Diarrhea

Diarrhea in Cancer Therapies

Posted by

0


Patients with cancer receiving chemotherapeutics may develop diarrhea, which can be highly distressing. In a recent journal article, oncologist Marcus Hentrich, MD, and gastroenterologist Volker Penndorf, MD, PhD, both of Rotkreuzklinikum in Munich, Germany, explained how affected patients should be treated.

As Hentrich and Penndorf explained, classical cytostatic drugs can induce diarrhea through direct damage to the intestinal mucosa. The pathomechanisms of monoclonal antibodies and oral targeted substances are not yet fully understood. According to the authors, the risk for toxic mucosal damage (toxic enteritis) increases with the severity and duration of neutropenia. Up to two thirds of patients with neutropenia develop diarrhea, and an infectious cause is rarely identified.

The cytostatic drug irinotecan, which can lead to an acute cholinergic syndrome within 24 hours, is a special case. This syndrome is characterized by watery diarrhea, abdominal cramps, vomiting, sweating, and bradycardia. Additionally, the development of late-onset diarrhea, occurring approximately 3 days after administration, is frequent.

According to the authors, risk factors for toxic enteritis with diarrhea include advanced age, poor performance and nutritional status, simultaneous radiotherapy of the abdomen and pelvis, and preexisting intestinal conditions.

Medication prophylaxis for chemotherapy-induced diarrhea has not been established. An exception is atropine for prophylaxis and treatment of irinotecan-induced cholinergic syndrome.

Indications for diagnostic procedures are outlined in the current German guideline for supportive therapy in patients with cancer.

For diarrhea accompanied by fever, blood cultures are mandatory. A complete blood count provides information on various aspects (leukocytosis as an inflammatory reaction, neutropenia as a marker for infection risk, hemoglobin as a marker for possible hemoconcentration or existing bleeding, and thrombocytopenia as a marker for bleeding tendency). Disproportionate thrombocytopenia may warrant assessment of fragmented cells and enterohemorrhagic Escherichia coli diagnostics.

To assess electrolyte and fluid loss, electrolytes, albumin, and total protein should be measured. The C-reactive protein value may help identify inflammatory conditions. It may also be elevated, however, because of tumor-related factors. Measuring urea and creatinine allows for estimating whether there is already a prerenal impairment of kidney function. Liver function parameters are mandatory for critically ill patients. In patients with hypotension or tachycardia, blood gas analysis and lactate determination are advisable. Among imaging techniques, ultrasound may be helpful. Indications for conventional abdominal x-ray are rare. In the presence of clinical signs of peritoneal irritation (such as guarding and rebound tenderness), a CT scan should be considered to detect further complications (perforation, ileus, enterocolitis, etc.) promptly.

Endoscopic examinations are recommended only in cases of persistent, worsening symptoms, according to the guideline. Colonoscopy is contraindicated in suspected neutropenic enterocolitis (NEC) because of the risk for perforation.

According to Hentrich and Penndorf, diarrhea therapy is carried out in stages and depends on the severity and response to each therapy. The Common Terminology Criteria for Adverse Events distinguishes the following severity grades:

  • Grade 1: < four stools per day above baseline
  • Grade 2: Four to six stools per day above baseline
  • Grade 3: ≥ seven stools per day above baseline; fecal incontinence, hospitalization indicated; limited activities of daily living
  • Grade 4: Life-threatening consequences, urgent intervention indicated

Therapy for Grades 1-2

The standard therapeutic after excluding infectious causes is loperamide (initially 4 mg orally, followed by 2 mg every 2-4 hours). A daily dose should not exceed 16 mg.

For irinotecan-associated diarrhea, adjunctive administration of budesonide (3 mg orally three times per day) with loperamide was shown to be effective in a small, randomized study (off-label). Another randomized study demonstrated the efficacy of combining loperamide with racecadotril (100 mg orally three times per day for 48 hours).

Therapy for Grade 3 Diarrhea

In severe diarrhea persisting despite loperamide therapy for 24-48 hours, octreotide (100-150 μg subcutaneously three times per day) may be administered (maximum three times 500 μg). Although octreotide is often used successfully for chemotherapy-induced diarrhea, it is not approved for this indication (off-label use).

