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DEAR DR. ROACH: With the flu season coming on, would you please discuss the difference between what people call the “stomach flu” and what the flu really is? I have two friends who said they weren’t getting the flu shot anymore because despite having it, they got the flu. They each described several hours of throwing up, but feeling better the next day.
I suggested that they probably had a gastrointestinal episode and not influenza, which is a respiratory disease. They insisted that they had the flu, and they’d always learned that the stomach flu is influenza and the flu shot is meant to prevent it. Since then I’ve spoken to two others who believe the same thing. – G.C.
ANSWER: You are right that there is much confusion about what influenza is. Influenza typically begins with sudden onset of fever, headache, fatigue and severe body and muscle aches. Influenza occurs about two days after exposure. There also often are symptoms of cough, sore throat and nasal discharge, just as there are with the common cold, but the sudden onset, fever (commonly 100 to 104 degrees) and muscle aches help distinguish cold from flu.
Gastrointestinal symptoms – such as nausea, vomiting and diarrhea – are less common in influenza, and these symptoms in absence of the major manifestations listed above makes the diagnosis of flu very unlikely. In late fall through early spring, some diarrheal illnesses (mostly viral) are common, but you are correct that these are NOT influenza.
The flu shot contains viral proteins, not live influenza, and it is incapable of causing the flu. Many people will have a sore arm and sometimes mild fever and body aches after a flu shot. This is just part of the body’s reaction, and it goes away by itself within 24 hours. There is a live influenza vaccine given by nasal spray, which also generally has mild side effects. This may be given to adults under 50.
The flu shot is not perfect: You still can get the flu after receiving the shot. However, the flu shot is effective at reducing the most serious cases of flu, such as influenza pneumonia, which can be life-threatening or fatal.
DEAR DR. ROACH: I’m a healthy 50-year-old woman, and I recently had my gallbladder removed. What are the effects of not having this organ? – I.T.
ANSWER: The gallbladder stores bile and release it when necessary after a meal. Bile is made by the liver and is needed for proper digestion, especially of fats. After gallbladder removal, usually because of gallstones, the liver takes over the job by storing bile in bile ducts, and releasing it at the right time, under the influence of hormones, such as cholecystokinin. After surgery, most people have no problems with digestion, as their body gets used to the new status quo after a few weeks.
Rarely, people who have had their gallbladder removed can develop postcholecystectomy syndrome, which manifests as upper abdominal pain. There are several possible causes. Discovering it requires expert evaluation, usually by the surgeon, and it often involves CT scans and a special kind of MRI (MRCP) to evaluate the biliary tract. Retained stones in the bile ducts, leakage of bile and strictures (narrowings) in the bile ducts are the most common causes of PCS.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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