Gastroenteritis
<gastroenterology,
pathology> An acute inflammation of the lining of the stomach and intestines, characterised by anorexia, nausea, diarrhoea, abdominal pain and weakness, which has
various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus and
Salmonella species, consumption of irritating food or drink or psychological factors such as anger, stress and fear.
A reaction to the Prevnar
and influenza vaccines, according to
the product manufacturer
Alternative names:
Rotavirus infection; Norwalk virus;
Gastroenteritis - viral
From the National Institute of
Health:
Causes, incidence and risk factors:
Viruses cause 30 to
40% of cases of infectious diarrhea in the U.S. and viral gastroenteritis is the second
most common illness, after upper respiratory infections.
Many types of viruses can cause gastroenteritis but the most common are rotavirus and
norwalk virus. Rotavirus is the leading cause of gastroenteritis in children and can also
occur in adults exposed to children with the virus. Norwalk virus causes group-related or
institutional diarrhea
with peak frequency during the winter. Norwalk-like viruses are common in school-age
children.
These viruses are often found in contaminated food or drinking water. The viruses cause
about 40% of group-related diarrheal illnesses. They affect older children and adults and
are more frequent during the winter months. Symptoms appear within 4 to 48 hours after
exposure to the contaminated food or water. The viruses are usually spread by the
fecal-oral route.
Rotavirus causes severe gastroenteritis in infants and young children. Severe dehydration and
death can occur in the young age group. It is responsible for up to 50% of the
hospitalizations of children with diarrhea. Outbreaks may also occur in geriatric settings
such as nursing homes. By the age of 3 most children have acquired antibodies to the
virus.
Gastroenteritis affects the young, the elderly, and immunosuppressed
people most severely.
 Symptoms
- Abdominal pain
- Abdominal cramping
- Diarrhea
- Nausea
- Vomiting
Additional symptoms that may be associated
with this disease:
dehydration
low urine output
dry mouth
sunken appearance to
the eyes
sunken fontanelle
(soft spot on an infant's head)
confusion
Signs and tests
Stool assays for the viruses can identify
the specific agent. A stool
culture may rule out bacterial causes of the illness.
Treatment
The objective of treatment is to replace
fluids and electrolytes (salt and minerals) lost by diarrhea. Antibiotic therapy is not
effective in viral illness. Antidiarrheal medications are generally not given, as they may
prolong the infectious process. Self-care measures to avoid dehydration include drinking
electrolyte solutions (available over-the-counter) to replace fluids lost by diarrhea.
People with diarrhea who are unable to take fluids by mouth because of nausea may need
intravenous fluids. This is especially true in small children.
People taking diuretics who develop diarrhea may be advised by their health care provider
to stop taking the diuretic during the acute episode.
CONSULT WITH YOUR HEALTH CARE PROVIDER
BEFORE YOU STOP TAKING A PRESCRIBED MEDICATION!
DO NOT give anti-diarrheal medications to
children unless directed to do so by a health care provider. Since the risk of dehydration
is greater in infants and young children, parents should closely monitor the number of wet
diapers changed per day when the child is sick. Electrolyte and fluid replacement
solutions for children are available in food and drug stores. Juice, soda or water do not
replace electrolytes lost from vomiting or diarrhea. Children with diarrhea often benefit
from dietary modifications until the diarrhea subsides.
Expectations
(prognosis)
Most infections will resolve spontaneously.
Children may become severely ill from dehydration caused by diarrhea.
Complications
Dehydration is the main complication.
Rarely, severe reactions may occur.
Prevention
Most infectious organisms are transmitted
by unwashed hands. The best way to prevent viral gastroenteritis is to handle food
properly and wash hands thoroughly after using the toilet.
Update Date: 1/26/2004
Updated by: Sreeni Jonnalagadda, M.D.,
Interventional and Pancreatobiliary Endoscopy, Washington University School of Medicine,
St. Louis, MO. Review provided by VeriMed Healthcare Network.
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