Viral Gastroenteritis: Nausea, Vomiting and Diarrhea - Causes and Relief

Victoria Wermers, RN,MSN,FNP, PMHNP
Oct 11, 2024
4 min read

Updated: Jul 1

The following is a discussion of viral gastroenteritis: Nausea, vomiting, and diarrhea and relief from illnesses like norovirus, rotavirus, adenoviruses (colds), COVID, and the flu, causes and relief.

Norovirus: There are several different strains of norovirus currently circulating. While numbers are not currently available on the CDC website, according to the site, in January 2025, it was considered the most common cause of gastroenteritis in the US, growing year-by-year, and cases in the US have been quite high in the last few months. It is one of those things that spreads like wildfire: This is a notorious problem on cruises and around elementary school classrooms, spread by food, water, and surfaces (the oral/fecal route). Besides gastric symptoms, it may be accompanied by a fever, body aches
Rotavirus: Rotavirus, which causes vomiting and diarrhea, is spread by the fecal-oral route.
Adenovirus: These people have cold symptoms, sometimes accompanied by nausea, vomiting, and diarrhea. Spread by personal contact and droplets.
Other underlying viral illness: Occasionally, viral gastroenteritis is caused by a different underlying viral illness, like respiratory illnesses like COVID-19 or the flu.

The Course of Viral Gastroenteritis: What to Expect

These are some of the symptoms patients dread the most. What happens? These viruses cause your stomach lining to become inflamed, which causes nausea, vomiting, and, often, diarrhea. The onset of nausea, vomiting, and diarrhea occurs about 1-2 days after exposure (consideration of timing is very important in differentiating between viral, bacterial gastroenteritis, and food poisoning). Symptoms usually last for a couple of days but may last as long as two weeks.

Understanding the course of viral gastroenteritis: nausea, vomiting, and diarrhea - causes, and relief measures, can make all the difference in the world to managing symptoms effectively. The next sections break down the common signs, treatment approaches, and both traditional and natural remedies to help you feel better faster.

Symptoms of Viral Gastroenteritis:

People with a viral cause of gastroenteritis usually experience watery diarrhea (non-bloody), stomach cramps, nausea, and vomiting.

Norovirus may be accompanied by low-grade fever, but this is not always the case.
Rotavirus is typically accompanied by a fever.
Adenovirus and other flu and COVID viruses typically cause respiratory symptoms, cough and cold symptoms, along with stomach problems.

Treatment of viral gastroenteritis

Treatment is typically symptomatic. There are various approaches to this, over the counter, alternative, and prescriptive, as noted below.

The treatment is like that of other types of infectious gastroenteritis.

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Nausea and Vomiting: OTC Medicines, Natural Remedies and Prescriptive Treatment

Over-the-Counter Medicines

Bismuth subsalicylate (common: Pepto Bismol or Kaopectate). These help slow stomach movement and irritation, bloating, and gas (do not take if you have a fever or blood in your stool). Be sure to check the label for contraindications. It may cause the stool to be black.
Emetrol as directed over the counter

Considered Natural Remedies:

Ginger
Honey – according to Mayo
Peppermint (tea)
Chamomile (tea)
Basil
Lemon Juice in warm water
Pressure Points from Dana-Farber Cancer Institute
Probiotics can significantly reduce the duration of diarrhea and perhaps help prevent it. An abstract in Science Direct cites studies of "bacteria (Lactobacillus, bifidobacterium,

Bacillus, Clostridium butyricum, Streptococcus, Enterococcus) and yeast (Saccharomyces boulardii)" in the management of an array of human diarrheal diseases. *Some people may not be able to take probiotics-especially those with an immune disorder.

Prescription medication

The following medication may be VERY important in maintaining hydration – again, one of the biggest factors in recovery:

Ondansetron/Zofran
Promethazine/Phenergan (more potential side effects than Zofran)

Please note- if you are of child-bearing age, are sexually active, and have nausea and vomiting only, with no diarrhea, you may want to check to make sure you are not pregnant.

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Diarrhea: OTC Medicines, Natural Remedies, and Prescriptive Treatments

Over-the-Counter Medicines

Diarrhea is often your body’s way of flushing out toxins, so it's generally best to let it resolve naturally. However, if symptoms become too uncomfortable or disruptive, the following options may help ease your discomfort:

Imodium AD (symptom Imodium Multi- has additional ingredients for
Bulking Agents – Oddly enough, bulking agents, which are used for constipation, it is also used for diarrhea because they expand in the GI tract and sometimes can help diarrhea turn into a more formed stool: Metamucil
Bismuth subsalicylate (common: Pepto Bismol or Kaopectate). (Read the contraindications on the label.) It may cause your stool to become black. Avoid if fever or if you have blood in your stool.

Considered Natural Remedies and Approaches

Acidophilus (Lactobacillus acidophilus) and Lactobacillus rhamnosis and

Lactobacillus reuteri (*Some people have contraindications to taking probiotics - for example, those on chemo, those with autoimmunity, pregnant, and nursing).

Prescriptive Treatment

Lomotil (Atropine and diphenoxylate) – Controlled substance
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Abdominal Pain/Cramping: OTC Medicines, Natural Remedies, and Prescriptive Treatment

Over-the-Counter

Pepto Bismol, as directed, over-the-counter, sometimes helps with abdominal discomfort

Natural Approaches and Herbal Remedies

Heating Pad to the abdomen (intermittently for 15 minutes at a time)
Peppermint (caps, teas) antispasmodic