James Palinsad

Gastroenteritis

Articlegastroenteritis
Digestive Health
Health & Wellness
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Contributed byMaulik P. Purohit MD MPHMay 27, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Gastric Flu
  • Stomach Flu

What is Gastroenteritis? (Definition/Background Information)

  • Gastroenteritis is an inflammation of stomach and intestines, mostly caused by viral, bacterial or parasitic infections. Occasionally, the condition can occur due to non-infectious causes. Individuals with weak immune systems are more prone to these infections
  • Some risk factors for developing the condition include drinking contaminated water, eating contaminated food, being in an unclean or unhygienic environment, being in close contact with infected individuals, and the presence of certain pre-existing conditions such as diabetes
  • The following could be the causes of Gastroenteritis:
    • Viruses, including Rotavirus, Norovirus, Adenovirus, and Astrovirus
    • Bacteria, including Escherichia coli, Campylobacter sp., Salmonella sp., and Shigella sp.
    • Parasites such as Entamoeba, Giardia, and Cryptosporidium
    • Toxic substances; from ingestion of improperly canned food, toxic fish, or spoilt food 
  • Viral Gastroenteritis is the most common type of Gastroenteritis that usually peaks during the winter months. It is characterized by nausea, vomiting, diarrhea, and abdominal pain
  • The diagnosis of Gastroenteritis is typically done with a physical examination and assessment of symptoms. When the symptoms are severe, such as bloody stools and uncontrolled diarrhea, a healthcare professional may opt for additional tests to confirm the diagnosis
  • Dehydration is the most serious complication of this condition that promptly needs hospitalization without which an individual could go into shock, kidney failure, coma, and death
  • Usually, most cases of Gastroenteritis with mild symptoms in healthy individuals resolve spontaneously in few days. Careful treatment is required in pregnant women, children under 5 years and adults over 65 years of age, and those with debilitating medical conditions
  • Some simple measures such as washing hands frequently, avoiding contaminated food and water, cooking food thoroughly before consuming, and getting vaccinated (such as against Rotaviruses) can help prevent contracting this condition
  • The prognosis is considered to be excellent for individuals in good health, as long as they take plenty of fluids to make up for the lost fluids. Young children and adults over 65 years of age tend to develop dehydration faster than others, but prompt treatment can ensure favorable results

Who gets Gastroenteritis? (Age and Sex Distribution)

  • Gastroenteritis can affect people of all age groups (both adults and children may be affected)
  • The elderly adults have the highest risk of contracting the severe form of the disease
  • Rotavirus is more common in children and Norovirus in adults
  • Viral Gastroenteritis is known to peak during November to April months
  • There is no gender, racial, or ethnic group predilection

What are the Risk Factors for Gastroenteritis? (Predisposing Factors)

The following are some risk factors associated with Gastroenteritis:

  • Consumption of contaminated food and water
  • Consumption of undercooked meat, milk products, and canned food
  • Poor hygiene, such as unwashed hands, dirty kitchens, use of unclean utensils and surfaces
  • Close contact with individuals who have the condition
  • Individuals with low immunity such as children and older individuals
  • Those with underlying medical conditions such as diabetes, HIV, cancers, and those on steroids for long durations
  • Outbreaks of Gastroenteritis are common among people living in closed communities, such as at daycare centers, students living in dormitories, military personnel, cruise ship crews, as these environments facilitate spread of infection from one individual to another

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Gastroenteritis? (Etiology)

The infectious causes of Gastroenteritis may be due to pathogens such as:

  • Viruses such as Rotavirus, Norovirus, Adenovirus, Astrovirus, etc.
  • Bacteria such as Campylobacter, E. coli, Salmonella, Shigella species, etc.
  • Worms (parasites), such as Entamoeba, Giardia, Crypstosporidium, etc.

Non-infectious causes of Gastroenteritis may include:

  • Toxic substances in certain foods, such as tetrodotoxin in puffer fish, ciguatera in predatory fish, scombroid in fish that is spoiled, and botulin in improperly preserved canned food
  • Having recently been treated with antibiotics can cause antibiotics-associated diarrhea

What are the Signs and Symptoms of Gastroenteritis?

