Stomach Flu – What to Do?

If you have the stomach flu (not really the flu, by the way), which means you have been experiencing nausea and potentially vomiting, no matter how hungry you might be, do not try to eat or drink anything for at least 60 (sixty) minutes after vomiting.  You need to start small and slow.  Try small sips of water or ice chips.  Limit yourself to just 1 (one) teaspoon every 3 (three) minutes until you have consumed about 1/2 (one-half) a cup of water.  Then wait 15 (fifteen) minutes before trying more fluids.  If your nausea has not increased and you do not vomit, you can then try other “clear” liquids.  Clear as in you can see through them.  This would include:

  • water
  • fruit juices that do not contain pulp and are transparent such as grape juice, apple juice, and cranberry juice
  • Kool-aid
  • Tea – sugar or honey can be added, but no milk
  • broth, but nothing solid
  • sports drinks
  • Popsicles, Jell-O and clear hard candy can also be tried

This DOES NOT include:

  • milk products
  • juices that are acidic or contain pulp such as orange juice, pineapple juice, tomato juis and all fruit nectors
  • alcohol (that includes beer and wine)
  • coffee

After 3 (three) to 4 (four) hours, if your nausea had diminished and you have not vomited, you can then try eating some dry foods.  Again, start small and slow and think bland or boring.  Saltines (soda crackers), pretzels, and dry plain toast are good options.

After another 3 (three) to 4 (four) hours with no vomiting or worsening of your nausea you can advance to more substantial food, but again small and slow and boring.  Try some soup with rice or noodles, plain rice, baked potato (no toppings), or bread products (no toppings).

If it has been 24 hours with no incidence of nausea or vomiting you can then progress to a more substantial bland diet and include items such as skinless chicken breast, banana, or applesauce.  Best to avoid fatty, greasy, and spicy foods, as well as milk products.  Give it a day or two for your stomach to recover before resuming your regular diet.

If you find that your nausea and vomiting is not going away and it has been more than 24 (twenty-four) hours since it’s onslaught , schedule an appointment with your doctor.

Maribeth Mulholland M.D.

Veggie Vitals – I do not like broccoli

bush-broccoli“I do not like broccoli. And I haven’t liked it since I was a little kid and my mother made me eat it. And I’m President of the United States and I’m not going to eat any more broccoli.” George H. W. Bush

The above quote was made when then President Bush banned broccoli from being served on Air Force One.  While I can certainly understand not like something – sauerkraut has never been served in my home – President Bush was definitely missing out on a good thing with broccoli.  It has been touted as a super vegetable.

  • Potassium – helps maintain a healthy nervous system and optimal brain function, promote regular muscle growth
  • Magnesium and calcium – helps regulate blood pressure
  • Vitamin C – fights free radicals and effective antihistamine for easing discomfort of common cold
  • Vitamin K and calcium – important for bone health and prevention of osteoporosis
  • Beta-carotene, zinc, and selenium – strengthen immune defense actions
  • Glucoraphanin – processed by the body into sulforaphane which rids the body of H. pylori, a bacterium found to highly increase risk of gastric cancer
  • Fiber – aids in digestion, maintains low blood sugar, and curbs overeating.
  • Carotenoid lutein – helps prevent age related macular degeneration and cataracts and may also slow down or prevent thickening of arteries.
  • B6 and folate reduce risk of atherosclerosis, heart attack, and stroke.

So, before you side with President Bush and ban broccoli from your home, consider the many health benefits this vegetable offers.  Maybe with a little bit of garlic and parmesan cheese you’ll be able to consume this veggie and reap the benefits of this super food.

Submitted by Tina Comston, M.Ed.

Hmm blood – that’s not normal….

There have been a lot of comments lately about seeing blood when having a bowel movement.  Not a normal occurrence and something that quite frankly can be a bit unnerving.

If you see blood in your stool or when you wipe – ask yourself a couple of questions:

  1.  Have you eaten anything red in the last couple of days? Beets, watermelon, red velvet cake – things along those lines that are really red in color.  Foods you eat can affect the color of your output.  If that’s the case, lay off the red foods and give it a day or two for everything to work through your system.   If you’re still seeing red – schedule an appointment with your doctor.
  2. Have you been constipated, having to work a little harder than normal to make things flow? Is the blood bright red?  If this sounds familiar, then most likely you are experiencing problems with hemorrhoids.  Start drinking more water and add fiber into your diet to get things moving more smoothly.  If the constipation is a thing of the past, and you’re still seeing  blood – schedule an appointment with your doctor.
  3. Is the blood more of a deep color, perhaps even brownish? This would indicate that the blood is coming from higher up in the intestinal track, perhaps even from the stomach area.  Don’t mess around with this one, schedule an appointment with your doctor.

