The Health Counsellor

Diarrhea is usually short-lived, lasting no more than a few days. But, when diarrhea lasts for weeks, it usually indicates that’s there’s another problem. If you have diarrhea for weeks or longer, you may have a condition such as irritable bowel disorder, or a more serious disorder, such as a persistent infection or inflammatory bowel disease.

Causes:

• Bacteria, parasites, viruses (including norovirus )
• Food poisoning e.g. from food that has been improperly stored
• Consumption of irritating food, drink or medication
• Pregnancy
• Overeating or overdrinking (especially alcohol)
• Stress and anxiety
• Taking antibiotics recently

Symptoms:

Symptoms may include abdominal pain, nausea, vomiting, diarrhea, and fever. People may feel very sick and vomit many times a day. Most people improve within three days. However, sometimes people become dehydrated and need medical treatment. Dehydration is the most serious complication. 

Transmission:

Norovirus, a common cause of infectious outbreaks, can easily spread from person to

person. People are contagious from the moment they begin to feel ill until at least three days after recovery. Good hygiene is critical to break the chain of transmission.

Specific means of transmission are:

• Having close contact with another person who is infected, for example by providing health care or sharing food or utensils
• Touching contaminated objects then touching your mouth
• Consuming contaminated food or drinks

Self care for adults

For vomiting, follow these instructions in order:

• Do not eat or drink anything for several hours after vomiting.
• Sip small amounts of water or suck ice chips every 15 minutes for 3-4 hours.
• Next, sip clear liquids every 15 minutes for 3-4 hours. Examples include water, sports drinks, flat soda, clear broth, gelatin, flavored ice, popsicles or apple juice. Do not drink citrus juices or milk. Increase fluids as tolerated.
• When you can tolerate clear liquids for several hours without vomiting and if you’re hungry, try eating small amounts of bland foods. Try foods such as bananas, rice, applesauce, dry toast, soda crackers (these foods are called BRAT diet). For 24-48 hours after the last episode of vomiting, avoid foods that can irritate or may be difficult to digest such alcohol, caffeine, fats/oils, spicy food, milk or cheese.
• When you can tolerate bland food, you can resume your normal diet. 

• Retake medications if vomiting occurs within 30 minutes of taking usual medication. If you vomited after taking oral contraceptive pills, use a back-up contraception method for the rest of the month.

When to call for medical advice:

• Call for medical care if you:
• Can’t keep down liquids or food for more than 24 hours
• Have fever (101º F or 38.3º C or higher) with abdominal pain (may include diarrhea, vomiting, nausea)
• Have diarrhea for more than 3 days or without gradual improvement over 5 days
• Have signs of dehydration, for example, lightheadedness, decreased urination (no urination at least every 8 hours) or severe fatigue
• Took antibiotics recently
• Have bloody diarrhea
• Have abdominal pain that is not relieved by vomiting and/or diarrhea (that is, abdominal pain is unrelated to episodes of vomiting or diarrhea)
• Have insulin-dependent diabetes and experience vomiting, diarrhea or nausea
• Are unable to take medications that you usually take
• Recently traveled to a country that poses a health risk

Prevention:

• Wash hands frequently with soap and water and wash for at least 15 seconds, especially after toilet visits and before eating. Hand-washing is more effective than hand sanitizer against norovirus , but do use alcohol-based sanitizer when hand-washing is not possible.

• Don’t share eating utensils, drinking glasses or bottles, toothbrushes or other personal items.
• Sharing keyboards and other items? Be sure to wash your hands and clean surfaces.
• Using wipes with bleach helps.
• Immediately after an episode of illness, flush vomit and feaces in the toilet and make sure that the surrounding area is clean.
• Before cleaning, put on disposable gloves if possible.
• Place contaminated waste in a plastic bag, tie the bag and put it in a trash receptacle.
• Avoid touching your eyes, nose or mouth.
• Stay home when you are sick and for 48 hours after the last episode.
• Avoid close contact with people who are sick, if possible.