes.

Thus, these lozenges allow optimal hydration during episodes of diarrhea but do not constitute a treatment against 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, the measures to prevent and control these infections are essentially based on the application of hand hygiene measures and measures to be adopted when preparing meals. First, the hands are the major vector for the transmission of acute viral gastroenteritis. To limit the risk of transmission, careful and frequent cleaning of hands with soap is necessary.

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

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

When to consult?

See your doctor if you have symptoms of diarrhea and:

  • You recently stayed in a tropical country;

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

  • You are over 75 or have a chronic illness

  • You are immunocompromised;

  • You can't drink;

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

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

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