In any of the above cases, if the symptoms persist for more than a couple of days, even if there isn’t any pain or discomfort, schedule an appointment with your doctor.

Submitted by Tina Comston, M.Ed.

Reviewed by Mary Lynn Kiacz, M.D.

Doodie in the Pool!

In this well-known scene from Caddy Shack, panic ensues when “doodie” is found in the pool.   While the movie is all in good fun, there’s actually some truth in there as well.  Crypto, AKA Cryptosporidium, is a microscopic parasite that can affect both humans and animals.  It lives in the intestines and is passed in the stool of an infected person or animal.  The most common means of transfer – water.  It is actually one of the most common causes of waterborne disease, both through recreational water such as swimming pools or lakes, and drinking water.  This parasite is very resilient and has a hard outer shell which allows it to survive outside the body for long periods of time and also makes it resistant to chlorine.

Those most at risk for contracting crypto are:

  • Children who attend day care centers
  • Child care workers
  • International travelers
  • Backpackers, hikers, and campers who drink unfiltered, untreated water
  • People, including swimmers, who swallow water from contaminated sources
  • People who handle infected cattle
  • People exposed to human feces through sexual contact

The most common symptom of crypto is watery diarrhea.  Other symptoms include:

  • Stomach cramps or pain
  • Dehydration
  • Nausea
  • Vomiting
  • Fever
  • Weight loss

If you become infected with crypto, you can expect the symptoms to appear in 2-10 days.  They will usually last about 1-2 weeks and may go in cycles where you seem to get better and then feel worse before the illness ends.  Most people with a healthy immune system recover without treatment.  An over the counter anti-diarrheal medicine can help and it’s important to drink plenty of fluids to prevent dehydration.

Crypto is very contagious. The following steps should be taken by those infected with Crypto to avoid spreading the disease to others:

  • Wash your hands frequently and thoroughly with soap and water, especially after changing diapers, using the toilet, and before eating or preparing food.
  • For at least 2 weeks after the diarrhea has stopped, do not swim in recreational water. You can contaminate water for several weeks after the symptoms have ended.
  • Avoid sexual practices, such as oral-anal contact, that bring you in contact with fecal matter.
  • Avoid contact with people who have a weakened immune system.
  • Do not put children who have Crypto in a child care setting until the diarrhea has ended.

If you suspect you have crypto, or your symptoms are not improving, schedule an appointment at Student Health Services or with your health care provider. 

In the meantime – if you see “doodie” in the pool, play out that scene in Caddy Shack and get out of the water ASAP!!

You can read more about Crypto at the CDC website:

Submitted by Tina Comston

Reviewed by Dr. Ryan Hanson

Stomach bug back on campus

click to enlarge

We have seen a LOT of students with a viral gastroenteritis (“stomach flu”) here at Student Health over the last couple of weeks.  Here’s what you should look out for and/or do if you think you’ve been hit with it.

Watery diarrhea is the main symptom: anywhere from 2 or 3 loose stools per day up to living on the toilet all day.  Other symptoms include:

  • Nausea and vomiting (some people will only have this without the diarrhea)
  • Stomach cramps, pain, or tenderness
  • Fever or chills
  • Appetite loss
  • Weakness
  • Dehydration

The most common cause is an infection by a virus that is spread by coming into contact with an infected person or by touching an object that has the virus on it.  Sometimes people are worried that they may have “food poisoning.” While it is certainly possible to get a similar illness from eating bad food, a viral infection is more common and for the most part, you treat them the same way.

To avoid catching the stomach virus, be sure to wash your hands a lot to prevent the spread of germs; don’t share cups/utensils/toothbrushes, etc.; and be sure you’re cooking and storing food properly.

Even though this is sometimes called a “24-hour stomach bug,” symptoms usually last 2 to 5 days and you may feel weak and fatigued for up to a week.

The mainstay of treatment is rest and replacing the fluids you are losing through vomiting and diarrhea.  Suck ice chips or drink small amounts of clear fluids often. Replace lost fluids and electrolytes with products such as non-caffeinated beverages (Sprite, Ginger Ale, GatorAde, PowerAde).  Stay away from orange juice, that will just cause irritation.  Once you feel like you can keep food down, stick with bland foods like rice, wheat, potatoes, bread, cereal, and lean meat like chicken.  Milk and dairy products can sometimes irritate your stomach after a stomach flu, so minimize them for a day or two and try to avoid fatty or greasy foods like hamburgers and pizza for a few days.

