How to avoid tummy bugs

What are tummy bugs?

Tummy bugs can be caused by lots of germs, including viruses and bacteria. Sometimes you catch them from food, often from other people. Symptoms include:

• Loose, watery stools, usually at least three to four times a day. This can last several days.

• Feeling sick or being sick. This usually settles in a day or so.

• Crampy tummy pains, often eased by going to the toilet.

• Fever and feeling generally unwell.

The biggest health concern of tummy bugs is getting dehydrated, because you're losing fluid from diarrhoea, being sick and sweating if you have a fever. Symptoms of dehydration include headache, dizziness, not passing water often, dry mouth and feeling weak.

Because small children and babies don't need to lose much fluid to upset their body fluid balance, they're at higher risk of dehydration. You need to be particularly wary of dehydration in under-ones (particularly if they're under 6 months, are small for their age or were born prematurely).

Pregnant women and older, frail people are at increased risk of dehydration too. Older people are more likely to be taking medicine such as diuretics (water tablets) to control their blood pressure, and these affect the body fluid balance also.

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Diarrhoea

Diarrhoea can be of sudden onset and lasting for less than four weeks (acute) or persistent (chronic). This leaflet deals with acute diarrhoea, which is common. In most cases, diarrhoea eases and goes within several days but sometimes takes longer. The main risk is lack of fluid in the body (dehydration). The main treatment is to have lots to drink, which aims to avoid dehydration. You should also eat as normally as possible. See a doctor if you suspect that you are dehydrating, or if you have any worrying symptoms such as those which are listed below.

by Dr Doug McKechnie, MRCGP

When should I worry?

See your doctor if:

• You've been abroad recently.

• You can't keep any fluids down.

• You have severe tummy pain.

• You have blood in your diarrhoea, or in your vomit.

• You have other medical problems.

• Your vomiting goes on for more than one to two days or your diarrhoea goes on for more than four days.

• You think you're getting dehydrated.

In babies and infants, signs to look out for include:

• Sunken eyes.

• Dry mouth, tongue or lips.

• Fewer wet nappies.

• Seeming lethargic or unusually irritable.

Cold hands or feet, rapid breathing, pale or mottled skin or drowsiness can be signs of severe dehydration in children - seek medical help urgently.

If you have diabetes, becoming unwell with any illness can upset your blood sugar control. The biggest risk of complications when you have a tummy bug comes if you're taking insulin - everyone with type 1 diabetes takes insulin, but some people with type 2 diabetes need it too.

Even if you're not eating, you'll need to take your insulin normally and may even need a higher dose than usual. It's also important to try to keep your fluid and carbohydrate intake up too. If you are taking medicine, that means you need to monitor your blood sugar, you should be monitoring really regularly and should see or speak to your doctor at an early stage.

How can I help myself?

• Drink, drink and drink some more! Fluid is the key to avoiding dehydration.

• If you're being sick, take sips every couple of minutes rather than larger amounts.

• Avoid sugary drinks as they can occasionally make symptoms worse.

• If you're over 60 or have other medical problems, consider rehydration drinks (from your GP or chemist).

Doctors used to suggest not eating when you had a tummy bug. Now we recommend eating as soon as you feel able, but avoiding heavy or spicy foods. Dry toast or crackers are good.

You can buy tablets for diarrhoea from your chemist. Don't take more than the recommended dose or take them for more than five days without seeing a doctor.

How can I avoid tummy bugs?

Washing your hands before you eat anything (and after visiting the toilet, gardening or touching animals) is good practice wherever you are. Extra precautions when travelling anywhere outside Western Europe, the USA or Australia/New Zealand include:

• Where food and drink is concerned, boil it, cook it, peel it or forget it!

• Avoid ice in drinks - it's made from the local water.

• Take a travel kettle to boil drinking water or ask your chemist about water sterilising tablets.

• Avoid food containing raw or partly cooked eggs (in the UK, the 'Lion brand' on eggs means the hens that produce them have been immunised against salmonella. You can't assume the same applies abroad).

• Avoid shellfish, especially if it's raw.

Lactose intolerance - what's it all about?

Many people become lactose intolerant after a tummy bug, but about one in 10 adults are intolerant to lactose all the time.

Not many people are allergic to lactose (found mostly in dairy products) but lots of people are intolerant to it. If you have a food allergy, even a tiny amount causes a reaction, and symptoms can include rashes, swelling around the lips, difficulty breathing and even collapsing. Food intolerance usually causes only tummy symptoms - bloating, wind, diarrhoea, tummy pain - and may not happen if you only eat a small amount.

If you think you might be lactose intolerant, try cutting out lactose-containing foods for two or three weeks, then add them in gradually. You'll need to avoid all dairy products but also some margarines, biscuits, cakes, breakfast cereals and crisps - read the packaging to find out which.

If you think you are lactose intolerant, you'll need to make sure you still get enough calcium in your diet while avoiding lactose. Lactofree® is a milk product with the lactose removed - you can get Lactofree® milky drinks, yoghurts and cheese in supermarkets. Tinned fish with bones (salmon, sardines, etc) are also good sources.

With thanks to 'My Weekly' magazine where this article was originally published.