The stomach flu isn’t a real diagnosis – there’s no such thing. I remember finding that out as a kid and being confused; after all, everyone around me had had it at one point or another. How could everyone be wrong? We’ve all used this term at some point to describe an illness that’s forced us to pray to (or sit with) the porcelain gods. However, it turns out it’s one of those generational quirks of language that’s been passed down, and it’s not founded in science.
The viruses or bacteria that we attribute to “the stomach flu” are very real, however, as I can tell you from personal experience. There’s just no such thing in epidemiology as a family of viruses or bacteria called “the stomach flu.”
Let’s start off by defining what the flu is. “Flu” is short for influenza, which is a viral infection that affects your respiratory system, namely your nose, throat, and lungs. Symptoms include coughing, congestion, fever, and muscle aches. According to the CDC, there are 3 types of influenza viruses: A, B, and C. The seasonal flu is typically an A or a B type, and it runs in cycles that are heavily skewed to wintertime in the United States. The C type is considered milder, and isn’t seasonally dependent or the type that’s a cause for epidemic concern. All three types are spread through contact with an infected person’s respiratory secretions, meaning contagious droplets of water that you inhale or get in your eyes, nose, mouth, when an infected person talks, coughs, or sneezes around you. Ewwwww.
The stomach flu, on the other hand is what we colloquially call a variety of digestive-related illnesses that involve distressing gastrointestinal symptoms (i.e. vomiting, diarrhea, stomach cramps, etc.) combined with malaise, and a low-grade fever, when in reality it’s a form of gastroenteritis (“gas-tro-enter-EYE-tis”). Gastroenteritis is caused by viruses and bacteria (and rarely, parasites) that infect the digestive tract, none of which are members of the influenza family.
I repeat: the “stomach flu” is a virus or bacteria that has much grosser consequences, and is not at all related to influenza.
Viral gastroenteritis is the most likely culprit when it comes to most of the so-called “stomach flus,” and it’s typically the result of one of two groups of viruses: Noroviruses or Rotaviruses. And, ick alert: you typically catch it from direct exposure to an infected person, exposure to infected fecal bacteria (poop), or exposure to things cross-contaminated by fecal bacteria like food that’s been handled by contaminated hands, since it’s so hard to completely sanitize against, as any Celebrity Cruise worker can tell you.
Grossed out yet?
A read-through of this horrifying in-depth article from
National Geographic on
the science of the Norovirus describes how it causes your body to become a walking germ factory; how hard it is to kill it on surfaces including your own skin, and how easy it is to infect those around you as you’re purging liquid from your intestinal tract cells at a rapid rate, and loading up each gram of your diarrhea with five billion Noroviruses. You read that right. Five billion. As for the infectiousness of your vomit? I’ll just leave this article on a the Norovirus Vomit Machine here. I can’t even.
Horrors of science aside, viral gastroenteritis is rotten because in addition to the symptoms listed in our handy-dandy graphic in this article, it’s completely exhausting and there’s nothing you can do other than rest, stick with eating what you can hold down, which may or may not include the once-heavily recommended B.R.A.T. diet (Bananas, Rice, Applesauce, and Toast) to coax your stomach into digestion, and to stay as hydrated as possible. Dehydration is the danger zone of these type of illnesses, which is where gastroenteritis can turn from miserable to deadly. It’s essential to replace liquids lost from loose stools and vomiting. For parents of kids who have had this, I’m sure you’ve had the hard task of trying to pressure these foods and liquids into your child who is exploding from both ends, and feeling like it’s all a waste because it’s coming back out as quickly as its going in. I’m sorry. You’re doing the right thing, though, since nutrients and liquids are critically important to maintain during these illnesses.
The Norovirus: Courtesy of the CDC
In my recent experience, I went to my local emergency room five days after my symptoms began, but only after I started to have heart palpitations and an unbearable case of heartburn. I managed to stay hydrated as I’d choked down an entire Pedialtye (ack!), but I was wrecked. The doctor attributed my illness to a nasty case of Norovirus, which is circulating in the San Diego area again, but he said those extra symptoms were actually from exhaustion and hunger – I needed more nutrients and rest. How could I get more nutrients if nothing was sticking in my stomach? I asked him. He said to keep eating anyway, since “your body has to finish shedding the diseased lining of your intestines for all of the purging to stop.” Fabulous, right?
Here’s the problem with waiting it out, however. You shouldn’t make the call to simply rest and switch to a BRAT-like diet on your own for you or your children and wait for the symptoms to pass for more than a day or two. Rest, hydrate, and bland diet, yes. However, viral gastroenteritis and bacterial infections (i.e. c.diff., salmonella and e.coli) that affect the digestive tract can initially look the same, be acquired through the same channels (contaminated food, etc.), but can’t be treated the same way.
You must treat the bacterial infections because they don’t just “run their course” without having massive impacts on you or your child’s system – and you likely need medical intervention like antibiotics to make them stop in a timely manner. Below are threshold recommendations per the Mayo Clinic, but your family physicians may have other guidelines so we urge you to contact them first:
Seek immediate medical care if in addition to the previously mentioned symptoms of malaise, stomach cramps, vomiting and diarrhea, you or your child havethe following symptoms:
- You’re not able to keep liquids down for 24 hours
- You’ve been vomiting for more than two days
- You’re vomiting blood
- You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
- You notice blood in your bowel movements
- You have a fever above 104 F (40 C)
For kids, seek medical care if they:
- Have a fever of 102 F (38.9 C) or higher
- Seem lethargic or very irritable
- Are in a lot of discomfort or pain
- Have bloody diarrhea
- Seem dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them
For babies seek medical care if they:
- Have vomiting that lasts more than several hours
- Haven’t had a wet diaper in six hours
- Have bloody stools or severe diarrhea
- Have a sunken soft spot (fontanel) on the top of his or her head
- Have a dry mouth or cry without tears
- Are unusually sleepy, drowsy or unresponsive
As always, self-diagnosis is not the way to go when you’re dealing with an illness, particularly one that’s this high-impact – consult your physician or child’s pediatrician for an exam and testing if you have any of the above symptoms and have a concern about you or your child’s well-being. And remember, until you do, hydrate, eat, and rest as much as you can!
For illness spreading and prevention tips, see this helpful guide.