Diarrhoea And Vomiting

Overview

Diarrhoea means passing loose, watery poo more often than usual. Vomiting means throwing up. Together they are often called a tummy bug. They usually happen together when your gut is irritated or infected. Most people get better within a few days without special treatment.

Very common. Most people have diarrhoea and vomiting at some point, and they are one of the most frequent reasons people ask a pharmacist or doctor for advice.

Anyone can get it, but it is especially common in children, people caring for young children, and people living in close groups such as care homes or student halls. Older adults and people with weak immune systems can become more unwell.

Symptoms

Common symptoms

• Loose, watery poo
• Needing to rush to the toilet
• Tummy cramps or pain
• Feeling sick (nausea)
• Being sick (vomiting)
• Fever or high temperature
• Headache
• Feeling tired or weak
• Loss of appetite
• Aching muscles

Symptoms in children

• Fewer wet nappies or less urine
• Dry mouth and lips
• Sunken eyes
• No tears when crying
• Being sleepier or more irritable than usual
• Skin that stays pinched when gently lifted
• Fast breathing
• Weakness or floppiness

Symptoms in older adults

• Feeling very weak or dizzy
• Confusion or new forgetfulness
• Dry mouth
• Dark yellow urine or passing little urine
• Falls or trouble standing
• Fast heartbeat

Causes

Main causes

• Viral infections, such as norovirus or rotavirus — the most common cause
• Bacterial food poisoning from contaminated food or water
• Parasites, especially after travel to some areas
• Side effects of some medicines
• Food intolerance or allergies
• Other infections outside the gut

Risk factors

• Poor hand hygiene
• Contaminated food or water
• Close contact with someone who is unwell
• A weakened immune system
• Travel to areas with poor sanitation
• Being very young or very old

When to see a doctor

See a doctor urgently if:

• Blood in your poo
• Severe tummy pain
• Signs of dehydration that are getting worse
• Vomiting that stops you keeping any fluids down
• A high fever that will not come down
• Recent travel abroad or a recent hospital stay
• You are pregnant or have a weakened immune system

Book a routine appointment if:

• Diarrhoea lasting more than 7 days
• Diarrhoea that keeps coming back
• Weight loss
• A change in bowel habits that lasts
• Symptoms after starting a new medicine

Diagnosis

A doctor or nurse can usually tell what is going on by asking about your symptoms, how long you have had them, and whether you have been in contact with someone else who is unwell. They will also check for signs of dehydration. Tests are not usually needed.

Tests that may be done

• A stool (poo) sample if the illness is severe, lasting, or has blood in it
• Blood tests to check for dehydration or infection
• A urine test to check how well you are hydrated
• Tests for specific infections if you have recently travelled or been in hospital

What to expect at your appointment

You will be asked about your symptoms, what you have eaten, any travel, and medicines you take. The doctor may press gently on your tummy and check your mouth, skin, and pulse for signs of dehydration. Most people do not need further tests.

Treatment

The main treatment is to replace the water and salts you have lost. Most people can do this at home with small, frequent sips of fluid. If you become dehydrated, a healthcare professional may give you special rehydration fluids. Antibiotics are not usually needed because most cases are caused by viruses.

Self-care at home

• Drink small sips of water often. A special oral rehydration drink from a pharmacy can help replace salts.
• If you are being sick, wait a few minutes, then start with a small sip. Build up slowly.
• Eat when you feel ready — plain foods like toast, rice, bananas, or soup are gentle on the tummy.
• Avoid sugary drinks, fruit juice, and fizzy drinks as they can make diarrhoea worse.
• Rest and wash your hands well with soap and water after using the toilet and before preparing food.
• Stay at home until you have not been sick or had diarrhoea for at least 48 hours, to avoid passing it on.
• Do not give anti-diarrhoea medicine to children unless a doctor tells you to.

Medical treatments

Most people do not need medical treatment. If you are very dehydrated, a doctor or nurse may give fluids through a drip. If a specific bacterial infection is found, a doctor may consider antibiotics, but this is not common. Anti-sickness medicine is sometimes used for adults, but it is not usually given to children. Always ask a pharmacist or doctor before taking any medicine, especially for children, pregnant women, or older adults.

When is surgery considered?

Surgery is very rarely needed for diarrhoea and vomiting. It may be considered if there is a serious complication, such as a hole in the bowel, but this is uncommon.

Living with this condition

Rest at home and keep sipping fluids. Wash your hands often. Clean the toilet and bathroom regularly. Avoid cooking for other people until you have been well for 48 hours.

Lifestyle tips

• Wash hands with soap and water after the toilet and before food
• Clean surfaces and toilets
• Do not share towels or flannels
• Stay off work or school until 48 hours after symptoms stop
• Avoid swimming pools for two weeks after diarrhoea

Diet and exercise

Eat small, plain meals when you feel able. Drink plenty of fluids. Avoid alcohol and caffeine until you feel better. Gentle activity like walking is fine when you feel up to it, but rest is more important at first.

Mental health and emotional wellbeing

Diarrhoea and vomiting can be worrying, especially if you are caring for a child or an older person. It can also feel embarrassing or isolating. Feeling anxious is normal. If you are struggling with your mental health, speak to a healthcare professional. If you are in crisis, contact your local emergency number or a crisis support service in your area.

Prevention

Yes. Good hand hygiene and food safety are the best ways to reduce the risk. Some causes, such as rotavirus in babies, can be prevented with a vaccine.

Vaccines

There is a vaccine for babies against rotavirus, a common cause of diarrhoea and vomiting in young children. Ask your local health service whether it is available in your area.

Screening programmes

There is no routine screening for diarrhoea and vomiting. If you have ongoing bowel changes, your doctor may suggest tests.

Complications

If left untreated

• Dehydration — the body losing too much water and salt
• Electrolyte imbalance — when the levels of salts in your body become unsafe
• Kidney problems from severe dehydration
• Malnutrition if the illness lasts a long time
• Spreading the infection to others

Long-term outlook

Most people make a full recovery within a few days. Drink fluids, rest, and ask for help if you are worried. With the right support, serious problems are rare.

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