Diarrhoea and Vomiting: What to Do

Can You Have Diarrhoea and Vomiting Together?

It's a common and often unpleasant experience, but yes, you can definitely have diarrhoea and vomiting at the same time. This combination is frequently caused by what's commonly known as a 'stomach bug' or gastroenteritis, a viral or bacterial infection that affects the digestive system. While it can be concerning, especially for young children and the elderly, these symptoms usually subside within a few days. The advice for managing diarrhoea and vomiting, whether they occur together or separately, remains largely the same, with a strong emphasis on staying hydrated and resting.

Understanding the Causes

The primary culprit behind simultaneous diarrhoea and vomiting is often an infection. Let's break down the common causes:

• Viruses: Norovirus and rotavirus are notorious for causing these symptoms. They are highly contagious and spread easily through contaminated food, water, or contact with an infected person.
• Bacteria: Food poisoning from bacteria like Campylobacter and E. coli can also lead to sudden onset of diarrhoea and vomiting. This often occurs after consuming undercooked food or food that has been improperly handled.
• Parasites: Less common in developed countries, but parasites like Giardia can cause similar symptoms, often contracted from contaminated water sources.
• Other Factors: While infections are the most frequent cause, diarrhoea can also be triggered by anxiety, food allergies, certain medications, or underlying chronic conditions like Irritable Bowel Syndrome (IBS). Vomiting, on its own, can sometimes be a reaction to certain foods or medications.

Home Treatment: Your First Line of Defence

In most cases, diarrhoea and vomiting can be managed effectively at home. The most crucial aspect of recovery is preventing dehydration. Here's what you should do:

Stay Hydrated: The Golden Rule

Fluid loss is the main concern with both diarrhoea and vomiting. It's vital to replenish lost fluids. Here's how:

• Drink Plenty of Fluids: Opt for water, weak, unsweetened squash, or clear broths. If you feel nauseous, try taking very small sips frequently rather than large gulps.
• Oral Rehydration Solutions (ORS): For babies, young children, the elderly, or those with weakened immune systems, ORS are highly recommended. These are specially formulated powders that you mix with water to replace lost salts and sugars. Pharmacists can advise on the best ORS products.
• Breastfeeding and Formula: If you're breastfeeding or bottle-feeding your baby, continue as normal. If they are being sick, try offering smaller feeds more frequently. For babies on formula or solids, offer small sips of water between feeds.

Rest and Eat When Able

• Get Plenty of Rest: Your body needs energy to fight off the infection. Stay at home and allow yourself to recover.
• Eat When You Feel Up To It: Don't force yourself to eat if you feel nauseous. When you do feel hungry, start with bland, easy-to-digest foods. Think toast, crackers, bananas, or rice. Avoid fatty, spicy, or very sugary foods, as these can sometimes worsen diarrhoea.

Pain Relief

If you're experiencing discomfort, paracetamol can be taken to help manage symptoms. Always follow the dosage instructions on the packaging, and never give paracetamol to children under the age of 16 without consulting a doctor or pharmacist. Crucially, do not give aspirin to children under 16.

What NOT to Do

There are certain things you should avoid when experiencing diarrhoea and vomiting:

• Avoid Fruit Juice and Fizzy Drinks: The high sugar content in many fruit juices and fizzy drinks can exacerbate diarrhoea.
• Do Not Dilute Formula: If you're preparing baby formula, always use the recommended strength. Weakening it can deprive the baby of essential nutrients and may worsen diarrhoea.
• No Anti-Diarrhoea Medicine for Young Children: Generally, children under 12 should not be given medication to stop diarrhoea without medical advice.

How Long Will It Last?

The duration of symptoms can vary:

While vomiting often subsides quickly, diarrhoea can linger for up to a week. If symptoms persist beyond these times, it's important to seek medical advice.

