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Gastroenteritis

Gastroenteritis

Introduction

Gastroenteritis also called infectious diarrhoea, is an inflammation of the GI tract (gastrointestinal tract) i.e., the stomach and the small intestine. It is caused by bacteria, viruses, as well as other microbes. The symptoms of gastroenteritis include abdominal pain, diarrhoea, and vomiting associated with lack of energy, dehydration, and fever.

The symptoms of the infection stay less than 2 weeks. Children are more susceptible to the infection due to the lack of immunity and, given the fact that they do not practice fine hygiene habits, they could fall prey to the infection.

Causes

Gastroenteritis could be due to viruses, as well as bacteria. However, there are numerous other causative agents of the infection. Many times, the cause of gastroenteritis could be non-infectious.

Here are the common causes of gastroenteritis:

  • Viral

The viruses that cause gastroenteritis include rotavirus, adenovirus, norovirus, as well as astrovirus. Children are most commonly affected by rotavirus. Majority of cases, around 70 percent, of infectious diarrhoea in children are due to viral infection.

As adults acquire immunity, rotavirus is less likely to cause infection in adults. 18 percent of all the cases are due to norovirus.

  • Bacterial

The primary cause of gastroenteritis due to bacteria is Campylobacter jejuni. Campylobacter species, Escherichia coli, Shigella, and Salmonella cause infection in children. In elderly patients, the culprit is Clostirdium difficile. It especially affects the elder adults who are hospitalized.

Bacterial gastroenteritis is caused by eating contaminated food. It could be due to eating raw or uncooked meat, seafood, poultry, eggs, unpasteurized milk, raw sprouts, soft cheese, vegetable juices and fruits. If these foods are contaminated and stay at room temperature for several hours, bacteria multiply and cause infection.
Acute traveller sdiarrhoea is also a kind of bacterial gastroenteritis.

  • Parasitic

Gastroenteritis can be caused by many protozoa. The most common parasite involved is Giardia lamblia. Other species include Cryptosporidium spp. and Entamoeba histolytica.

Transmission

Transmission of infection generally occurs due to drinking contaminated water. Also, sharing personal objects between people could also cause the infection.

Infection is common in children due to poor hygiene. Poor nutritional status, as well as living in crowded areas, also lead to increased chances of infection.

  • Non-infectious causes

There are several non-infectious causes of gastroenteritis. The common causes include several medications like NSAIDs, foods like lactose (in intolerant people), and gluten (in celiac disease patients).

Crohn's disease is also associated with gastroenteritis. It is a non-infectious cause of severe gastroenteritis.

Symptoms of Gastroenteritis

The major symptoms of gastroenteritis are:

  • Diarrhoea
  • Vomiting

The other associated symptoms include:

  • Stomach pain
  • Abdominal cramps
  • Nausea
  • Fever
  • Headache

Due to excessive watery diarrhoea and vomiting, the patient becomes dehydrated. The signs of dehydration should be kept in a check. The signs of dehydration include dry skin, dry mouth, feeling lightheaded, and feeling very thirsty.

The signs and symptoms of gastroenteritis begin in 12 to 72 hours after the contraction of the causative agent.

The infection due to viruses usually subsides within one week. The infection also involves fatigue, headache, fever, as well as muscle pain. The children who are infected with rotavirus recover within 3 to 8 days.

In case of bacterial infections, the infection might stay for several weeks. The infection can lead to severe abdominal pain. Bloody stools occur in case of bacterial infection.

In the cases where the causative factor is Campylobacter species, reactive arthritis occurs. But, this only happens in around 1 percent of people. Guillain-Barre syndrome can be seen in 0.1 percent of people. With the infection due to Shigella species or Shiga-toxin producing E. coli, Haemolytic uremic syndrome is seen. Certain viral infections can lead to benign infantile seizures.

Gastroenteritis and Children

Children can suffer severe dehydration due to gastroenteritis. If the children are suffering from infection, it gets very important to see the signs of dehydration like feeling very thirsty, dry mouth, and dry skin. The medications should always be given medications only after consulting the doctor. The medications indicated for controlling vomiting and diarrhoea are not generally prescribed in children below five years of age.

Vaccine against rotavirus is given to children to prevent rotavirus induced diarrhoea.

Treatment

The treatment modalities used for gastroenteritis include:

  • Fluids

The patients are advised to take plenty of fluids. The patients must take extra fluids along with what they normally take.

The doctors generally advise the patients to take 200 ml of water after each episode of diarrhoea. After a vomit, the patients are advised to wait for about 5 to 10 minutes before drinking the water again.

The patients must not take the drinks that include sugar as these drinks can exacerbate diarrhoea.

Patients who are frail or more than 60 years of age are advised to take rehydration drinks. Same is advised to the patients who have some underlying health issue. In conjunction with the rehydrated treatment, the patients are also advised to take anti-secretory medications.

  • Eat normally

Many patients entirely stop eating food, but they must take light meals in small portions. Do not eat spicy, heavy, or fatty food. Plain food like wholesome bread, as well as rice is the best meal to take in gastroenteritis.

  • Medications

Anti-diarrheal medications are recommended to reduce the number of motions. Lopermide is considered as the safest and the most effective. It should not be taken for more than 5 days. Also, it is not recommended in the children less than 12 years of age.

Ibuprofen and paracetamol is indicated in case of headache and fever.

Antibiotic treatment is prescribed in case of bacterial infection.

Precautions

Here are some of the preventive measures for gastroenteritis:

  • Wash hands thoroughly after using the toilet. Dry hands properly.
  • Wash hands before eating food and after playing with pet or gardening.
  • Avoid sharing towels.
  • Daily clean the toilets with disinfectants.

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