Diarrhea and vomiting: what helps with vomiting diarrhea?

Did you know that around 65 million acute gastrointestinal diseases occur in adults in Germany every year? If you spend large parts of the day in the toilet with diarrhea, it is often due to an infection. We explain what you can do about it and how you can best prevent gastrointestinal infections.

What gastrointestinal infections are there?

A rumbling stomach associated with nausea and diarrhea is popularly known as ” gastrointestinal” or “gastrointestinal flu” . You are probably familiar with this term, but it is misleading. Because the contagious influenza A and influenza B viruses of a real flu have nothing to do with an infection of the gastrointestinal tract.

If the upper and lower digestive tract are affected, the doctor speaks of gastroenteritis – this is an inflammatory disease of the gastrointestinal tract. This can manifest itself with the symptoms vomiting and diarrhea. We speak of diarrhea if those affected have “unshaped” to liquid stools more than three times a day.

Gastroenteritis can have a number of causes. By the way: If the stomach is not affected, it is called enteritis.

The causes of gastroenteritis can be divided into three groups:

1. Infections with viruses or bacteria

In the case of gastrointestinal complaints that set in quickly, infections with rotaviruses or noroviruses are common. According to the Robert Koch Institute , as little as 10 to 100 viruses are enough to trigger infectious gastroenteritis (“gastrointestinal flu”). If bacteria such as the bacterial strain Campylobacter jejuni (Campylobacter enteritis), coli bacteria such as Escherichia coli or Salmonella are responsible for the infection, severe abdominal pain often occurs in addition to diarrhea, which can also occur as an accompanying symptom with viral diseases.

Infectious gastroenteritis causes inflammation of the mucous membrane of the gastrointestinal tract caused by viruses, bacteria or (more rarely) parasites . These get into the mouth through food or a smear infection and thus into the digestive tract.

Bacteria multiply on protein-rich foods such as eggs, poultry, meat, milk or ice cream if hygiene is poor or the cold chain is interrupted . If they get into the body, they often damage the intestinal mucosa via toxins.

After infection, our immune system tries to get rid of the intruders, with fever, general malaise as well as headache and body aches or fatigue often added as defense reactions .

Acute infectious gastroenteritis occurs about six hours to two days after infection with the pathogens and usually subsides within a few days in healthy people . Depending on the pathogen, however, the course of the disease can be severe. This is not uncommon for infections with EHEC bacteria, salmonella, but also noroviruses.

2. Intolerances and allergies

Gastroenteritis can also be caused by “eating the wrong thing”. A distinction should be made here between a food allergy and a food intolerance.

But there are two key differences:

With a food allergy, the immune system is misdirected, causing your body to produce specific IgE antibodies that are directed against proteins that are ingested with food. These proteins are recognized by messenger substances in your immune system as harmful substances and are fought by triggering an allergic reaction.

In the case of food intolerance, there is a digestive disorder. The reason for this is either a lack of the enzymes necessary for digestion and the utilization of food components , or more rarely a genetic defect in which an enzyme required for digestion cannot be produced by the body.

FOOD ALLERGIES

When a certain part of our immune system reacts to actually harmless, but recognized as foreign substances in food, this is often expressed in inflammatory defense reactions combined with symptoms such as diarrhea or itching. In severe cases, anaphylactic reactions such as shortness of breath, drop in blood pressure or edema can occur. 

The most common allergies are to nuts, legumes, pome and stone fruits, carrots and celery, as well as soy and wheat.

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LACTOSE INTOLERANCE / LACTOSE INTOLERANCE

If insufficient lactase can be produced in the intestinal mucosa , lactose ingested with food is transported from the small intestine to the large intestine, almost undigested. Lactase is the enzyme that breaks down milk sugar, i.e. lactose, in our small intestine.

The lactose we do not ingest is later broken down by the bacteria in the colon . This produces lactic acid and carbon dioxide, among other things. Painful gas and diarrhea can result.

