“Stomach flu,” or viral gastroenteritis, is an intestinal infection causing inflammation of the stomach and intestines. This common illness is usually self-limiting, resolving on its own. Most cases can be managed at home, but understanding when symptoms require emergency medical attention is important.
Common Symptoms and Home Management
Stomach flu typically presents with nausea, vomiting, watery diarrhea, abdominal cramps, and sometimes a low-grade fever, headache, or muscle aches. Symptoms can begin suddenly and generally last for one to three days, though some cases might extend up to a week or two.
Managing these symptoms at home focuses on preventing dehydration, the most frequent complication. Consuming small, frequent sips of clear fluids like water, clear broths, or oral rehydration solutions helps replace lost fluids and electrolytes. Once vomiting subsides, gradually reintroduce bland foods such as bananas, rice, applesauce, and toast (the BRAT diet). Avoid highly seasoned, fatty, or sugary foods, caffeine, and alcohol, which can irritate the digestive system and worsen dehydration.
Urgent Symptoms Requiring Emergency Care
While most stomach flu cases are mild, certain warning signs indicate a need for immediate emergency medical attention. These symptoms suggest severe dehydration or other serious complications.
Severe dehydration is a primary concern. Signs include decreased urination or no urine output, extreme thirst, a very dry mouth and tongue, and a lack of tears when crying, particularly in children. Adults may experience dizziness, lightheadedness, confusion, or lethargy. The skin may also appear dry and shriveled, and when pinched, it may take longer than usual to return to its normal position.
Persistent high fever is a concern. While a low-grade fever can accompany stomach flu, a fever consistently above 102°F (39°C) warrants medical evaluation, as it could signal a more severe infection or complication. This is particularly true if accompanied by other concerning symptoms.
Severe and unrelenting abdominal pain, especially if localized or sharp, requires emergency care. While stomach cramps are common with gastroenteritis, intense pain that does not subside could indicate a different, more serious abdominal issue, such as appendicitis or a bowel obstruction.
The presence of blood in vomit or stools requires immediate medical attention. Bloody or black, tarry stools, or vomit containing blood, can indicate internal bleeding or a more severe infection.
Persistent vomiting that prevents any fluid intake is a concern. If an individual cannot keep down even small sips of fluid for an extended period (typically 24 hours or more), they are at high risk of severe dehydration and may require intravenous fluids.
Any signs of neurological changes, such as unusual confusion, extreme lethargy, unresponsiveness, or a stiff neck, are serious symptoms. These changes can indicate severe dehydration affecting brain function or other serious underlying conditions.
Special Considerations for Vulnerable Groups
Certain populations are at increased risk for complications from stomach flu and may need medical attention sooner, even with less severe symptoms. Infants and young children are particularly vulnerable due to their smaller body size and higher metabolic rate, making them prone to rapid dehydration. Parents and caregivers should watch for signs like fewer wet diapers (no wet diapers for three hours or more), lack of tears when crying, dry mouth and tongue, sunken eyes or soft spots on the head, and unusual drowsiness or irritability.
The elderly face higher risks because their bodies may have a reduced ability to regulate fluids and electrolytes, and they may have underlying health conditions. Dehydration can quickly worsen existing conditions in older adults. Pregnant individuals also require careful monitoring, as severe dehydration can affect both the mother and the developing fetus.
Individuals with weakened immune systems are more susceptible to severe and prolonged infections. This includes people with chronic illnesses, those undergoing chemotherapy, organ transplant recipients, or individuals on immunosuppressant medications. For these groups, a lower threshold for seeking emergency care is appropriate, as their bodies may struggle to fight off the viral infection effectively.
Preparing for an Emergency Room Visit
If an ER visit is necessary, preparation can streamline the process. Bring a list of all current medications, including dosages, and any known allergies. A brief summary of the patient’s medical history, especially any chronic conditions, provides valuable context for medical staff.
Provide detailed information about current symptoms, including onset, severity, and changes. Note fluid intake and frequency of vomiting or diarrhea. At the emergency room, expect a triage process where medical staff will assess the urgency of the condition. Tests like blood work or stool samples may be performed.