Diarrhoea and vomiting teleconsult in Singapore
Diarrhoea and vomiting in adults are most often caused by viral gastroenteritis (stomach flu) or food poisoning, but the symptoms also overlap with travellers’ diarrhoea, antibiotic-associated diarrhoea, irritable bowel syndrome flares and food intolerance. A teleconsult helps you sort the cause, plan rehydration, decide on anti-nausea or anti-diarrhoea medication, and avoid the small minority of cases that need in-person testing or admission.
What is diarrhoea and vomiting?
Acute diarrhoea is defined as 3 or more loose stools a day for less than 14 days. The commonest cause is viral gastroenteritis (norovirus, rotavirus). Other common causes in Singapore include bacterial food poisoning from Salmonella (poultry, eggs), Campylobacter (poultry), Vibrio parahaemolyticus (seafood) or Bacillus cereus (reheated rice and noodles); travellers’ diarrhoea after trips to South/South-East Asia (enterotoxigenic E. coli, Giardia); and antibiotic-associated diarrhoea including Clostridioides difficile in patients recently on broad-spectrum antibiotics.
Chronic or recurrent symptoms point to different causes: irritable bowel syndrome (IBS), lactose or fructose intolerance, inflammatory bowel disease (Crohn’s, ulcerative colitis), coeliac disease, or thyroid dysfunction. These need a different workup — usually a stool sample, blood tests and sometimes endoscopy — and benefit from in-person review.
What commonly causes it
- Viral gastroenteritis — norovirus, rotavirus (commonest cause overall)
- Bacterial food poisoning — Salmonella, Campylobacter, Shigella, Vibrio, E. coli, Bacillus cereus
- Travellers’ diarrhoea — ETEC, Giardia, Cryptosporidium after travel
- Antibiotic-associated diarrhoea, including Clostridioides difficile after recent antibiotics
- Food intolerance — lactose, fructose; coeliac disease (gluten)
- Irritable bowel syndrome (IBS) flares, often stress-triggered
- Inflammatory bowel disease (Crohn’s, ulcerative colitis) — usually with weight loss, bloody diarrhoea
- Medication side effects — metformin, magnesium-containing antacids, chemotherapy
When teleconsult may be suitable
- Acute watery diarrhoea or vomiting in an otherwise well adult who can drink fluids
- Suspected food poisoning with a known recent food source
- Travellers’ diarrhoea returning from a trip in the last 2 weeks
- Mild antibiotic-associated diarrhoea without fever or blood
- Familiar IBS flare in a patient with a previous diagnosis
- Need for an MC, anti-nausea medication or oral rehydration advice
When to seek in-person care
- Bloody or black tarry stools, or red-currant-jelly stools
- Severe, localised or rigid abdominal pain — possible appendicitis, perforation, bowel obstruction
- Persistent vomiting preventing any oral intake for 12+ hours
- Signs of dehydration: dizziness on standing, very low urine output, confusion, fainting
- Fever above 39°C with profuse bloody diarrhoea (suspected dysentery)
- Symptoms in infants under 6 months, pregnancy, dialysis or significant immune compromise
- Weight loss, night-time diarrhoea, anaemia — suggest inflammatory bowel disease or malabsorption and need in-person workup
What to tell the doctor
- Count diarrhoea and vomiting episodes over the last 24 hours
- Check the colour of stools (watery, bloody, black, mucousy)
- Note last food source and whether others who shared the meal are also unwell
- Share any travel in the last 2 weeks and any recent antibiotic use
- Take your temperature, list current medication and drug allergies
What you can safely do at home
- Oral rehydration salts (Hydralyte, Pedialyte) or diluted 100Plus 1:1 with water — sip slowly, 100 ml every 10 minutes
- Avoid plain water alone — it does not replace electrolytes
- BRAT diet for 24 hours (bananas, rice, applesauce, toast), then return to normal foods
- Avoid dairy, alcohol, caffeine and fruit juice until stools normalise
- For travellers’ diarrhoea, consider a single dose of loperamide for symptom relief — avoid it if there is fever or blood
- Probiotics (Saccharomyces boulardii) may shorten antibiotic-associated diarrhoea
What the doctor will ask
- Symptom pattern: number of episodes, watery vs bloody, urine output, ability to drink
- Pain: mild and crampy vs severe, localised or rigid (the latter is a red flag)
- Recent food, travel, sick contacts, and any antibiotic course in the last 8 weeks
- Pregnancy possibility, age, diabetes, kidney disease, immunosuppression
- Previous IBS or inflammatory bowel disease diagnosis; current medications
Frequently asked questions
How do I know if it is food poisoning or stomach flu?
Food poisoning usually starts 2 to 12 hours after a suspect meal and resolves in 24 hours; vomiting is often the dominant symptom. Viral gastroenteritis (stomach flu) tends to start over hours-to-days, often with other household members affected, lasts 24 to 72 hours, and includes more diarrhoea and cramping. The treatment for mild cases is the same — rehydration and rest.
Should I take Imodium (loperamide)?
Loperamide is safe and helpful for watery diarrhoea without fever or blood. Avoid it when there is bloody diarrhoea or high fever — slowing the gut can prolong bacterial dysentery. It is also avoided in young children. When in doubt, ask the doctor before using it.
I just came back from travel and have diarrhoea. What should I do?
Travellers’ diarrhoea is usually self-limiting in 3 to 5 days. Treat with oral rehydration salts and rest. See a doctor (in person preferred) if there is bloody stool, high fever, persistent symptoms beyond 5 days, or if you went to a high-risk area for typhoid, cholera, or hepatitis. A stool sample test may be useful.
I just finished antibiotics and now have diarrhoea — should I worry?
Mild antibiotic-associated diarrhoea is common and usually self-limits within 1 to 2 weeks of stopping the antibiotic. Probiotics help. See a doctor in person urgently if the diarrhoea is severe, bloody, with fever, abdominal pain, or in an immunocompromised patient — this can be Clostridioides difficile colitis, which needs specific treatment.
When should I head to A&E instead of using teleconsult?
Go to A&E for bloody or black stools, severe or localised abdominal pain, persistent vomiting preventing any fluid intake, fainting, confusion, very low urine output, or symptoms in an infant under 6 months. Pregnancy with dehydration risk also warrants same-day in-person review.