Gastroenteritis
Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and intestine. It is frequently called stomach or intestinal flu, although the influenza virus is not associated with this illness. Major symptoms include nausea and vomiting, diarrhea, and abdominal cramps. These symptoms are sometimes also accompanied by fever and overall weakness. Gastroenteritis typically lasts about three days. Adults usually recover without problems, but children, the elderly, and people with underlying disease are more vulnerable to complications such as dehydration.
Gastroenteritis is rarely life-threatening in the United States and other developed nations. However, an estimated 220,000 children younger than age five are hospitalized with gastroenteritis symptoms in the United States annually. Of these, 300 die as a result of severe diarrhea and dehydration. In developing nations, diarrheal illnesses are a major cause of death. In 1990, approximately three million deaths occurred worldwide as a result of diarrheal illness.
Gastroenteritis commonly arises from consuming food or beverages containing viruses, bacteria, or parasites. Certain medications and excessive alcohol can also irritate the digestive tract to the point of inducing gastroenteritis.
The most common cause of gastroenteritis is viral infection. Exposure often occurs by consuming materials contaminated by excrement (fecal-oral route). Viruses involved in gastroenteritis include rotavirus, adenovirus, astrovirus, and calicivirus and small round-structured viruses (SRSVs).
Bacterial gastroenteritis frequently results from unsanitary drinking water or food--common in developing nations. Natural or man-made disasters can make underlying sanitation and food-safety problems worse. In developed nations, modern food production can expose millions of people to disease-causing bacteria through its intensive production and distribution methods. Common types of bacterial gastroenteritis are linked to Salmonella and Campylobacter bacteria; however, Escherichia coli (E.coli) 0157 and Listeria monocytogenes are creating increased concern in developed nations. In developing countries, cholera and shigella remain of great concern, and research to develop long-term vaccines is underway.
Gastroenteritis usually shouldn't require a visit to the doctor. However, medical treatment is essential if symptoms worsen or if complications develop. Infants, young children, the elderly, and persons with underlying disease require special attention in this regard.
The greatest danger presented by gastroenteritis is dehydration. Fluid loss through diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-threatening problems such as heartbeat abnormalities. Dehydration should be suspected if dry mouth, increased or excessive thirst, or scanty urination is experienced.
If symptoms do not clear up within a week, an infection or disorder more serious than gastroenteritis may be involved. Symptoms requiring prompt medical attention include high fever (102° F [38.9°C] or above), blood or mucus in the diarrhea, blood in the vomit, and severe abdominal pain or swelling.
Unless there is an outbreak affecting several people or complications are encountered in a particular case, identifying the specific cause of the illness is not a priority. However, if identification of the infectious agent is required, a stool sample will be collected and analyzed for the presence of viruses, disease-causing bacteria, or parasites.
For comfort and convenience, over-the-counter medications such as Pepto Bismol may be used to relieve symptoms. A doctor may prescribe a more powerful antidiarrheal drug such as motofen or lomotil. Should disease-causing bacteria or parasites be identified in the patient's stool sample, e, an antibiotic may be prescribed.
It is important to stay hydrated and nourished during a bout of gastroenteritis. If you are not dehydrated, it should be enough to drink generous amounts of nonalcoholic fluids such as water or juice. Caffeine should be avoided, since it increases urine output. The traditional BRAT diet--bananas, rice, applesauce, and toast--is tolerated by the tender gastrointestinal system, but it is not particularly nutritious. Many, but not all, medical researchers recommend a diet that includes complex carbohydrates (e.g., rice, wheat, potatoes, bread, and cereal), lean meats, yogurt, fruit, and vegetables. Milk and other dairy products shouldn't create problems if they are part of the normal diet. Fatty foods or foods with a lot of sugar should be avoided.
Minimal to moderate dehydration is treated with oral rehydrating solutions that contain glucose and electrolytes. These are commercially available under names such as Naturalyte, Pedialyte, Infalyte, and Rehydralyte. Oral rehydrating solutions are specially formulated. Fluids that are not so formulated--such as cola, apple juice, broth, and sports beverages--are not recommended to treat dehydration. If vomiting makes drinking difficult, small, frequent amounts of fluid may be better tolerated. Should oral rehydration fail or severe dehydration occur, medical treatment in the form of intravenous therapy is required.
Alternative treatments for uncomplicated gastroenteritis include meadowsweet (Filipendula ulmaria) slippery elm, (Ulmus fulva) or homeopathic remedies including Arsenicum album, ipecac, or Nux vomica. Live cultures of Lactobacillus acidophilus are said to soothe the digestive tract and return the intestinal flora to normal. L. acidophilus is found in live-culture yogurt, as well as in capsule or powder form at health food stores. Castor oil packs to the abdomen can reduce inflammation and also reduce spasms or discomfort.
There are few steps that can be taken to avoid gastroenteritis. Hand-washing, and ensuring that food is well-cooked and unspoiled can prevent bacterial gastroenteritis, but may not be effective against viral gastroenteritis.
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