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Clinician’s Corner: Gastroenteritis (“Stomach Flu”)

Nausea, vomiting and diarrhea seem to “run” together!  Diarrhea, like vomiting is frequently due to a response of the gastrointestinal tract to remove bacteria and toxins.  Like nausea, the most frequent problem that diarrhea causes is dehydration.  As with vomiting, our goal for our patients with gastroenteritis (“stomach flu”) is to prevent dehydration.  This is the time of year we see patients standing in the gastrointestinal section, holding a box of Imodium, and looking our way for some help.  Always feel free to ask your Thompson Pharmacist!

Before you pull that box of loperamide off the shelf, your Thompson Pharmacist will have a few (actually quite a few) questions?

  • How long and how often do you have these episodes?
  • Any other symptoms?
  • Which anti-diarrhea medications have you tried?
  • Characteristics of your stool?
  • Have you changed your diet? Drinking non-chlorinated water?
  • Have you recently traveled to a foreign country?
  • Anyone in your household have diarrhea or can you contribute it to a particular food?
  • What medications are you currently taking?
  • Any medical conditions or chronic illnesses?

You must see a physician immediately if any of the following symptoms: (source: cdc.gov)

  • Elderly age
  • History of chronic medical conditions or concurrent illness
  • Fever over 102.2 °F
  • Visible blood in stool
  • High output of diarrhea, including frequent and substantial volumes of stool
  • Persistent vomiting
  • Signs consistent with dehydration (e.g., sunken eyes or decreased tears, dry mucous membranes, orthostatic hypotension or decreased urine output)
  • Change in mental status (irritability, apathy, or lethargy)
  • Less than ideal response to oral rehydration therapy already administered or inability to administer oral rehydration therapy

May I check your med list??  Here are some drugs that have the potential to cause diarrhea: Have your Thompson Pharmacist check your med list in the pharmacy!

What if it is the “Stomach flu”- gastroenteritis:

  • Follow same rules for dehydration as for nausea and vomiting. We recommend oral rehydration solutions (Pedialyte®)
  • Imodium® (loperamide) should be considered only in adult patients who have no fever or having diarrhea with blood or mucus. Imodium may reduce diarrheal output and cramps, but do not accelerate cure.
  • Imodium (loperamide) should not be used for children unless recommended by a prescriber.