Gastroenteritis can present with mild as well as severe signs and symptoms as listed below:

  • Mild symptoms:
    • Mild nausea, vomiting, and abdominal pain
    • Diarrhea, usually without blood or pus with limited episodes
    • Mild fever(less than 101 F) with body aches and headaches
  • Severe symptoms may be alarming (especially in children) and may include the following:
    • Severe and persistent vomiting for more than 1 day
    • Diarrhea (10 times/day) for more than 2 days
    • Mild symptoms lasting more than 1 week in spite of home remedies
    • Blood in stool
    • Severe abdominal pain
    • High fever (more than 102 F)
    • Weight loss
    • Symptoms of dehydration including extreme thirst, low amount and deep color of urine, and dry mouth and skin
    • In young children, symptoms such as crying without  tears, sunken eyes, no wet diapers in 6 hours, unusually sleepy or drowsy, not accepting feeds, and trouble breathing
    • Symptoms of food poisoning associated with canned foods include blurry or double vision, difficulty breathing, and muscle weakness

How is Gastroenteritis Diagnosed?

An accurate diagnosis of Gastroenteritis might require the following:

  • A complete evaluation of medical history, along with a thorough physical examination
  • In case of severe dehydration, blood tests to assess for electrolytes, complete blood count, kidney function, and glucose level
  • In case of bloody stools, certain stool tests (ova stool test) to check for organisms, toxins, worms, eggs of worms, etc.
  • Abdominal ultrasound or CT scan of the abdomen for those with severe abdominal pain
  • In case of prolonged and recurrent episodes of Gastroenteritis, other tests to determine non -infectious causes, and tests to check the level of body immunity

Note: In a majority of individuals, Gastroenteritis is caused by a virus. In such cases, identification of the specific virus is usually not required for treatment purposes.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Gastroenteritis?

The potential complications of Gastroenteritis may include:

  • Dehydration caused by inadequate intake of water or oral rehydration solution (ORS) can lead to light-headedness, weakness, and lethargy
  • If not treated promptly, those with severe dehydration can develop low blood pressure, shock, or kidney failure
  • Reactive arthritis: Joint pain and swelling secondary to bacterial diarrhea
  • Guillain-Barré syndrome: A complication of bacterial diarrhea characterized by muscle pain, weakness, and tingling
  • Gastroenteritis caused by  E. coli and Shigella bacteria can rarely result in kidney damage with low blood cell count called hemolytic uremic syndrome (HUS)

How is Gastroenteritis Treated?

The treatment for Gastroenteritis depends on whether the symptoms are mild or severe and upon the cause of the condition:

  • Mild symptoms do not need any treatment since they are self resolving within 2-3 days of home remedies, which may include drinking plenty of fluids at regular intervals or oral rehydration solution (ORS) for replacement of minerals and essential salts of body is essential
  • Avoiding spicy, hot or high-fat foods, dairy products, alcohol, and caffeine for a day or two helps recover faster

In case of severe symptoms, a healthcare professional should be consulted.

  • Gastroenteritis with severe dehydration needs prompt hospitalization with administration of intravenous fluids and medicines to stop vomiting and diarrhea
  • Gastroenteritis caused by some bacteria and worms may need specific medications to treat them. Specific treatment is usually given after confirming the exact cause of the infection.

How can Gastroenteritis be Prevented?

The following preventive measures for Gastroenteritis may be employed:

  • Maintaining proper hand hygiene and avoiding close contact with individuals with Gastroenteritis  
  • Ensure clean kitchen surfaces and utensils
  • Eating properly cooked food, especially meat, poultry, and dairy products
  • Proper washing of raw vegetables and fruits before consumption
  • Drinking clean/hygienic water while travelling, especially in high-risk regions
  • Consulting healthcare professionals for the need of vaccinations, 4-6 weeks before travel
  • Breastfeeding in infants is reported to reduce the frequency of Gastroenteritis
  • Vaccination against Rotavirus in infants and young children

What is the Prognosis of Gastroenteritis? (Outcomes/Resolutions)

  • The prognosis of Gastroenteritis is usually excellent, as long as the individual stays well-hydrated
  • Almost all individuals with viral Gastroenteritis with mild symptoms recover quickly within 3-5 days with home remedies
  • Prognosis depends on how well one responds to treatment and one’s ability to rehydrate. However, a majority of individuals recover fully from Gastroenteritis resulting in an excellent prognosis
  • Children under 5 years of age, those older than 65 years of age, individuals with low immunity, and underlying medical conditions, are prone to developing dehydration rapidly
  • The outcome also depends upon the cause of Gastroenteritis. The prognosis for a viral Gastroenteritis is better than the prognosis of a bacterial Gastroenteritis

Additional and Relevant Useful Information for Gastroenteritis:

  • Viral Gastroenteritis is usually acquired through contaminated food or water. Sharing of utensils and towels used by infected individuals can also result in transmission of the infection

The following article link is a helpful resource that will help you better understand viral gastroenteritis:

https://www.dovemed.com/diseases-conditions/viral-gastroenteritis/

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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