According to the authors, other therapy options for loperamide-refractory diarrhea include codeine, tincture of opium, budesonide, and racecadotril. Psyllium husk or diphenoxylate plus atropine may also be attempted. In patients with prolonged neutropenia, overdosing of motility inhibitors should be avoided because of the risk for ileus.

The use of probiotics for chemotherapy-induced diarrhea cannot be generally recommended because of insufficient evidence, and cases of probiotic-associated bacteremia and fungemia have been described.

A particularly serious complication of intensive chemotherapy associated with diarrhea is NEC. It is characterized by fever, abdominal pain, and diarrhea during severe neutropenia (neutrophil count < 500/μL), the authors explained. NEC occurs predominantly, but not exclusively, after intensive chemotherapy for hematologic malignancies, especially acute leukemias.

More common than NEC and often preceding it is the so-called chemotherapy-associated bowel syndrome. It is characterized by fever ≥ 37.8 °C and abdominal pain or absence of stool for at least 72 hours.

Therapy consists of conservative symptomatic measures such as diet, adequate hydration with electrolyte balance, and analgesia. Due to the high risk for bacteremia, antibiotic therapy is indicated after blood cultures are obtained (piperacillin-tazobactam or a carbapenem). According to the authors, NEC improves in most patients with neutrophil regeneration. Granulocyte colony-stimulating factor therapy appears reasonable in this context, although conclusive studies are lacking. Surgical intervention with removal of necrotic bowel segments may be considered in exceptional cases.

Herb Can Help Avoid Drug Resistance in Treating Lung Cancer: New Study

Posted by

0


Lung cancer ranks as the No.1 killer of all cancers globally. (Kateryna Kon/Shutterstock)

Lung cancer ranks as the No.1 killer of all cancers globally.

0:002:41

Lung cancer ranks as the No.1 killer of all cancers globally. The main treatment method of Western medicine for non-small cell lung cancer, the most common type of lung cancer, is targeted therapy.

However, a thorny problem with targeted therapy is the development of drug resistance in patients.

Lee Mi-hyun, a pre-Korean medicine professor at Dongshin University in South Korea, announced on Nov. 14 that the extract of a herb “costustoot” could solve the problem of patients’ resistance to the targeted drug Osimertinib.

Lung cancer can be pathologically divided into small lung cancer and non-small cell lung cancer (NSCLC). More than 80 percent of lung cancer patients have non-small cell lung cancer, and about 50 percent of non-small cell lung cancers have mutations in the epidermal growth factor receptor (EGFR).

In treating the gene mutation, if the patient is injected with the targeted anti-cancer agent Osimertinib for a long period of time, the body will develop resistance to the drug, reducing the effectiveness of the treatment.

Osimertinib is a third-generation epidermal growth factor receptor inhibitor (EGFR-tyrosine kinase inhibitors, EGFR-TKIs), a targeted drug.

It was approved by the Food and Drug Administration and the European Union in 2017 for the treatment of non-small cell lung cancer and by the China Food and Drug Administration in 2018 for the treatment of advanced or metastatic non-small cell lung cancer.

Epoch Times Photo
A study shows that the extract of the herb “costustoot” could solve the problem of patients’ resistance to the targeted drug Osimertinib.

Lee found that this resistance is due to the over presence of MEK and AKT proteins that affect cancer cell proliferation and survival.

Based on this, Lee confirmed that costunolide, extracted from the roots of costustoot, was able to target MEK and AKT proteins, effectively blocking cancer appreciation and inducing death in oxitinib-resistant cells and animal models.

From the perspective of Korean medicine (traditional Chinese medicine), costustoot is mainly used to treat thoracic or epigastric abdominal distension, jaundice, lack of appetite, diarrhea, tenesmus, and food stagnation.

Modern pharmacological studies have shown that costustoot has the functions of protecting gastric mucosa, anti-inflammatory, analgesic, regulating gastrointestinal motility, improving gallbladder, inhibiting pathogenic microorganisms, and anti-tumor.

“We are conducting various studies to solve the problem of drug resistance in the treatment of lung cancer by Western medicine, and we will try to make these studies an opportunity for the development of Korean medicine,” Lee said.