Those affected should limit or even refrain from consuming milk and certain dairy products such as butter, yogurt, quark and certain types of cheese .

Fructose intolerance/ Fructose intolerance

If a larger proportion of fructose is not already absorbed in the small intestine and thus reaches the large intestine, doctors speak of intestinal fructose malabsorption , or simply: fructose intolerance . The unabsorbed (malabsorbed) fructose binds water in the large intestine and leads to symptoms such as diarrhea, flatulence and abdominal pain. Hereditary, i.e. genetically determined, fructose intolerance, which can be traced back to an enzyme defect, occurs much less frequently. When fructose is broken down in the liver, the enzyme aldolase B is missing, which means that the fructose content in the cells is toxic and has an impact on the body’s blood sugar balance.

Even with people without allergies or intolerances, the consumption of large amounts of ripe fruit with a lot of fructose (e.g. bananas, cherries, apples and grapes) can lead to large amounts of water being bound in the intestines during digestion. This can cause liquid stools.

3. Poisoning

If gastroenteritis is caused by toxins, one speaks of food poisoning.

POISONS PRODUCED BY BACTERIA AND MOLD

Different types of mold and bacteria are widespread in nature and feel very comfortable in a warm and humid environment. If, for example, raw meat is not stored refrigerated for a few hours in summer, staphylococci can quickly settle on it, which are found on the nasal mucous membrane of around 80 percent of all people and multiply particularly quickly at temperatures of 30 to 37 degrees Celsius

The spores of naturally widespread molds, which are transported via the air, quickly settle on plant-based foods in a warm and humid environment. If, for example, nuts have not been stored in a dry and cool place, discoloration and unpleasant smells can be noticed during peeling , which indicate the presence of mold. If a fungal attack is detected, the respective food should no longer be consumed, as the fungus has usually already spread to larger areas invisible to the naked eye, warns the Federal Office for Consumer Protection and Food Safety.

Both the metabolic products of various bacterial strains and molds (mycotoxins) are toxic to our organism. If food contaminated with bacteria or mold is consumed, it can lead to inflammation of the mucous membranes in our digestive tract , resulting in the symptoms of food poisoning.

Toxic gastroenteritis can also occur as a result of taking medication . For example, after taking antibiotics or taking medication that lower the acidity in the stomach (proton pump inhibitors) , the bacteria of the type Clostridium difficile can increasingly settle in the colon, which can cause severe watery or bloody diarrhea as well as abdominal pain and fever.

Gastroenteritis: These are the most common symptoms

Depending on where the mucous membrane is attacked in our digestive tract, the symptoms of gastroenteritis can vary greatly.

What are the symptoms of a gastrointestinal infection?

If viruses are the trigger for a gastrointestinal infection, doctors speak of infectious gastroenteritis. This usually sets in suddenly with the ingestion of the pathogens through food. The body tries to excrete the virus strains (often rotaviruses or noroviruses) or their toxic metabolic products via a defense reaction by flushing out.

Symptoms include nausea, strong nausea or gushing vomiting . Fever and loss of appetite, pain in the limbs, skin rash or mucus and blood in the stool can also occur as side effects. Get the pathogens continue into the small intestine or large intestine, patients suffer most under diarrhea (diarrhea). Our alarmed immune system tries to excrete the virus through bowel movements. A combination of these symptoms, i.e. vomiting diarrhea, is also possible.

Rather ambiguous side effects are abdominal cramps or muscle pain (myalgia). Those affected often complain of tiredness and headaches. The clinical symptoms usually subside after 12 to 48 hours.

