An Overview of the 24-Hour Stomach Flu
What You Should Know About Gastroenteritis
Medically reviewed by Jane Kim, MD
A 24-hour stomach bug is a viral infection that causes diarrhea and vomiting. Most cases are easily treatable and resolve in one to three days.
Sometimes called the "stomach flu," the 24-hour stomach bug is a type of gastroenteritis caused by a contagious infection like norovirus.
This article discusses the 24-hour stomach bug. It explains the causes, diagnosis, and treatment of viral gastroenteritis. It also details why the stomach bug is not the same as the flu and ways to prevent it.
What Does a 24-Hour Stomach Bug Feel Like?
A 24-hour stomach bug is really viral gastroenteritis—inflammation in your stomach and gastrointestinal tract (digestive system)—that causes diarrhea.
Viral gastroenteritis also leads to other symptoms that include:
A stomach bug generally comes on suddenly and hits hard. The symptoms then gradually decrease as you get better.
Despite being called the 24-hour stomach bug most cases of viral gastroenteritis last longer than a day. Depending on the cause, a stomach bug can linger for up to 10 days.
Related:Symptoms of Stomach Flu
What Causes a 24-Hour Stomach Bug?
The stomach bug is usually caused by a virus. Food poisoning, bacterial infections, and parasites can cause similar symptoms and may be mistaken for a 24-hour stomach bug.
Common Viral Causes
Stomach bugs are often caused by viruses. The typical culprits include:
Rotavirus: Most common in babies between 3 months and 15 months old
Adenovirus: Most common in children under 2
Norovirus: Most common cause of adult cases
Astrovirus: Affects all ages; typically known for mild infections in children, but researchers are finding strains that affect the nervous system and may lead to life-threatening complications
About 60% of all stomach flu cases in the United States are due to norovirus. That comes out to around 21 million norovirus infections each year.
Viruses that cause stomach bugs are extremely contagious and easily passed from person to person.
The fecal-oral route (from not washing hands after defecating, changing diapers, digging in contaminated soil, etc.) is the primary mode of transmission. The following also plays a role:
Direct contact with a sick person
Aerosolized (airborne) particles from vomit
Consuming contaminated food and water
Surfaces contaminated with norovirus
Symptoms may last for just a day or two, or they may continue for more than a week.
Symptoms usually appear one to three days after exposure to viral gastroenteritis. Depending on the type of virus, the stomach bug can be contagious before symptoms appear and for up to two weeks after you recover. In general, children should be symptom-free for 48 hours before returning to school.
Food Poisoning vs. 24-Hour Stomach Bug
Food poisoning is often mistaken for a 24-hour stomach bug but is caused by bacteria or parasites instead of a virus.
Symptoms of food poisoning tend to come on faster than the stomach bug. Diarrhea and vomiting often begin within a few hours of ingesting contaminated food or water.
Bacteria-associated gastroenteritis is primarily related to something you ate and can be caused by:
These bacterial infections are transmitted through contaminated poultry or other tainted foods, including meat, produce, and dairy products. Campylobacter strains account for around one-third of all bacterial cases.
Symptoms of bacterial gastroenteritis can last anywhere from one to 10 days and may require antibiotics.
Parasites can also cause similar symptoms. Parasitic infections are spread through contaminated food, water, or soil. The primary culprits of parasite-associated gastroenteritis are:
Parasitic infections typically take longer to resolve than viral or bacterial gastroenteritis. Symptoms commonly last between two and six weeks.
Related:Stomach Flu Causes and Risk Factors
Is a Stomach Bug Really the Flu?
When describing a stomach bug, the term "flu" is a misnomer. In medical terms, the flu (influenza) is a common viral respiratory infection. It involves symptoms such as:
Congestion
Sore throat
Body aches
Fatigue
Headaches
When you get a flu vaccine, this is what you're being protected from—not gastroenteritis.
Stomach Flu
AKA gastroenteritis, infectious diarrhea
Gastrointestinal infection that can be caused by a virus, bacterium, or parasite
Spreads through person-to-person contact, contaminated food or water, or contact with infected feces
Symptoms include vomiting, diarrhea, fever, and stomach pain
Vomiting usually lasts 24 hours; diarrhea may continue for several days
Most can't be prevented with a vaccine
Flu
AKA seasonal influenza
Upper respiratory infection caused by a virus
Spreads through droplets in the air caused by coughing or sneezing
Symptoms include fever, chills, muscle aches, cough, and congestion
May last from two to 10 days
May be prevented with a yearly vaccine
Diagnosis
You may know the cause of your symptoms before even seeing a healthcare provider.