Are Carbs Bad for You? What Eating Carbs Actually Does to Your Body

Posted by

0


Not all carbohydrates are created equal.
Sliced brown bread on a white background

Thinking about carbs probably conjures up images of anything and everything you’ve been programmed to avoid: pasta, cookies, cake, bread. These foods get a bad rap, so it’s no wonder that so many of us get the impression that carbs are bad for you. Nutritional advice in the past has trained us to almost fear them—and feel guilty for breaking down and indulging in their dense, bready goodness.

But what if we told you you’re thinking about this all wrong? (And not just because food guilt is a waste of time, as well as a harmful way to think about eating.) Yes, some types of carbohydrates don’t have much in the way of nutritional benefits: We’re looking at you, sugar. Sugar is a basic, broken-down carbohydrate, devoid of any nutrients. And as you’ve undoubtedly heard, eating too much added sugar is associated with a host of health problems. It’s reasonable to want to limit the amount of added sugar you consume on a regular basis, from a health perspective.

But complex carbohydrates, like those found in whole grain breads, grains like quinoa and farro, and yes, fruits, veggies, and dairy, are all part of a healthy diet. In fact, your body needs carbohydrates to complete its basic functions.Here’s what’s really happening inside your body when you eat carbs, and why they’re not the villains you’ve been taught to believe.

So, are carbs bad for you or good for you? Well, that’s really not the question you should be asking. Because when you look closely, not all carbs are created equal.

Carbs get a bad rap because we all think of the less-healthy ones—simple carbs like white bread, donuts, bagels, sugary cereal—which aren’t great for our health. But carbs come in two forms: simple and complex. “Simple carbohydrates are made up of short chains of carbon molecules that require little breakdown and go directly into the bloodstream [and cause a blood sugar spike],” Kim Larson, R.D., spokesperson for the Academy of Nutrition and Dietetics, tells SELF. Any simple carbohydrate, or just straight up sugar, really has no redeeming qualities, nutritionally speaking. Sugar is also associated with inflammation, which is connected to a slew of of problems, like heart disease and cancer. If you’re interested in the science around sugar and our bodies, you might want to check out Sugar Science, a (self-described) “authoritative source for the scientific evidence about sugar and its impact on health,” created by a team of health scientists from the University of California at San Francisco.

But about complex carbohydrates. These carbs have longer chains of carbon molecules, so it takes longer for your body to break them down. Which means the sugar isn’t dumped into our bloodstream such as what happens with simple carbs. “We experience a more steady-state infusion of sugar into our bloodstream that supplies longer lasting energy,” Larson says.

carbs_farro

 

Whatever type of carbohydrates you eat, your body works to break them down to their simplest form: glucose.

“The breakdown of carbohydrates starts in our mouth with salivary enzymes, then goes to the mechanical churning of the stomach using digestive enzymes, along with B vitamins (the helpers), and the journey ends when they are in their simplest form, glucose, which is then absorbed in the small intestine,” Larson explains. Glucose then travels to the liver to be distributed throughout the body. Your cells first use whatever glucose they need for energy, sending it to the muscles and tissues in your body. Some gets stored in the liver as a reserve tank, and any excess is stored as fat, both in the liver and in adipose tissue around your body. We know loading up on sugar is bad for our bodies, and can lead to chronic diseases like obesity and diabetes. Too much of any carbohydrate can do that, too, since it all ends up as glucose.

We need carbohydrates for our bodies to even function.

Carbohydrates are our bodies’ main source of energy. “Glucose is the form of sugar that our brains use,” explains Keri Glassman, R.D. We need a certain amount of it to fuel all of our metabolic processes “so we can have energy to do things like breathe, digest, run, work, think.” Literally, everything. Fat and protein have their jobs, too, but when it comes to getting that basic energy, carbs are key.

So, what about the whole weight-gain thing? “Certainly eating too much of anything (including protein and fat) will cause weight gain,” Larson explains. Just eating more calories than you burn in a day can lead to weight gain. The problem is that simple carbs and sugars won’t keep you full, so they’re really easy to overeat. If you eat healthy carbs, as part of a balanced diet that also includes protein and fat, your body will function the way it should.

carbs_cauliflower

 

Healthy, complex carbs are found in more foods than you think. And you should be eating them every day.