Most of the time, the stomach flu will resolve on its own and you can manage it at home.  Loperamide (Imodium AD) is available over-the-counter for diarrhea.  If the nausea is severe, we can prescribe you anti-nausea medication at the student health center.   Be sure to contact the student health center if:

  • Symptoms last longer than 2 days
  • You see blood or mucus in your stool
  • You can’t keep fluids down
  • You have signs or symptoms of dehydration: dry mouth, lightheadedness or dizziness

John A. Vaughn, MD (OSU SHS)

Revised by Tina Comston, M.Ed.

 

Help! I saw blood on the toilet paper after I wiped – what should I do!?

mayo foundation

Q: Help! I saw bright red blood on the toilet paper after I wiped.  What should I do!? 

Short A: Come in to see us so we can check it out.

Long A: Don’t panic. We see this all the time at Student Health and it’s rarely as scary as it looks.  You’re probably dealing with a hemorrhoid: a very common, and literal, pain in the butt. 

Hemorrhoids are abnormally swollen veins in the rectum or anus that bleed with minor pressure, such as that which occurs from bowel movements.  They can be painful or painless depending on their location, and are often associated with rectal pain and itching, a lump that you can feel and/or rectal bleeding. 

Risk factors for developing hemorrhoids include

  • Poor fiber intake
  • Prolonged sitting or standing
  • Being overweight
  • Pregnancy
  • Chronic constipation or diarrhea
  • Engaging in anal sex

When you come to the Student Health Center, we will ask you a lot of embarrassing questions and do an embarrassing examination to rule out other more serious causes of rectal bleeding such as infections, inflammatory bowel disease, anal fissures and even (rarely) colon cancer.  Since some hemorrhoids are located a few inches inside the rectal canal, we may have to use a small, lubricated, clear plastic tube called an anoscope to look on the inside.

The mainstay of hemorrhoid treatment (and prevention) is fiber, fiber, fiber.  Most of us don’t get enough fiber in our diet, which leads to constipation, which leads to straining to have a bowel movement, which leads to increased pressure in the rectal veins which… you get the idea.  Supplementing your diet with soluble fiber supplements (Metamucil or Benefiber) will work wonders for this problem.  Other things you can do include:

  • Avoid straining and prolonged sitting on the toilet
  • Lose weight if necessary
  • Drink 8 to 10 glasses of water per day
  • Exercise regularly
  • Gently clean the anal area with soft, moistened paper after each bowel movement and avoid the urge to scratch – as an old family doctor once told me: “Wipe, don’t polish!”

Again, while it can certainly be scary, rectal bleeding is rarely a sign of a life-threatening condition.  But if it happens to you, be sure to see your health care provider to make sure it isn’t, especially if the bleeding is dark brown or black, is heavy, you feel weak or light-headed, or the pain gets suddenly a lot worse.

 

John A. Vaughn, MD
Student Health Services
The Ohio State University

Medical Mythbusters – Does gum really stay in your stomach for 7 years?

photo: wikimedia commons

My belly hurts!

Q: Is it true that swallowed gum stays in your stomach for 7 years?

A:  This myth is definitely false.  The body is very good at digesting material that it can use and passing the rest out in the stool.  It is true that your body is unable to digest the synthetic portion of chewing gum, but it doesn’t stay in the stomach for an extended period of time because the stomach periodically empties into the small intestine.  The gum then moves through the small intestine into the colon and is eventually passed in the stool. 

There are many substances that the body cannot digest that pass harmlessly through our system – for instance, this is why you will often see the outside fiber shell of corn in your bowel movements.  Tougher things than gum will often pass through harmlessly in a couple of days, as any parent of a toddler who swallowed a penny can tell you. 

Of course, if you swallow something that is too large to fit through the various valves and tubes in your guts, it can cause an intestinal obstruction.  So if you swallow a large amount of gum in a relatively small amount of time it can theoretically clump up into a large mass of indigestible substance (called a bezoar) that can get trapped in your GI system.  This medical emergency is very rare, but believe me – it if does happen, it’ll take a lot less than 7 years for you to figure out something ain’t right.

So the next time you’re at a fancy restaurant with a cloth napkin and nowhere to put your gum, you can swallow it with confidence.  Despite what the “old wives’ tale” says, it’ll be out of your system in a day or two.

Adam Brandeberry (Ohio State College of Medicine)

John A. Vaughn, MD (Ohio State Student Health Services)

Unusual medical news – Hibachi Hazards

CT A

CT B

Public Health looks for patterns that lead to hazards, and hazards that lead to illness or death.  Over a 15 month period starting in March, 2011, 6 people were seen in emergency departments within a single hospital system in Providence, Rhode Island, 3 with severe pain with swallowing, and three with severe abdominal pain. 

What was the common thread linking these cases?  Each of them had short pieces of metal lodged in their GI tract, either in the throat and esophagus, or in the intestines. 

Next, it was determined that all six had outdoor grills, and all of the grills had wire brushes for cleaning the grill racks. 