During this time there is a high risk of infection because some of the pathogens, e.g. B. noroviruses, are very resistant. The Robert Koch Institute (RKI) therefore also points out, for example, that there is an obligation to report suspected acute, infectious gastroenteritis , provided that the patient handles food or works in a communal catering facility such as a kitchen or restaurant. In addition, due to the rapid transferability and high risk of infection, according to the German Infection Protection Act, there is an obligation to report gastroenterides caused by the following pathogens:

  • enterohemorrhagic coliform bacteria (EHEC)
  • Salmonella Typhi
  • Vibrio cholerae
  • Norovirus (reporting only for direct evidence from stool)
  • Rotavirus
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When do you have to see a doctor?

If you have severe circulatory problems, muscle cramps, sleepiness, confusion or a high fever, if you have blood in your stool or vomiting diarrhea lasts longer than three days, you should urgently consult a doctor – even though you are actually healthy. Further risk groups are small children, pregnant women or the elderly who , in addition to weakened immune systems, quickly suffer from the consequences of the loss of salt and fluid caused by vomiting and diarrhea. This dehydration can quickly affect the circulatory system with side effects such as palpitations, low blood pressure and fatigue and, in the form of confusion, affect mental performance.

In more severe cases, the attending physician can use infusions to compensate for dehydration in the body. If nausea is a severe symptom, the doctor can also decide whether antiemetics can be used to suppress the nausea . Short-term hospitalization is only required in rare cases.

What to do about rotavirus and norovirus?

The Robert Koch Institute registers around 50,000 infections with the rotavirus in Germany. Rotaviruses are the most common cause of dehydrating diarrhea in children in the first two years of life .  It is transmitted fecal-orally, which means that the pathogens usually get into the mouth via a smear infection from excrement. Rotavirus infection causes nausea and vomiting, and can also trigger a high fever. The good news: Rotavirus infection can be prevented by vaccination . It is particularly useful for small children, the elderly and people with a weakened immune system.

However, there is no vaccination against norovirus infections, which are also very common. Here, too, children, the elderly and people with a weakened immune system are particularly at risk. Like rotaviruses, noroviruses romp about in buildings or facilities where many people are housed in confined spaces. In old people’s homes, kindergartens and schools, it is very easy to get infected with the norovirus, which enters the mouth and thus the digestive tract either through contaminated food and drinks or via a smear infection .

The virus can get on your hands and from there into your mouth through handshakes, drying on a contaminated towel, or touching a contaminated door handle or faucet in the bathroom. The Federal Center for Health Education (BzgA) warns that infection can also occur through small, virus-containing droplets in the air that arise when vomiting . Because our immune system is particularly susceptible in the winter months and we are often with other people in heated rooms, infections occur particularly often from October to March .

Diarrhea and Vomiting: What to Do Now

If you register the symptoms of vomiting diarrhea, you should do one thing above all: act immediately to support your recovery and also to protect your environment!

We have put together a small checklist for you:

DRINK A LOT

If you notice a very dry tongue or dark urine output, it indicates a large loss of fluid that can occur with vomiting and diarrhea. Then at the latest it is time to act. To balance it out, drink two to three liters of still water, diluted juices, unsweetened herbal teas or use oral rehydration solutions from the pharmacy every day.

A TIP ON “OLD HOME REMEDIES”

You should avoid cola because of its high sugar content. Salt sticks are also a common home remedy to compensate for the loss of electrolytes. But be careful: pretzel sticks contain sodium, but no potassium. Special solutions or powders for mixing special drinking solutions from the pharmacy are a useful addition. You can find more about this in our article: Why cola and pretzel sticks are not a good combination for stomach pain .