When someone says, “I’m cutting out carbs,” they usually mean they’re cutting out breads and pasta, Larson explains. Many of us forget that milk, whole grains, fruits, and vegetables are all carbohydrates, and also come with essential nutrients like fiber and protein. So when you’re eating cauliflower, peas, bananas, apples, broccoli—the list goes on—you’re indeed eating carbohydrates. And your body is happy about it.

Ditching all carbs isn’t a good move. Instead, eat the good kinds in moderation. “Over half of our daily calories should come from quality carbohydrates, like whole grains, dairy, fruits, and vegetables,” Larson notes. “We cannot support the brain if we are taking in less than 120 grams of carbohydrate per day, and a lack of glucose (like oxygen) to the brain can cause irreversible damage.” So certainly cut out those bad carbs, but you can (and should) eat the healthy ones every single day.

Here’s Why Your Poop Can Be So Freaking Weird on Your Period

Posted by

0


You know what we’re talking about.
Poop-And-Periods

Most people are pretty open about the “joys” that come with having a period, like cramps, bloating, and sore boobs. But there’s one period side effect people really need to discuss more often, because maybe sharing the burden can at least make the load a little lighter: period poop.

Everyone’s situation is different, but it’s not uncommon for your regular poop habits to take a temporary vacation when you’re on your period, or be suddenly replaced with a whole lot of diarrhea, or both. “Many women do get bowel changes just before or during their period,” Kyle Staller, M.D., a gastroenterologist at Massachusetts General Hospital, tells SELF.

You’ve probably noticed this and dismissed it as just one of those body things, but there’s an actual biological cause you should know about.

“The reason that this happens is largely due to hormones,” says Dr. Staller. Pre-period constipation could be a result of an increase in the hormone progesterone, which starts to increase in the time between ovulation and when you get your period. Progesterone can cause food to move more slowly through your intestines, backing you up in the process.

So what about that diarrhea, though? Hormone-like substances called prostaglandins could be to blame for that. The cells that make up the lining of your uterus (known as endometrial cells), produce these prostaglandins, which get released as the lining of your uterus breaks down right before and during your period. If your body makes a lot of prostaglandins, they can make their way into the muscle that lines your bowels. There, they can cause your intestines to contract just like your uterus and push out fecal matter quickly, causing diarrhea in the process, Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California, tells SELF. (Fun fact: These prostaglandins are also responsible for those painful cramps you might get every month.)

Of course, this can all vary in different people. But if you notice you experience constipation or diarrhea right around your period like clockwork, this may be why.

Having certain health conditions can also exacerbate period-related bowel changes.

If you struggle with a health condition like endometriosis, Crohn’s disease, irritable bowel syndrome, or ulcerative colitis, having your period can cause a flare-up of your symptoms. Ultimately, the symptoms you experience depend on your condition, Dr. Farhadi says.

For example, if you struggle with Crohn’s disease, which can often cause diarrhea, or IBS-D (a form of IBS that causes people to have diarrhea), your body’s release of prostaglandins during your period may cause you poop even more than usual. But if you suffer from IBS-C (IBS that causes people to have constipation), you may find yourself struggling even more to have a BM on your period as progesterone further slows your bowels’ activity. Since ulcerative colitis can lead to both diarrhea and constipation, you might experience an uptick in either during your period.

And unfortunately endometriosis can lead to pain during bowel movements around your period, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF. Endometriosis is a disease where endometrial tissue that normally grows inside the uterus (or, as is up for debate, tissue similar to endometrial lining) grows outside of the uterus. This tissue can attach to your bowels and start trouble. “You then have bleeding around that area, and that can cause pain when you have a bowel movement,” Dr. Greves explains.

If your poop gets weird on your period, there are a few things you can do to cope.

The most important step is knowing what’s normal for you on your period and doing what you can to minimize any additional triggers. For instance, if you always get diarrhea during your period, and you know that coffee tends to make you poop more, it’s a good idea to cut back a little when you’re actually on your period, Dr. Farhadi says. You can also take Immodium on the first day of your period in anticipation of diarrhea, or carry it with you in case it strikes, he says. If you deal with constipation during your period, try upping your fiber and water intake in the middle of your cycle, when constipation-prompting progesterone levels start rising.

