When is it necessary to take antibiotics for diarrhoea and stomachache?

Besides loose stools due to gut sensitivity or special chronic inflammatory diseases, most diarrhoea is caused by ingestion of contaminated food or beverages. These contaminants can be pre-formed toxin, viruses, and at times pathogenic bacteria. The good news is acute onset diarrhoea is usually self-limiting with adequate hydration, and most people recover from it within 1-2 weeks and do not require any antibiotics.

In severe diarrhoea, especially one presenting with high temperature and blood in the stools or one with severe symptoms of localised abdominal pain and significant elevation of the white cell count, one may require a course of antibiotics to help while awaiting investigation results.

By and large, most stomachaches do not require the use of antibiotics; not especially when the cause has not been worked out properly. Misuse or overuse of antibiotics can encourage the emergence of multi-resistant strains of pathogen. Besides, antibiotics have side effects that may worsen the abdominal discomfort and prolong any diarrhoea.

- Dr Quan

Antibiotics are indicated only in acute gastroenteritis caused by bacteria which is tested from stool. Stomach ache is not treated with antibiotics.

However, if there is a bacteria in stoamch called Helicobacter pylori associated with gastritis or ulcer, treatment with antibiotics is given to eradicate this bacteria. The eradication need to be confirmed subsequently 3 months later with yurea breath test.