Brief Summary of Gastroenteritis

Also called intestinal flu, traveler’s diarrhea, viral enteritis, and food poisoning, gastroenteritis is a self-limiting disorder characterized by diarrhea, nausea, vomiting, and abdominal cramping. It occurs in all age-groups and is a major cause of morbidity and mortality in underdeveloped nations.
It can also be life-threatening in elderly and debilitated people.

Causes
Gastroenteritis has many possible causes, including the following:

• bacteria (responsible for acute food poisoning)—Staphylococcus aureus, Salmonella, Shigella, Clostridium botulinum, Escherichia coli, Clostridium perfringens
• amoebae—especially Entamoeba histolytica
• parasites—Ascaris, Enterobius, Trichinella spiralis
• viruses (may be responsible for traveler’s diarrhea)—adenovirus, echovirus, or coxsackievirus
• ingestion of toxins—plants or toadstools (mushrooms)
• drug reactions—antibiotics
• enzyme deficiencies
• food allergens.

The bowel reacts to any of these enterotoxins with hypermotility, producing severe diarrhea and secondary depletion of intracellular fluid.

Signs and symptoms
Clinical manifestations vary, depending on the pathologic organism and the level of GI tract involved. Gastroenteritis produces symptoms such as diarrhea, abdominal discomfort (ranging from cramping to pain), nausea, and vomiting. Other possible symptoms include fever, malaise, and borborygmi.
In children and elderly and debilitated people, gastroenteritis produces the same symptoms, but the inability of these patients to tolerate electrolyte and fluid losses leads to a higher mortality.

Diagnosis
Patient history can aid diagnosis of gastroenteritis. A stool culture should be obtained. Blood cultures are indicated in febrile patients.

Treatment
Usually supportive, treatment consists of nutritional support and increased fluid intake.
An episode of acute gastroenteritis is self-limiting. When an episode is severe and produces symptoms for more than 3 or 4 days and the patient is a young child or an elderly or debilitated person, hospitalization may be necessary. Treatment may include fluid and electrolyte replacement, antibiotic therapy, and antiemetics.