EASILY DIGESTIBLE MEALS BRING NEW ENERGY
  • Bananas:  The tropical fruit contains large amounts of potassium, magnesium and vitamin B6, which is important for protein metabolism . In addition, bananas contain a great deal of the fiber pectin and bind water in the intestine, which helps to thicken the food pulp in the intestine.
  • Rusks:  The double-baked bread is a classic home remedy, very digestible and contains little fat. If the rusk is too dry or hard for you , you can also have dry white bread as an alternative .
  • Potatoes:  The tuber contains little fat, but a lot of fiber as food for your intestinal bacteria and a lot of potassium and thus replenishes your empty electrolyte stores. Jacket potatoes, which you can also eat pureed, are best suited. In addition to an appropriate diet, other remedies can also help to get the symptoms of diarrhea under control.
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Here you will find a small checklist with active ingredients that can alleviate the symptoms of acute diarrhea:

FLOH TOGETHER DISHES

The coarsely and finely ground seed coats contain 85 percent soluble fiber . When mixed with water, the psyllium husks swell and form a gel-like mass that can regulate the consistency of the stool. In the case of diarrhea, the stool can also be thickened. Soak two teaspoons (5 to 10 grams) of psyllium husks in about 100 ml of water or unsweetened tea before drinking this mixture up to three times a day. Important: Since flea seeds swell, you should drink two glasses of water again after taking them. Flea seeds are available in organic shops, pharmacies or health food stores.

RACECADOTRIL

Preparations with the active ingredient are antidiarrheal. For adults, these preparations are available from pharmacies without a prescription. Racecadotril inhibits the formation of the enzyme enkephalinase and thus combats the excessive influx of water and electrolytes into the intestine without impairing the bowel movement (motility). This normalizes bowel movements and reduces the urge to go to the bathroom. 50 percent of patients recover after taking Racecadotril within 10 hours, 80 percent within a day.

LOPERAMID

The active ingredient inhibits the movement and muscle activity of the intestine and counteracts the formation of secretions. This reduces the frequency of the stool and solidifies the stool. Adults should initially take 4 mg, then 2 mg after each unformed stool (max. 12 mg / day). Without a doctor’s recommendation, the intake should not last longer than two days. Loperamide must not be used in febrile or bloody diarrhea.

PROBIOTICS

These are microorganisms, mostly bacteria from the group of lactic acid bacteria, which – taken orally – survive the gastrointestinal passage in sufficiently high numbers. Once in the intestine, they support the unbalanced intestinal flora and help the intestine to help itself. Various products with certain bacteria and yeasts are available for the probiotic treatment of diarrheal diseases. You can get advice on this from your doctor or pharmacy.

How you can prevent gastrointestinal infections

The most important thing in preventing virus-induced gastrointestinal flu is thorough hygiene . Since the pathogens are mainly transmitted through smear infections, you should wash your hands thoroughly after every use of the toilet and before preparing food or drinks . You should use a clean towel to dry off and replace it with a fresh one regularly. Only use your own hygiene items so that you can be sure that they are not contaminated by pathogens from others.

If you deal with a sick person on a daily basis, you should avoid direct skin contact with them for up to two days after the symptoms of the disease have subsided. When caring for sick family members, especiallyObviously, if your child has gastroenteritis , this is difficult. Therefore, wash your hands thoroughly after coming into contact with a sick person. Surfaces around the patient such as doorknobs, sinks, floors or toilets should be cleaned with a little water and a cleaning agent and, if necessary, also disinfected.

Since noroviruses are very resistant and can withstand temperatures of 70 degrees Celsius for several minutes without damage, you should have cooked potentially contaminated foods such as dishes with seafood or meat well before consuming them. In summer you should try to avoid direct contact or consumption of raw meat – germs can quickly settle on this.

Diarrhea and vomiting: common causes and pathogens in vomiting diarrhea

Diarrhea should not be taken lightly, because the causes can be varied. If there are pathogens behind, they are excreted naturally after a few days and accompanying complaints such as abdominal pain or nausea subside again.

No vomiting diarrhea, but also uncomfortable: diarrhea in the heat

In addition to a sufficient supply of lost water and electrolytes, which have been washed out, it is crucial to alleviate the diarrhea. However, especially if the symptoms are severe or long-lasting or recur, you should consult a doctor. Especially pregnant women, children or the elderly should seek medical advice quickly if they have vomiting diarrhea.

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