Treatment for acute vomiting and diarrhoea should normally start with general supportive measures to maintain hydration. NICE guidance on diarrhoea and vomiting is around preventing dehydration and looking out for signs and symptoms of shock.3,31,33

For adults, antidiarrhoeal or antimotility drugs are not usually necessary for managing gastroenteritis, but may be useful in mild to moderate diarrhoea. Loperamide is the drug of choice. However, antimotility drugs should not be used if the person has:31

·       blood and/or mucus in the stools;

·       high fever (indicating dysentery);

·       confirmed, probable, or suspected VTEC infection;

·       shigellosis.

Antiemetics are not usually necessary in acute gastroenteritis, but may be needed if vomiting is severe. Antibiotics should not be used in acute diarrhoea of unknown pathology. However, they may be of some use where the microbiological cause is known.31

NICE advises against children being given antidiarrhoeal drugs, and antibiotics should be avoided in most circumstances.33