It can also help to pop some non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs, a common class of pain relievers, can block certain enzymes in your body from making prostaglandins. With fewer prostaglandins roaming around, you may get some relief from an achy belly and incessant pooping.

If you’re really having a hard time with poop issues on your period, talk to your doctor. They may be able to recommend next steps or refer you to a specialist who can. Your period is already annoying enough without spending forever on the toilet, either basically pooping water or straining hard to go in the first place.

Probiotics Do Not Reduce Diarrhea Risk in Large Trial.

Posted by

0


Probiotic supplements did not prevent antibiotic-associated diarrhea (AAD) or Clostridium difficile diarrhea (CDD) in a large randomized, double-blind, placebo-controlled trial.

Stephen J. Allen, MD, from Swansea University, United Kingdom, and colleagues reported the results in an article published onlineAugust 8 in the Lancet.

The researchers recruited patients 65 years or older to the Probiotic lactobacilli and bifidobacteria in antibiotic-associated diarrhoea andClostridium difficile diarrhoea in the elderly (PLACIDE) trial if they were exposed to 1 or more oral or parenteral antibiotics in the preceding 7 days or were about to begin antibiotic therapy. Participants were enrolled from 5 hospitals between December 1, 2008, and February 28, 2012, and were excluded if there were existing diarrhea or CDD in the previous 3 months, significant immune system compromise, any illness requiring intensive care, prosthetic heart valve, or underlying gastrointestinal disease. The primary study outcomes were the occurrence of AAD within 8 weeks of recruitment and CDD within 12 weeks of recruitment.

Overall, 1493 patients were randomly assigned to the microbial preparation group and 1488 to the placebo group. Of those, the researchers included 1470 and 1471, respectively, in the primary-endpoint analyses. Antibiotic exposure was similar between the 2 groups. The probiotic preparation consisted of a capsule containing 2 strains of Lactobacillus acidophilus and 2 strains of bifidobacterium.

The researchers found no difference between the groups in the incidence of ADD (including CDD). In the probiotics group,159 (10.8%) patients developed ADD compared with 153 (10.4%) patients in the placebo group (relative risk [RR], 1.04; 95% confidence interval [CI], 0.84 – 1.28; P = 0.71).

The study authors also found that CDD was an uncommon cause of ADD, occurring in only 12 (0.8%) participants in the microbial preparation group and 17 (1.2%) participants in the placebo group (RR, 0.71; 95% CI, 0.34-1.47; P = 0.35).

“Our trial suggests that properties common to many so-called probiotic bacteria, such as the production of lactic acid, are not effective against AAD in older inpatients,” write Dr. Allen and colleagues.

Although the authors note that this “is the largest trial so far for this problem,” they acknowledge study weaknesses such as low ethnic diversity and lack of participation by eligible patients resulting from an unwillingness to take an additional preparation.

“Our findings do not provide statistical evidence to support recommendations for the routine use of microbial preparations for the prevention of AAD and CDD,” conclude the study authors.

In an accompanying editorial, Nick Daneman, MD, FRCPC, from the University of Toronto, Ontario, Canada, points out that recent meta-analyses have shown large positive effects with the use of probiotic supplements. He also notes that statistical variations such as a low event rate in the current study and overlapping confidence intervals between this study and the meta-analysis may account for the differing results.

However, the size of the current study “dwarfs” previous studies, most of which, he says, were small single institution efforts. “PLACIDE is a large and rigorous negative study, and we must judge whether it can tip the balance of probiotic evidence,” he writes.

“At the very least, the low absolute risk reductions in PLACIDE question the cost-effectiveness of probiotics,” writes Dr. Daneman. In addition, “lactobacilli and bifidobacteria are only two types of non­pathogenic bacteria, and we must consider whether they can really tip the balance of a diverse gut ecosystem,” he concludes.

