STAY WELL & SPARKLE!: Gastroenteritis


Dr. Sam Christian, MD.
Dr. Sam Christian, MD.

Crab an’ callaloo, sancoach, titiwi, souse, fwanshin, a good old braf. It’s Independence and chances are you savoured some fine creole cuisine – but not if a mal vaht got you.

Gastroenteritis (‘gastro’ or mal vaht in Patois) is one of the more common diseases world-wide, yet misconceptions persist as to the cause and treatment. It is an inflammation of the stomach and or intestine resulting in a constellation of symptoms including vomiting, diarrhea and crampy abdominal pain. The condition typically manifests within 1 to 72 hours after contact with the causative against agent. Technically it is self-limiting, meaning that, like the common cold, it is supposed to go away by itself. In practice as we shall see, that can be quite another story.

Big medical words can sometimes be confusing. Gastritis is not ‘gastro.’ Gastritis is a chronic, dull upper belly ache, generally worse when hungry and relieved by food, milk or antacids such as Mylanta, Rolaids or Tums. Gastritis is a prelude to stomach ulcers, but that’s the subject of a future article.

Gastroenteritis on the other hand, tends to be explosive. You are in your usual state of good health when suddenly you feel the need to go to the bathroom. You leave what you are doing, but on the way, you realize you have to run…run…RUN! In fact, in some parts of the world that’s exactly what it is called: ‘the runs.’

Real gastroenteritis is caused by viruses, bacteria or parasites. In children, the cause is often Rotavirus, in adults Campylobacter. Food left standing at room temperature for several hours cause bacteria to multiply. Incidents of food poisoning on a mass scale in big countries are often caused by food contaminated with bacteria called E. coli and Salmonella. Deaths occur. From my travels I can attest that Dominica’s education and certification of food vendors is quite advanced. This likely explains why there are no serious tourist advisories against drinking the water or eating the food. Congratulations!

The main risk of gastritis is dehydration. Look at the joint just past your knuckles. Pinch the skin at the back of that joint on the middle or index finger. It should gradually flatten back within 30 seconds. If it does not, you are ‘dry’ and need fluids. There are few tortures greater than that nauseous saliva build-up signalling repeated heaving and wretching. Don’t look at me as if you don’t know what I’m talking about. When mal vaht takes hold, nothing more comes up except a few drops of greenish-yellow, bitter bile. Or cramps that comes from having to rush to the throne, sweating bullets, straining again and again for naught.

The main treatment of gastroenteritis is fluid replacement. If you are still throwing up, don’t try to eat. That will only prolong your misery. It may seem obvious to you now, but there is a tendency to look at the clock and think, “Poor me. It’s lunch time. I missed breakfast already. I should put something on my stomach.” The body can hold out a lot longer than a few hours. Trust me. Add a half a teaspoon each of salt and sugar to a cup of water and try some sips of that. Give it a couple hours. If that stays down, try a couple mouthfuls. If that stays down, advance to something light: ginger tea, jello, yogurt, porridge, crackers; not much.

Andrews Liver Salts, Pepto-Bismol and such over-the-counter medications can help settle the stomach. Imodium can be a God-send. More often than not, it will stop diarrhea dead in its tracks! The BRAT diet (Banana, Rice, Applesauce and Tea) is not as highly recommended as before but still should be considered. Coconut water is the new sheriff in town when it comes to fluid replacement. It has the similar nutrients to mother’s milk and is already being used instead of major sports drinks by a growing number of professional athletes. Imagine that!

If, despite the above measures, symptoms persist, you may start feeling dizzy and confused. At this point, it’s off to the District Clinic, Urgent Care or Accident and Emergency for further evaluation and probable IV fluids. Be ready to tell your healthcare professional exactly what were your recent meals and where. Let us wash our hands often and use sanitizers. That will allow us to think more delicious thoughts. It’s Independence: Happy Eating!

Mal vaht, mal vaht, go away;                                                                                 
Come NOT again another day…


Dr. Sam Christian is an American-trained surgeon who runs the newly opened Urgent Care on 137 Bath Road. It offers general medical care, minor surgery, acupuncture microdermabrasion and Botox. To schedule your free wellness visit and tour of the facility, call 440-9133 or write

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  1. Macalla
    April 29, 2018

    I know this is old, but really need to clarify that the BRAT diet is Bananna, Rice, Applesauce and TOAST. Tea, especially woth Caffeine can exacerbate symptoms of stomach bugs.

  2. just saying
    November 5, 2013

    thanks for the info. I have experience this twice.

  3. inspired
    November 5, 2013

    good article

  4. Just saying
    November 4, 2013

    Got this twice. Thanks for the info doc.

  5. smile
    November 4, 2013

    very good article.

    November 3, 2013

    I remember having a few of these “poor me” moments in my time. I wish I had the benefit of this info, Doc. I’d have saved myself a lot of grief…

  7. Anonymous
    November 3, 2013

    Very informative.

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