How to rehydrate during gastroenteritis, diarrhea and vomiting?

Your doctor or pharmacist has already recommended that you drink plenty of water when you have suffered from gastroenteritis. Indeed, the latter can cause diarrhea and vomiting, which has consequences on your level of hydration. In this article we will see what gastroenteritis is and what its causes are. Then, we will present the origins and consequences on the body of diarrhea and vomiting. Finally, we will see the means to rehydrate .

What is gastroenteritis?

Gastroenteritis is a gastrointestinal infection caused by certain viruses, bacteria or parasites that cause inflammation of the intestinal mucosa. Among the different forms of gastroenteritis, we distinguish viral gastroenteritis which occurs mainly in winter, usually in the form of an epidemic. In general, it lasts less than 3 days and does not require drug treatment.

There is also bacterial gastroenteritis, which can be caused by different bacteria such as Escherichia coli or Salmonella. In this case, antibiotic treatment is necessary.

Whatever the cause of gastroenteritis, it causes dehydration (especially if accompanied by vomiting), and is accentuated in people at risk such as the elderly, infants or people with a chronic illness. The incubation period is between 24 and 72 hours, that is to say that it is after this period following contact with the bacteria that the first signs of gastroenteritis appear. The first manifestation of this is acute and sudden diarrhea. Diarrhea is when there is an increase in the frequency of stools (more than 3 stools in 24 hours) accompanied by a change in their consistency ranging from soft to liquid. During gastroenteritis, nausea and/or vomiting, abdominal pain, fever and sometimes blood in the stool can also be found.

Diarrhea: causes and physiological consequences

Apart from gastroenteritis, diarrhea can be caused by food intolerance (or even food allergies), chronic inflammation of the intestine, hormonal disorders, overactive transit, unbalanced intestinal flora or taking medication. In fact, diarrhea is one of the side effects of many medications.

Normally, water is absorbed in the intestine (in the jejunum, ileum and colon) by active salt transport and osmosis. Water is also secreted into the lumen of the intestine, there is a real balance between secretion and absorption of water allowing optimal assimilation of nutrients and then drying of the stools which then become solid.

However, through different mechanisms, water is not well absorbed and/or secreted too much, there is then an excess of water in the intestine and the stools remain liquid or soft which causes diarrhea. Thus, during diarrhea, there is a significant loss of water and electrolytes and if they last several days, this can lead to a state of dehydration if the losses are not compensated.

To avoid worsening diarrhea, there are foods that are recommended and others that should be avoided.

What to eat during diarrhea:

- Avoid all foods that promote intestinal transit such as fibers contained in fruits and vegetables

- However, certain fruits and vegetables are recommended for diarrhea, such as bananas and carrots or cooked fruits such as compotes (apple, pear, quince, etc.)

- Avoid fatty and spicy foods

- Eat starchy foods (rice and white pasta, potatoes) because they have a constipating effect

- Add a little more salt to dishes. Salt helps to retain water in the body as well as mineral salts.

- Favor vegetable fats over animal fats

- Prefer lean meats like poultry

Vomiting:

Vomiting is the expulsion of stomach contents through the mouth. However, since water is absorbed by the intestine (located after the stomach), this can lead to dehydration because the water does not reach the body.

Gastrointestinal tract infections, food poisoning, migraine attacks, digestive tract diseases, alcohol abuse, meningitis, dizziness, motion sickness or carbon monoxide poisoning can cause vomiting.

How to rehydrate properly?

Symptoms of dehydration are important to recognize because dehydration can have serious consequences on the body. These symptoms include: intense thirst, decreased urine output, dry mouth and tongue, dry skin, fever, headaches, and dizziness.

To achieve optimal hydration and avoid worsening dehydration, there are a few rules:

- Drinking about 2 liters of water per day helps prevent dehydration

- Sodas and fruit juices are prohibited

- Coffee should be avoided because it is a laxative.

- Avoid alcoholic drinks

- Drink tea, herbal teas or soups

- Sparkling water but decarbonated because bubbles are not good for the digestive tract. This water is rich in mineral salts essential for better rehydration

Oral rehydration salts (ORS) are composed of electrolytes (sodium, potassium, chloride, etc.) and sugar (such as glucose) and are used to prepare a solution to treat dehydration. ORS are among the WHO's essential medicines and are used in infants and young children to prevent severe dehydration during diarrhea. Thus, ORS “ saves millions of lives worldwide ” according to the WHO and reduces “ by 33% the need for intravenous solutions ” which are used as first-line rehydration in hospitals and therefore leads to a decrease in hospitalizations of children caused by diarrhea.

https://apps.who.int/mediacentre/news/releases/release35/en/index.html

The WHO has therefore given recommendations in terms of hydration during diarrhea, particularly in young children:

“ Main measures for treatment:

● Rehydration: using oral rehydration salts (ORS) for moderate dehydration or no signs of dehydration. ORS is a solution of pure water, salt and sugar. Each treatment costs just a few cents. ORS is absorbed in the small intestine and replaces fluid and electrolyte losses in the stool.

● Rehydration: intravenously in cases of severe dehydration or shock.

● Zinc supplements: they reduce the duration of the diarrheal episode by 25% and the volume of stools by 30%.

● Nutrient-rich foods: The vicious cycle of malnutrition and diarrhea can be broken by continuing to provide nutrient-rich foods, including breast milk, during a diarrheal episode and by providing nutritious diets, including exclusive breastfeeding for the first 6 months of life, to healthy children.

● Consult a health worker, especially for management of persistent diarrhea, when there is blood in the stool, or if there are signs of dehydration.”

https://www.who.int/en/news-room/fact-sheets/detail/diarrheal-disease

Hydratis lozenges are based on the principle of ORS. In fact, they are composed of electrolytes (magnesium, potassium, chloride, zinc, manganese, sodium chloride) and dextrose which is a sugar.

The tablets thus allow better absorption of water and constitute an important supply of electrolytes.

Since elderly people are among those most at risk of dehydration, there is a specific “senior” range which comes in sachet form.

These lozenges and sachets can therefore be used to prevent dehydration in the context of gastroenteritis and/or diarrhea.

In conclusion, gastroenteritis can cause diarrhea and/or vomiting responsible for a significant loss of water and mineral salts (also called electrolytes) which can lead to a state of dehydration. Thus, it is necessary to hydrate well in order to compensate for the losses.