Funding for this study was provided by the Health Technology Assessment program of the National Institute for Health Research, with additional funding provided by the County Durham and Tees Valley, National Institute for Health Research Comprehensive Local Research Network. Dr. Allen has done research in probiotics supported by Cultech, UK; has been an invited guest at the Yakult Probiotic Symposium; and has received research funding from Yakult, UK. The other authors and the editorialist have disclosed no relevant financial relationships.

Source: Lancet.

 

 

 

Source: Medscape.com

 

Probiotics Fail to Reduce Antibiotic-Related Diarrhea.

Posted by

0


High-dose probiotics do not prevent diarrhea in older hospitalized patients, according to a large study in the Lancet.

Nearly 3000 inpatients aged 65 and older who were on antibiotic therapy were randomized to 21 days of a placebo capsule or a capsule containing lactobacilli and bifidobacteria, taken once daily. After 8 weeks, the incidence of antibiotic-associated diarrhea or Clostridium difficile diarrhea did not differ significantly between the groups.

The authors conclude: “Our findings do not provide statistical evidence to support recommendations for the routine use of microbial preparations for the prevention” of diarrhea.

Source: Lancet 

What place for racecadotril?

Posted by

0


Abstract

Worldwide, there are about two billion cases of diarrhoeal disease every year and it is the second leading cause of death in children under 5 years of age, killing 1.5 million children annually.1 The most severe threat posed by diarrhoea is dehydration. In the UK, the incidence of diarrhoea is about one episode per person per year,2 and approximately 10% of children younger than 5 years old present to healthcare services with gastroenteritis each year.3▼Racecadotril (Hidrasec) is the first in a new class of antidiarrhoeal drug (‘enkephalinase inhibitor’) that has an antisecretory mechanism and is licensed in adults, children and infants (over 3 months of age) for symptomatic treatment of acute diarrhoea or as complementary treatment when causal treatment is possible.4–6 Here we review the evidence for racecadotril and its place in the management of acute diarrhoea.

 

Source: BMJ

 

 

 

Probiotics to Prevent Clostridium difficile–Associated Diarrhea.

Posted by

0


Probiotic prophylaxis lowered the incidence of CDAD by 66%.

Antibiotic treatment disturbs the normal gastrointestinal flora and raises risk for Clostridium difficile–associated diarrhea (CDAD). To evaluate the effectiveness and safety of probiotics for preventing CDAD, researchers performed a systematic review and meta-analysis. CDAD was defined as an episode of diarrhea associated with a positive C. difficile culture or toxin assay.

Twenty randomized, controlled trials that involved 3818 adults and children were included in the analysis; 18 studies were placebo controlled. Information on antibiotic regimens was not provided. Probiotics used in the trials included Bifidobacterium, Lactobacillus, Saccharomyces, and Streptococcus species.

Probiotics lowered the incidence of CDAD by approximately 66%. The incidence of adverse events, including abdominal cramping, nausea, fever and flatulence, was higher among controls than among probiotic recipients (12.6% vs. 9.3%); no serious adverse events were attributed to probiotics. The results were similar among children and adults, with lower and higher doses of probiotics, and across the different probiotic species.

Comment: The authors believe that their meta-analysis provides moderate-quality evidence to support a clinically significant protective effect of probiotics in preventing C. difficile–associated diarrhea. As with any meta-analysis, the quality of individual studies varied; the grading methodology used in this analysis required a larger sample size for the evidence to be considered high quality. Nevertheless, given the lack of serious adverse events, we might reasonably encourage use of probiotics, particularly for susceptible patients, such as those who are receiving broad-spectrum antibiotics.

Source:Journal Watch General Medicine

Prevent the Spread of Norovirus.

Posted by

0


Norovirus causes about 20 million gastroenteritis cases each year in the United States. There’s no vaccine to prevent infection and no drug to treat it. Wash your hands often and follow simple tips to stay healthy.

Noroviruses are a group of related viruses. Infection with these viruses affects the stomach and intestines and causes an illness called gastroenteritis (GAS-tro-en-ter-I-tis; inflammation of the stomach and intestines).

Anyone Can Get Norovirus

Anyone can be infected with noroviruses and get sick. Also, you can get norovirus illness more than once during your life. The illness often begins suddenly. You may feel very sick, with stomach cramping, throwing up, or diarrhea.

