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.
Gastroenteritis is caused by different viruses and bacteria.
· Bacterial 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 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.
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.