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Intestinal Infection (Gastroenteritis)

Gastroenteritis is gastrointestinal tract inflammation involving the stomach and small intestines which results to acute diarrhea. Transmission is through consumption of contaminated food and water. The infection is usually caused by viral infection and sometimes bacterial infection, parasites, toxins and it may be an adverse reaction to medication or diet. Gastroenteritis kills five to eight thousand people worldwide per year because of inadequate treatment. It is the leading cause of death in infants and in children.

Classification

Gastroenteritis is caused by different viruses and bacteria.

· Bacterial Gastroenteritis

Intestinal Infection (Gastroenteritis)In patients with diarrhea, the most common cause is Pseudomembranous colitis which is treated with antibiotics. It is important to distinguish between viral and bacterial cause especially if a child is admitted in the hospital because viruses are not treated with antibiotics. Bacteria Campylobacter, Shigella and parasites like Giardia are treated with antibiotics. An example of bacterial gastroenteritis is Traveller’s diarrhea.

· Viral Gastroenteritis

Norovirus, rotavirus, astrovirus and adenovirus are some of the viruses causing viral gastroenteritis. Viral gastroenteritis is self-limiting. Infected children usually develop full recovery in a few days. Viruses don’t respond to antibiotics. Children who are admitted in the hospital because of viral gastroenteritis are tested for rotavirus A for data surveillance purposes to determine the effects of rotavirus vaccination program.

Signs and Symptoms

Gastroenteritis symptoms usually include spasms or stomach pain, vomiting and or diarrhea, with upper small bowel non-inflammatory bowel infection or inflammatory infection in the colon. Gastroenteritis is usually acute in onset and self-limiting which usually last for one to six days.

Other symptoms include nausea and vomiting, loss of appetite, diarrhea, headaches, fever, abdominal pain, flatulence, bloody stools or dysentery which suggest amoeba, Salmonella, Campylobacter, shigella, and E. coli strains infection, weakness and fainting, and heartburn.

Viral diarreha in children causes frequent stools that are watery. A diarrhea with stains of blood may indicate bacterial colitis. Bile can be vomited in some cases.

Diagnosis

Diagnosis of Gastroenteritis is based on symptoms, physical examination, and complete medical history. A medical history should be accurate to determine the existence or non-existence of similar symptoms with the available friends and family members. Physician usually asks questions about the frequency, duration, and bowel movement description or if vomiting is experienced.

If simple gastroenteritis is experienced, no specific diagnostic test is done. However, if symptoms presented include bloody stools, fever and persistent diarrhea for two weeks, the stool is examined for Clostridium difficile and other cultures for Shigella, Salmonella, E. coli and Campylobacter.

Treatment

Usually, gastroenteritis is a self-limiting condition where in pharmacological therapy is not needed. To replace the fluids and electrolytes lost is the objective of the treatment. In children with mild to moderate dehydration, oral rehydration is done. Ondansetron and Metoclopramide are also helpful in children.

Rehydration is the primary treatment for children experiencing gastroenteritis to replenish the water loss. Oral rehydration therapy is done but in cases where the patient becomes unconscious, intravenous fluids are rendered. Oral rehydration salts are also recommended.

Medications for bacterial gastroenteritis include anti-emetics to stop the vomiting, antibiotics and sometimes antimotility drugs but it is usually discouraged in patients with bloody diarrhea.

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Viral Gastroenteritis

Gastroenteritis is the inflammation of the stomach, and the intestines as well. Viral gastroenteritis is caused by different viruses resulting to vomiting and diarrhea. It is also known as “stomach flu” but influenza viruses are not the cause.

Causes

Norovirus, rotavirus, type 40 and 41 adenoviruses and astrovirus are the cause of viral gastroenteritis. Bacteria don’t cause viral gastroenteritis or parasites or medications though the symptoms are sometimes similar.

Symptoms

Vomiting and watery diarrhea are the main symptoms of this viral infection. The infected person may have fever, headache and stomach ache. Usually the symptoms begin one to two days after a viral infection that caused the gastroenteritis. It may last up to ten days depending on the type of virus that caused the illness. Viral gastroenteritis is not a serious illness to most people who were infected. They can recover easily without associated problem. It becomes serious if a person isn’t able to replenish the water loss due to vomiting and diarrhea.

Viral Gastroenteritis Transmission

Viral gastroenteritis is a communicable disease. The virus is spread through drinking or eating of contaminated foods and close contact to the infected person. Food can be contaminated if the handler or preparer of the food is infected with viral gastroenteritis. This happens if they don’t wash their hands after using the bathroom. Shellfish are contaminated through sewage. People get gastroenteritis from contaminated selfish harvested from contaminated water causing diarrhea. Drinking of contaminated water also helps spread this viral disease.

Viral gastroenteritis happens in any country with different activity according to season. Astrovirus and rotavirus infection occur in the cooler months. Adenovirus occurs in all seasons. Norovirus virus also occurs in all seasons but favorably in winter. It usually occurs in places such as schools, nursing homes, child care facilities and in group settings like in cruise ships, banquet halls, campgrounds and dormitories.

Diagnosis

Diagnosis is made by physicians based on the symptoms presented by the patient. Rotavirus is diagnosed through testing of the stool in the laboratory.

Treatment

The primary concern in treating children and adults is to prevent dehydration or severe water loss in the body. The treatment begins at your home. Your physician will give specific instructions about rehydration. It is recommended to have a supply of ORS or oral rehydration solution all the time to be used when diarrhea occurs in a child. It can be purchased in the pharmacies without prescription. There are written instructions in the package of ORS which you can follow but be sure to use boiled water. Antibiotics should be avoided because it is not beneficial to viral infections unless prescribed by the physician.

Prevention

Frequent disinfection of surfaces especially contaminated ones with chlorine bleach, hand washing and prompt washing of soiled clothing prevents one from getting infected. Avoid water or foods that are contaminated. Rotavirus gastroenteritis can be prevented through vaccines. There are two kinds of licensed vaccines for rotavirus gastroenteritis to protect infants and children from severe diarrhea made by rotavirus. It is given with other vaccines in the child’s first year of life.

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