Foreign object ingestion resulted in approximately 80,000 ED visits in 2010.

If you scrape off your grill, wiping it down before firing it up might save you from emergency surgery!

Good Eating!

Roger Miller, MD (OSU Student Health Services)

Injuries from Ingestion of Wire Bristles from Grill-Cleaning Brushes – Providence, Rhode Island, March 2011-June 2012, Morbidity and Mortality Weekly, July 6, 2012 / 61(26);490-492.

Gettin’ a little dirty may actually be good for you

Bing Images

Science has done it again. Dirty pigs are healthier pigs. It has been proven. Don’t ask how, because it involved a lot of fetal pigs (which makes my undergraduate pig dissecting PTSD flare up), poop and blood.  But it also involved a lot of wallowing and I am ALL about science that proves that wallowing is good for you.

Sure, the title – Environmentally-acquired bacteria influence microbial diversity and natural innate immune responses at gut surfaces – scintillating as it is, might not immediately strike you as a defense of all that is good about being dirty. But pull up a chair and consider the dirty details.

Gut immunologists took baby pigs and sent them outside, inside or into a kind of antibiotic-laced biologic bubble. The guts of the outdoor, mud-wallowing pigs were full of healthier bacteria than the indoor pig guts. Not only was there more of the good stuff in outdoor beasts, there was also less harmful bacteria in the chute. Most cool and interesting, though, is that the bacterial composition of the piggies’ guts influenced the expression of immunologic genes: pristine, white-glove pork expressed more inflammatory genes and other icky inflammatory stuff.

I know what you’re thinking. Pigs aren’t human, Dr. Rentel. True. Based on this study I’m not going to build a heated pigsty with a giant HDTV for me and my kids in the backyard. There is, however, a growing, stinking, microbial-filled gooey heap of evidence that human interaction with bacteria is good. Why does the prevalence of autoimmune diseases and allergies keep going up? This study gives some very direct, powerful evidence as to how the cascade of autoimmune badness gets started. Okay, yes, in pigs, but pigs are a whole lot like us.

As my favorite infectious disease specialist in the whole wide world (Dr. George Gianakopoulos) used to say, “Nature abhors a vacuum. Kill the good bacteria and welcome in the bad.”  I’m not saying you should order dirt for take-out tonight.  But skipping the whole-body antimicrobial gel bath every day might not be a bad idea. 

Victoria Rentel, MD (OSU Student Health Services Alum)

BMC Biology 2009, 7:79

Stomach bug hitting campus hard!

click to enlarge

We have seen a LOT of students with a viral gastroenteritis (“stomach flu”) here at Student Health over the last couple of weeks.  Here’s what you should look out for and/or do if you think you’ve been hit with it.

Watery diarrhea is the main symptom: anywhere from 2 or 3 loose stools per day up to living on the toilet all day.  Other symptoms include:

  • Nausea and vomiting (some people will only have this without the diarrhea)
  • Stomach cramps, pain, or tenderness
  • Fever or chills
  • Appetite loss
  • Weakness
  • Dehydration

The most common cause is an infection by a virus that is spread by coming into contact with an infected person or by touching an object that has the virus on it.  Sometimes people are worried that they may have “food poisoning.” While it is certainly possible to get a similar illness from eating bad food, a viral infection is more common and for the most part, you treat them the same way.

To avoid catching the stomach virus, be sure to wash your hands a lot to prevent the spread of germs; don’t share cups/utensils/toothbrushes, etc.; and be sure you’re cooking and storing food properly.

Even though this is sometimes called a “24-hour stomach bug,” symptoms usually last 2 to 5 days and you may feel weak and fatigued for up to a week.

The mainstay of treatment is rest and replacing the fluids you are losing through vomiting and diarrhea.  Suck ice chips or drink small amounts of clear fluids often. Replace lost fluids and electrolytes with products such as non-caffeinated beverages (Sprite, Ginger Ale, GatorAde, PowerAde).  Once you feel like you can keep food down, stick with bland foods like rice, wheat, potatoes, bread, cereal, and lean meat like chicken.  Milk and dairy products can sometimes irritate your stomach after a stomach flu, so minimize them for a day or two and try to avoid fatty or greasy foods for a few days.

Most of the time, the stomach flu will resolve on its own and you can manage it at home.  Loperamide (Imodium AD) is available over-the-counter for diarrhea.  If the nausea is severe, we can prescribe you anti-nausea medication at the student health center.   Be sure to contact the student health center if:

  • Symptoms last longer than 2 days
  • You see blood or mucus in your stool
  • You can’t keep fluids down
  • You have signs or symptoms of dehydration: dry mouth, lightheadedness or dizziness

John A. Vaughn, MD (OSU SHS)