Gastroenteritis

We have selected the following expert medical opinion based on its clarity, reliability and accuracy. Credits: Sourced from the Cleveland Clinic, Ohio. Please refer to your own medical practitioner for a final perspective, assessment or evaluation.

Overview

What is gastroenteritis?

Gastroenteritis is an inflammation of the gastrointestinal tract (the pathway responsible for digestion that includes the mouth, oesophagus, stomach, and intestines). Gastroenteritis is also sometimes referred to as "stomach flu," even though it may not be related to influenza.
 

How common is gastroenteritis?

Because gastroenteritis is so similar to diarrhoea, and because so many cases do not require hospitalization, it is difficult to determine how many cases of gastroenteritis occur per year. Worldwide, it is estimated that 3 to 5 billion cases of acute diarrhoea (which can be caused by many other diseases besides gastroenteritis) occur per year, with about 100 million cases in the United States (roughly one to 2.5 cases of diarrhoea per child). Severe gastroenteritis is estimated to cause about 5 to 10 million deaths per year worldwide, and about 10,000 deaths per year in the United States.

Who is at risk for gastroenteritis?

Anyone can get the disease.

People who are at a higher risk include:

• Children in daycare
• Students living in dormitories
• Military personnel
• Travelers
• People with immune systems that are weakened by disease or medications or not fully developed (i.e., infants) are usually affected most severely

Causes

What causes gastroenteritis?

Gastroenteritis can be caused by viral, bacterial, or parasitic infections. Viral gastroenteritis is contagious and is responsible for the majority of outbreaks in developed countries.


Common routes of infection include:

• Food (especially seafood)
• Contaminated water
• Contact with an infected person
• Unwashed hands
• Dirty utensils
• In less developed countries, gastroenteritis is more often spread through contaminated food or water.

Symptoms

What are the symptoms of gastroenteritis?

The main symptom of gastroenteritis is diarrhoea becomes infected during gastroenteritis, it loses its ability to retain fluids, which causes the person's faeces to become loose or watery.


Other symptoms include:

• Abdominal pain or cramping
• Nausea 
• Vomiting
• Fever 
• Poor feeding (in infants)
• Unintentional weight loss (may be a sign of dehydration)
• Excessive sweating
• Clammy skin
• Muscle pain or joint stiffness
• Faecal Incontinence (loss of stool control)

Because of the symptoms of vomiting and diarrhoea, people who have gastroenteritis can become dehydrated quickly.

It is very important to watch for signs of dehydration, which include:

• Extreme thirst
• Urine that is darker in colour, or less in amount
• Dry skin 
• Dry mouth 
• Sunken cheeks or eyes
• In infants, dry diapers (for more than 4-6 hours)

Diagnosis

How is gastroenteritis diagnosed?

The doctor will take a medical history to make sure that nothing else is causing the symptoms. A stool culture (a laboratory test to identify bacteria and other organisms from a sample of faeces) can be used to determine the specific virus or germ that is causing gastroenteritis.

Other diseases that could cause diarrhoea and vomiting are pneumonia, septicaemia (a disease caused by toxic bacteria in the bloodstream, urinary tract infection, and meningitis (an infection that causes inflammation of the membranes of the spinal cord or brain).

Conditions that require surgery, such as appendicitis, intussusception (a condition in which the intestine folds into itself, causing blockage) and Hirschsprung's disease (a condition where nerve cells in the intestinal walls do not develop properly) can also cause symptoms similar to gastroenteritis.

Treatment 

How is gastroenteritis treated?

The body can usually fight off the disease on its own within a few days. The most important factor when treating gastroenteritis is the replacement of fluids and electrolytes that are lost because of the diarrhoea and vomiting.

Foods that contain electrolytes and complex carbohydrates, such as potatoes, lean meats (for example, fish and chicken), and whole grains can help replace nutrients. You can also buy electrolyte and fluid replacement solutions at grocery and drug stores. Or, if hospitalization is required, the nutrients can be replaced intravenously (injected directly into the veins).

Antibiotics will not be effective if the cause of gastroenteritis is a viral infection. They are only used for bacterial infections. Your doctor will advise you on an appropriate agent.

Prevention

How can gastroenteritis be prevented?

There are several steps that you can take to reduce your risk of getting gastroenteritis, including:

• Washing your hands frequently , especially after going to the bathroom and when you are working with food.
• Cleaning and disinfecting kitchen surfaces, especially when working with raw meat or eggs.
• Keeping raw meat, eggs, and poultry away from foods that are eaten raw.
• Drinking bottled water and avoiding ice cubes when traveling, especially in developing countries.

Recommended websites

For further reading go to:

• Norovirus - Centers for Disease Control and Prevention
• Viral Gastroenteritis - National Institute of Diabetes and Digestive and Kidney Diseases
• Diarrheal Diseases – Acute and Chronic. American College of Gastroenterology 

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