Preventing the Spread of Infection

Gastroenteritis is highly contagious. To protect others, it's essential to practice good hygiene:

• Stay Home: Avoid school or work until you have been symptom-free (no vomiting or diarrhoea) for at least 48 hours. If you have a fever or feel generally unwell, it's best to stay home until you feel significantly better.
• Frequent Handwashing: This is paramount. Wash your hands thoroughly with soap and warm water after using the toilet, before eating, and before preparing food.
• Cleanliness is Key: Regularly clean toilet seats, flush handles, taps, and frequently touched surfaces with a disinfectant.
• Laundry: Wash any clothing or bedding that may have come into contact with vomit or faeces separately, using a hot wash cycle.
• Avoid Sharing: Do not share towels, flannels, cutlery, or utensils with others while you are ill and for a period afterwards.
• Food Preparation: If possible, avoid preparing food for others when you are ill.
• Swimming Pools: Refrain from using swimming pools for at least 48 hours after your symptoms have completely stopped.

When to Seek Professional Advice

While most cases resolve on their own, there are situations where you should consult a healthcare professional:

Speak to a Pharmacist if:

• You or your child (over 5 years) show signs of dehydration (dark, smelly urine, reduced urination, feeling dizzy).
• You are elderly, have a weakened immune system, or have other health conditions that increase your risk of dehydration.
• You need to stop diarrhoea for a specific, short period (e.g., for travel). A pharmacist may recommend oral rehydration powders or short-term anti-diarrhoea medication like loperamide (not for children under 12).

Call 111 for Urgent Advice if:

• You are worried about a baby under 12 months old.
• Your child stops feeding while ill.
• A child under 5 has signs of dehydration (e.g., fewer wet nappies than usual).
• Dehydration symptoms persist even after using ORS.
• You or your child keep being sick and cannot keep any fluids down.
• There is blood in the diarrhoea or bleeding from the bottom.
• Diarrhoea lasts for more than 7 days, or vomiting for more than 2 days.

Immediate Action Required: Call 999 or Go to A&E if:

These are signs of a more serious condition:

• Vomiting blood or vomit that resembles 'ground coffee'.
• Green vomit (in adults).
• Yellow-green or green vomit (in children).
• Suspected poisoning.
• Stiff neck and pain when looking at bright lights.
• Sudden, severe headache.
• Sudden, severe tummy ache.
• Pale, blue, grey, or blotchy skin, lips, or tongue (this can be harder to spot on darker skin tones).
• Severe difficulty breathing or rapid, short breaths.
• Confusion or unresponsiveness.

Important Note on A&E: If you need to go to A&E, do not drive yourself. Ask someone to take you or call 999 for an ambulance. Bring any medications you are currently taking with you.

What is Considered Severe Pain?

Understanding pain levels can help you gauge the severity of your symptoms:

• Severe Pain: Constant, debilitating pain that makes it difficult to think, talk, or sleep. Movement is extremely challenging.
• Moderate Pain: Constant pain that interferes with concentration or sleep, but you can still manage basic activities like getting up and washing.
• Mild Pain: Pain that comes and goes, is noticeable but doesn't prevent you from carrying out daily activities.

If you experience severe pain, seek medical attention immediately.

Frequently Asked Questions

Q1: Can I eat normally if I have diarrhoea and vomiting?
A1: It's best to start with bland foods like toast, crackers, bananas, and rice when you feel able to eat. Avoid fatty, spicy, or sugary foods initially, as they can worsen symptoms.

Q2: How can I prevent dehydration?
A2: The key is to drink plenty of fluids, such as water, weak squash, or clear broths. Take small, frequent sips, especially if you feel nauseous. Oral rehydration solutions are particularly effective.

Q3: When should I return to work or school?
A3: You should stay off work or school until you have been free of vomiting and diarrhoea for at least 48 hours.

Q4: Is it safe to give my child anti-diarrhoea medicine?
A4: Generally, children under 12 should not be given medication to stop diarrhoea without consulting a doctor or pharmacist. Always follow professional advice.

Q5: What if my baby has diarrhoea and vomiting?
A5: Continue with breast or bottle feeds, offering smaller amounts more frequently if they are being sick. Offer small sips of water between feeds. Seek urgent advice from 111 or a GP if you are worried, especially if the baby stops feeding or shows signs of dehydration.

Remember, while these symptoms are common, paying attention to hydration and hygiene is key to a swift recovery and preventing the spread of infection.

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