Viral gastroenteritis in adults

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Last reviewed: 24 Apr 2025
Last updated: 09 May 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • diarrhoea
  • vomiting
  • nausea
  • abdominal pain
Full details

Other diagnostic factors

  • malaise
  • anorexia
  • fever
  • volume depletion
Full details

Risk factors

  • exposure to contaminated food or water sources
  • close contact with infected people
  • poor hygiene
  • extreme ages
  • HIV infection
  • organ transplantation
  • chronic illness
Full details

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
  • full blood count
  • urea and electrolytes
  • creatinine
Full details

Investigations to consider

  • stool for culture, ova, and parasites
  • stool viral culture
Full details

Treatment algorithm

ACUTE

mild to moderate dehydration

severe dehydration or unable to tolerate oral fluids

Contributors

Expert advisers

Alexander Alexiou, MB, BS, BSc, DCH, FRCEM, DipIMC RSEd

Consultant in Emergency Medicine

Royal London Hospital

Consultant in Physician Response Unit

Barts Health NHS Trust/London Air Ambulance

London

UK

Disclosures

AA declares that he has no competing interests.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

Kyle E. Brown MD, FAASLD

Associate Professor of Internal Medicine

University of Iowa

Carver College of Medicine

Iowa City

IA

Jenny Currigan

ST6 Emergency Medicine Trainee

Royal London Hospital

Barts Health NHS Trust

London

UK

Johann Grundlingh MBChB, FCEM, FFICM, EDICM, DFMS, DipMedTox, MMedTox, MSB, ERT, MEWI, MBA

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

London

Honorary Senior Lecturer

Queen Mary University

London

UK

Disclosures

KEB, JC and JG declare that they have no competing interests.

Peer reviewers

Adam Evans

Consultant Physician

Acute Medicine and Infectious Diseases Physician

Royal Victoria Infirmary

Newcastle upon Tyne

UK

Disclosures

AE declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Bányai K, Estes MK, Martella V, et al. Viral gastroenteritis. Lancet. 2018 Jul 14;392(10142):175-86. Abstract

Barr W, Smith A. Acute diarrhea. Am Fam Physician. 2014 Feb 1;89(3):180-9. Abstract

Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018 Mar 1;378(9):829-39.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Bacterial gastroenteritis
    • Protozoal infections
    • Helminthic infections
    More Differentials
  • Guidelines

    • Intravenous fluid therapy in adults in hospital
    • General information to prepare for and manage norovirus in care settings
    More Guidelines
  • Patient information

    Diarrhoea in adults

    More Patient information
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