For example, if you and several others get sick after eating at a restaurant, food poisoning is a reasonable assumption. If sickness spreads through the household in waves and is going around school, it is likely a viral infection.
Symptoms that aren't severe and only last a few days likely won't need medical attention.
If you do see a healthcare provider, they may diagnose gastroenteritis just from the symptoms and circumstances you describe. They'll also likely be aware of anything that's spreading through the community.
In severe or prolonged cases, your provider may need more information. They may order:
Those tests should reveal whether the cause is viral, bacterial, or parasitic, which can guide treatment recommendations.
Sometimes COVID-19 can cause gastroenteritis-like symptoms. In some people, these symptoms may be present even if respiratory symptoms aren't.
Treatment
Symptoms of a 24-hour stomach bug usually go away on their own. The main focus of treatment is to prevent dehydration due to fever, vomiting, and diarrhea.
These treatments may help to relieve symptoms and prevent complications:
Stay hydrated. Water, oral rehydration solutions, and electrolyte-rich sports drinks are good choices, but avoid sugary sodas and fruit juice. Broth or ice pops are also helpful for preventing dehydration.
Follow the BRAT diet—banana, rice, apple, and toast—to ease a queasy stomach and stop diarrhea. Other bland foods that can help include saltine crackers and mashed potatoes.
Anti-nausea medicines like Reglan (metoclopramide) or Zofran (ondansetron) can be prescribed to reduce vomiting and lessen the risk of dehydration.
Anti-diarrheal medication like Pepto-Bismol (bismuth subsalicylate) or Imodium (loperamide) can be taken to relieve diarrhea, but should not be used in children or if you have bloody stools.
Tylenol (acetaminophen) can be taken to relieve fever; other over-the-counter fever reducers (ibuprofen, naproxen, aspirin) are more likely to upset your stomach.
Antibiotics are ineffective against viruses that commonly cause the 24-hour stomach bug but may be prescribed to help clear up gastroenteritis caused by bacterial food poisoning.
You're better off preventing gastroenteritis than treating it. Frequent hand washing, especially after using the toilet, and good food hygiene help to prevent the transmission of a 24-hour stomach bug.
Learn More:How to Prevent the Stomach Flu
When to Call a Healthcare Provider
If you are pregnant, immunocompromised, over age 65, or recently hospitalized or on antibiotics, you should contact your healthcare provider for advice.
Call your healthcare provider immediately or go to the emergency room if you have the following:
Vomiting for more than 24 hours
Diarrhea for several days
Violent vomiting
Blood in your vomit or stool
Trouble keeping fluids down
Signs of severe dehydration (no urine for more than eight hours, dizziness, weakness, confusion, fainting, fever over 101 degrees F)
Additional symptoms in infants and children that warrant a call to your child's pediatrician include:
Crying without tears
Diarrhea that lasts longer than two days
Dry mouth or cracked lips
Eyes appear sunken
Inability to keep even small sips of liquid down, lasting more than a few hours
Lethargy or the child appears unusually sleepy or less alert
No wet diapers for four to six hours in babies or no urination for six to eight hours in older children
The soft spot on an infant's skull appears depressed or sunken
Related:When to See a Doctor for Vomiting
Summary
A 24-hour stomach bug is a viral infection. It is spread through contact with an infected person, airborne particles, and contaminated surfaces. It can also be transmitted through contaminated water or food. This is not the same as food poisoning, which is caused by a bacterial or parasitic infection.
Common symptoms of the stomach bug include diarrhea, abdominal pain, nausea, vomiting, and fever. Sometimes, the stomach bug may go away after 24 hours. But it may take up to 10 days before you fully recover. People are generally contagious for 48 hours after symptoms resolved, though some viruses can
Treatments may involve medications to stop vomiting and diarrhea, following a bland diet, and ensuring proper hydration. Get medical help for severe symptoms.
Related:4 Home Remedies for Stomach Flu