Viral gastrointestinal (GI) viruses are no fun for anyone, but they are especially worrisome for a person living with Duchenne muscular dystrophy. GI viruses affect the GI track – the stomach and intestine (i.e., ‘gut’) – resulting in abdominal pain/discomfort, nausea, vomiting, intestinal pain/discomfort, cramps and diarrhea. Thank goodness they usually have a ‘short course,’ most lasting less than 24 hours.
What should I do if I am/my child is vomiting or has horrible diarrhea?
If you/your child is taking daily corticosteroids, steroid doses should not be missed for more than 24 hours.* Missing more than 24 hours of corticosteroids can result in acute adrenal insufficiency, or adrenal crisis, which can be a life-threatening condition. Click here to learn more about the effects of missing more than 24 hours of steroids.
If vomiting continues, and steroid doses are missed for more than 24 hours, you will need to go to a hospital or urgent care either for:
- Medication to help stop vomiting long enough to take the oral steroid dose, or
- IV steroid dosing to replace the missed oral steroid dose.
Emergency steroid recommendations can be found on PPMD's website, the PPMD emergency card, and the PPMD mobile app.
A GI virus is most likely a “minor stress” to the body, and will not require stress dosing of steroids. If stress dosing is needed, stress doses can be found in the PJ Nicholoff Steroid Protocol. If you are concerned, contact either your primary care or neuromuscular care provider.
*24 hours from when the last dose was due. For example: If you are due to take a dose at 7am Monday, and miss it, you should get a dose in before 7am Tuesday or seek medical attention if that is not possible.
- Eating and Drinking
While dehydration is a worry, it is really important to ‘rest’ an unhappy GI tract. If there is vomiting, please do not try to eat or drink anything until vomiting has stopped for at least an hour.
When vomiting has stopped for at least an hour, reintroduce fluids very slowly, starting with ice chips or sips of clear liquids
After at least 2 hours of no vomiting, reintroduce foods very slowly, starting with very small amounts of very bland foods (crackers, toast, etc.).
If vomiting continues longer than 24 hours, or if you are concerned, contact your primary care provider.
What else can we do to stay as healthy as possible?
- Wash hands often with soap and water for 15-20 seconds, especially after using the restroom and changing diapers
- If soap and water is not available, use an alcohol based hand sanitizer
- Wash your hands before preparing food or eating
- Avoid sharing utensils with or drinking after someone who is sick
- Avoid touching eyes, nose, and mouth with unwashed hands
- Be sure all family members have been immunized against the flu
Please do your best to stay healthy!