Noroviruses are the most common cause of gastroenteritis in the United States. CDC estimates that each year more than 20 million cases of acute gastroenteritis are caused by noroviruses. That means about 1 in every 15 Americans will get norovirus illness each year. Norovirus is also estimated to cause over 70,000 hospitalizations and 800 deaths each year in the United States.

Many Names, Same Symptoms

You may hear norovirus illness called “food poisoning” or “stomach flu.” It is true that food poisoning can be caused by noroviruses. But, other germs and chemicals can also cause food poisoning. Norovirus illness is not related to the flu (influenza), which is a respiratory illness caused by influenza virus.

Symptoms of norovirus infection usually include diarrhea, throwing up, nausea, and stomach cramping.

Other, less common symptoms may include low-grade fever, chills, headache, muscle aches, and general sense of fatigue.

Norovirus illness is usually not serious. Most people get better in 1­ to 2 days. But, norovirus illness can be serious in young children, the elderly, and people with other health conditions; it can lead to severe dehydration, hospitalization and even death.

You may get dehydrated if you are not able to drink enough liquids to replace the fluids lost from throwing up or having diarrhea many times a day. Symptoms of dehydration include a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up. Children who are dehydrated may also cry with few or no tears and be unusually sleepy or fussy.

The best way to prevent dehydration is to drink plenty of liquids. Oral rehydration fluids are the most helpful for severe dehydration. But other drinks without caffeine or alcohol can help with mild dehydration. However, these drinks may not replace important nutrients and minerals that are lost due to vomiting and diarrhea.

If you think you or someone you are caring for is severely dehydrated, contact your doctor. For more information on norovirus and dehydration, see norovirus treatment.

Norovirus Spreads Quickly

Norovirus can spread quickly from person to person in crowded, closed places like long-term care facilities, daycare centers, schools, hotels, and cruise ships. Noroviruses can also be a major cause of gastroenteritis in restaurants and catered-meal settings if contaminated food is served.

Norovirus and Food

Norovirus is a leading cause of disease from contaminated foods in the United States. Foods that are most commonly involved in foodborne norovirus outbreaks include leafy greens (such as lettuce), fresh fruits, and shellfish (such as oysters). However, any food item that is served raw or handled after being cooked can become contaminated with noroviruses.

The viruses are found in the vomit and stool of infected people. You can get it by

  • Eating food or drinking liquids that are contaminated with norovirus (someone gets stool or vomit on their hands, then touches food or drink).
  • Touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth.
  • Having direct contact with a person who is infected with norovirus (for example, when caring for someone with norovirus or sharing foods or eating utensils with them).

People with norovirus illness are contagious from the moment they begin feeling sick until at least 3 days after they recover. But, some people may be contagious for even longer.

Norovirus: No Vaccine and No Treatment

There is no vaccine to prevent norovirus infection. Also, there is no drug to treat people who get sick from the virus. Antibiotics will not help if you have norovirus illness. This is because antibiotics fight against bacteria, not viruses. The best way to reduce your chance of getting norovirus is by following some simple tips.

Stop the Spread of Norovirus

Practice proper hand hygiene

Wash your hands carefully with soap and water, especially after using the toilet and changing diapers and always before eating or preparing food. If soap and water aren’t available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water.

Take care in the kitchen

Carefully wash fruits and vegetables, and cook oysters and other shellfish thoroughly before eating them.

Do not prepare food while infected

People with norovirus illness should not prepare food for others while they have symptoms and for 3 days after they recover from their illness.

Clean and disinfect contaminated surfaces

After throwing up or having diarrhea, immediately clean and disinfect contaminated surfaces by using a bleach-based household cleaner as directed on the product label. If no such cleaning product is available, you can use a solution made with 5 tablespoons to 1.5 cups of household bleach per 1 gallon of water.

Wash laundry thoroughly

Immediately remove and wash clothing or linens that may be contaminated with vomit or stool. Handle soiled items carefully—without agitating them—to avoid spreading virus. If available, wear rubber or disposable gloves while handling soiled clothing or linens and wash your hands after handling. The items should be washed with detergent at the maximum available cycle length and then machine dried.

Source:CDC