Dr. Bernadette Carr answers your questions on gastroenteritis and pilonidal sinus

Gastroenteritis and pilonidal sinus explained by Dr. Bernadette Carr.

My husband and two children (aged seven and nine) are just over a vomiting bug. I am always very careful at home about hygiene around food. Is there anything I can do to prevent it?

Gastroenteritis can be very unpleasant and is caused by a number of viruses. Norovirus is considered the most common cause of outbreaks of acute gastroenteritis among all age groups.

The virus causes an infection in the intestines, the symptoms are nausea, vomiting and watery diarrhoea. Some people may have mild fever, headaches and abdominal cramps.

Norovirus is very contagious and spreads easily and quickly through person-to-person contact or from touching a contaminated surface or other objects.

Symptoms begin within 12-48 hours of being infected and usually last one to two days, the first symptom is usually a sudden onset of feeling sick (nausea), which is followed by projectile vomiting with diarrhoea which may last slightly longer.

There is no specific treatment for norovirus, however it is very important to ensure that you are well hydrated.

It is not possible to completely prevent contracting the virus but here are some suggestions which might help to prevent the infection spreading:

*Make sure everyone washes their hands with liquid soap frequently and thoroughly, particularly before preparing, eating food and after going to the toilet.

*Give everyone their own towel and do not share cutlery, cups, mugs or glasses. If you contract the virus, have someone else do all food preparation and cooking for at least 48 hours to avoid passing on the infection.

*Keep all surfaces scrupulously clean and use bleach based cleaner for kitchen and bathroom.

*Wash clothes and bed linen from an infected person separately and in as hot a temperature as possible depending on the fabric.

With children, I would also advise washing down all toys with hot water and soap, wash soft toys in a washing machine, bearing in mind the maker’s instructions.

Children should not attend school or a childcare facility until at least 48 hours after the last episode of diarrhoea or vomiting.

As the virus will pass without treatment, it is not always necessary to visit your GP.

However, if the symptoms continue beyond 48 hours, the patient has severe dehydration or you are in any way concerned, then seek medical attention.

Q. My brother had surgery recently for a pilonidal sinus. I have never heard of this, could you explain what it is?

A. A sinus is a channel or tunnel in the skin and pilonidal means a ‘nest of hairs’. The pilonidal sinus or sacrococcygeal fistula is a sinus channel in the skin at the cleft of the buttocks and is more common in men than women. 

This can also occur between the fingers, particularly in barbers and at the umbilicus (belly button). Hairs or fragments of hairs push into the skin and irritate it; this can then cause inflammation and pain.

Why this happens is unclear, it is possible that there is an anomaly present from birth as often more than one member of a family will develop the condition.

Another possibility is that pressure on the hair follicles damages the hairs and they are pushed into the skin. If the sinus becomes infected, pus will collect and an abscess will usually develop.

The risk of developing a pilonidal sinus is increased if:

*You are overweight or obese.

*Your job involves a lot of sitting or driving.

*You have a lot of body hair.

*You had a previous injury to this area of skin.

*If you are a barber or farmer.

The symptoms of a pilonidal sinus include: pain, redness and swelling of the skin; blood or pus draining from the skin; a high temperature.

If the sinus is not infected no treatment may be necessary other than keeping the area clean and dry. However, if there is an infection then surgery may be required to either drain the abscess or remove the sinus.

The extent of the surgery will vary and a surgeon will advise on the procedure.


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