Viral gastroenteritis in adults

Volume depletion, loss of electrolytes, and inadequate fluid and electrolyte resuscitation can cause serious electrolyte imbalances. The most common electrolyte disturbances include hypernatraemia, hyponatraemia, and hypokalaemia.

Selection of appropriate fluids for rehydration and monitoring of electrolytes in severe cases can help to prevent this complication. Central pontine myelinolysis or cerebral oedema can occur if sodium correction is not managed optimally. In hypernatraemic volume depletion, oral rehydration therapy might be safer than intravenous therapy because it is less likely to lead to a precipitous increase in intracellular water, associated with seizures and elevated intracranial pressure.

Assessment of metabolic acidosis

Severe volume depletion can cause hypotension and acute tubular necrosis due to pre-renal azotaemia.

In addition to rehydration, some patients require dialysis until renal function recovers.

Acute kidney injury

Lactose intolerance can occur after acute viral gastroenteritis because of the loss of intestinal brush-border enzymes. This can persist for several weeks or may be permanent in some cases.

Intolerance to cows' milk or soya protein may also develop because of a hypersensitivity reaction.

Lactose intolerance should be treated with a lactose-free diet, or use of a commercially available lactase preparation, given orally. Slow introduction of lactose after a few weeks may be tolerated.

In the case of other food intolerance, the precipitating food should be avoided. Reintroduction of the food after complete recovery is possible in most cases.