Here’s How To Survive Your Next Stomach Bug
Nobody wants to be sick. Especially after fighting the flu and cold for most of winter. Here's how to stay on top of your game

November 1, 2016

Cases of this dreaded digestive illness spike in the winter, but can carry through to summer. Here’s how you can fight back

You’ve felt it before, and it’s happening again: The lurching in your stomach, the nausea rising in your throat, and the cold sweat that starts prickling to alert you that if you don’t make it to the bathroom quickly, your favorite khaki pants might never be the same again.

Yep, you’ve got what’s commonly known as the stomach flu, but what medical professionals more studiously call “acute gastroenteritis.” That’s the official term for expelling the contents of your stomach violently through both ends, and to feel like death while doing so.
Acute gastroenteritis can be caused by a number of things, but the most common bug is a virus called norovirus. This nasty vomiting-and-diarrheal illness peaks in the winter, when people tend to congregate indoors within a close proximity to each other.

“This is incredibly contagious,” says Harris Masket, M.D., the chief physician in the urgent care clinic at University Health Services at University of California at Berkeley.

That’s probably why the bug accounts for up to 21 million illnesses, 1.9 million doctor’s office visits, and 71,000 hospitalizations each year, as a 2013 Centers for Disease Control and Prevention (CDC) study estimated.

So the chances of evading a puking-and-pooping episode this winter might not be in your favor. But if you do come down with the illness, there are some things you can do to get back on your feet—and off the porcelain throne—a little quicker.

How Do I Get It in the First Place?

Are you sure you want to know? Like many viruses, norovirus is transmitted through the delightful-sounding fecal-oral route, says Keith Borg, M.D., Ph.D., an associate professor in the division of emergency medicine and pediatric emergency medicine at the Medical University of South Carolina.

When a guy with the bug has diarrhea, microscopic viral particles get transferred to his hands after going to the bathroom. If he doesn’t scrub up well enough at the sink, those particles will persist.

So when he touches something next—the doorknob, the water cooler, or your dinner—the tiny specks hop off and wait for their next host. Eat the infected food, or touch one of those surfaces and bring your hands to your mouth, and the virus has entered your body.

The bug can also be spread by miniscule vomit particles, says Dr. Borg. So if you’re sharing utensils with someone who’s thrown up recently, you can pick up the virus from their mouth and transfer it into your own.

Once it enters your body, it makes its home in your GI tract, where it begins to multiply and make you feel sick. Your body senses the infection and wants it out of there—which is where things get messy.

“Your body tries to expel it and get rid of it,” Dr. Borg says, “but diarrhea and vomiting also help with the transmission of the virus.”

How Do I Know I Have It?

You’ll feel pretty damn lousy. That means vomiting, watery diarrhea, stomach cramps, and possibly low-grade fever or chills, from anywhere from 24 to 72 hours.

You probably won’t know for sure you have norovirus, though. Docs usually don’t test for it unless you’re involved in an outbreak, such as on a cruise ship or in a restaurant, says Dr. Borg. And that’s okay, since the symptoms and the treatment for viral diarrhea bugs and the ones that cause other infections like bacterial “food poisoning” are pretty similar.

But still, it’s important to be on the lookout for red-flag symptoms that could indicate something more serious. Constant and progressive abdominal pain can signal appendicitis, especially if vomiting and fever are involved, too.

Bloody diarrhea can indicate a salmonella infection or even inflammatory bowel disease. If you have these symptoms—or high fever, really bad chills, or aches—you’ll want to see a doc so he can evaluate what’s actually going on.

How Can I Beat the Barf?

After you puke up the contents of your morning breakfast, you may be tempted to immediately grab H2O to rehydrate. Resist the urge: The number one problem Dr. Masket sees in norovirus patients is drinking too soon after an episode.

“When you throw up, your stomach is really irritated,” he explains. “And the only thing that putting something in your belly is going to do is probably make you throw up again. And then you’re going to get even more dehydrated.”

So follow his rule: Wait one full hour before taking in any liquid by mouth, which will allow your stomach time to calm down. Then start with just a sip of something like juice or a sports drink.

If your stomach doesn’t rebel, follow with another sip 10 minutes later. Then keep following the 10-minute rule, gradually adding a little more fluid (up to 2 ounces every 10 minutes) when you can tolerate it. And no solid foods until you’ve stopped hurling.

How Can I Stop Pooping Faster?

Having diarrhea also means sticking to an all-liquid diet. “Usually any solid food is just going to make you have more diarrhea,” says Dr. Masket. “Your body is going to take that and throw it out, and also pull some fluids and salt with it. That can worsen your dehydration.”
Pick liquids that contain sugar and electrolytes to replace the fluid you’re losing. Choose kinds like apple juice, clear broths, or sports drinks, and dilute any sugary drinks with water, since too much sugar can pull water from your gut and exacerbate diarrhea, says Dr. Borg.

When your squirts begin to improve—and when you start to feel hungry— you can graduate from clear liquids to bland foods. You’ll know you’re on the mend when your stool firms up and your bathroom trips die down.

That’s when you can try foods like bananas, rice, applesauce, or crackers, which aren’t very taxing on your digestive system. But back off from bland foods for a couple hours if you’re still logging toilet time.

If your first foray into solids was a success, you can continue gradually adding your normal foods back into your diet. It’s also a good idea to avoid dairy products or high-fat or greasy foods for the entire duration of your sickness. These are more difficult to digest.

Can I Take Meds for It?

Over-the-counter pain relievers, such as Advil or Tylenol, can help reduce fever and improve any achiness or malaise you may be feeling.

You might be tempted to take Imodium to put some brakes on the diarrhea, but it’s best to let the virus run its course, says Dr. Masket.

Plus, if you don’t actually have norovirus—maybe you have an inflammatory or bacterial cause instead—medications can actually make you feel worse. So before you pop the pill, consult with your doctor first.

When you’ve got your doc on the line, you can also ask him about some prescription anti-nausea meds like Zofran (ondansetron), says Dr. Borg. These can help you get fluids down, which can help prevent dehydration.

When Should I See a Doctor?

During the 24 to 72 hours you’re sick, stay home, get plenty of rest, and keep hydrated. In most cases, this self-treatment is all you need.

But there are some instances where you might need to see a doctor. The main cause of worry with norovirus is dehydration, since you’re depleting fluids and essential minerals from your body with the vomiting and diarrhea.

If you’ve been unable to stop spewing in 24 hours, and can’t tolerate fluids without triggering another attack, you may benefit from venturing to the doctor’s office.

“You’re a ticking time bomb, because you’re only going to get more dehydrated every moment,” says Dr. Masket.

Dehydration can cause you to feel lightheaded, dizzy, or even pass out. In severe cases, it may even lead to an electrolyte disturbance that can cause irregular heart beat. If this sounds like you, make an appointment immediately, says Dr. Masket.

Another reason to see your M.D.: if your diarrhea continues full force even after several days. It’s common to experience altered bowel function for up to 10 days after your illness—say, changes in regularity or stool consistency—but if it shows no sign of improvement, you may need to be evaluated.

And while you’re sick, make sure you’re washing your hands well to prevent the spread of the sickness to other poor suckers. You’re most contagious during the first 48 hours of your symptoms, says Dr. Masket. But the virus can stay in your stool for a couple weeks after you’ve recovered.