Gastroenteritis 

Definition
Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and
intestine. It is frequently referred to as the 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 problem, but children, the elderly, and anyone with an underlying disease are more
vulnerable to complications such as dehydration.

Description
Gastroenteritis is an uncomfortable and inconvenient ailment, but it 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 children, 300 die as a result of severe diarrhea and
dehydration. In developing nations, diarrheal illnesses are a major source of mortality. In 1990, approximately three
million deaths occurred worldwide as a result of diarrheal illness.
The most common cause of gastroenteritis is viral infection. Viruses such as rotavirus, adenovirus, astrovirus, and
calicivirus and small round-structured viruses (SRSVs) are found all over the world. Exposure typically occurs
through the fecal-oral route, such as by consuming foods contaminated by fecal material related to poor sanitation.
However, the infective dose can be very low (approximately 100 virus particles), so other routes of transmission are
quite probable.
Typically, children are more vulnerable to rotaviruses, the most significant cause of acute watery diarrhea. Annually,
worldwide, rotaviruses are estimated to cause 800,000 deaths in children below age five. For this reason, much
research has gone into developing a vaccine to protect children from this virus. Adults can be infected with
rotaviruses, but these infections typically have minimal or no symptoms.
Children are also susceptible to adenoviruses and astroviruses, which are minor causes of childhood gastroenteritis.
Adults experience illness from astroviruses as well, but the major causes of adult viral gastroenteritis are the
caliciviruses and SRSVs. These viruses also cause illness in children. The SRSVs are a type of calicivirus and
include the Norwalk, Southhampton, and Lonsdale viruses. These viruses are the most likely to produce vomiting as
a major symptom.
Bacterial gastroenteritis is frequently a result of poor sanitation, the lack of safe drinking water, or contaminated
food-conditions common in developing nations. Natural or man-made disasters can make underlying problems in
sanitation and food safety worse. In developed nations, the modern food production system potentially exposes
millions of people to disease-causing bacteria through its intensive production and distribution methods. Common
types of bacterial gastroenteritis can be linked to Salmonella and Campylobacter bacteria; however, Escherichia
coli 0157 and Listeria monocytogenes are creating increased concern in developed nations. Cholera and Shigella
remain two diseases of great concern in developing countries, and research to develop long-term vaccines against
them is underway.

Causes and symptoms

Gastroenteritis arises from ingestion of viruses, certain bacteria, or parasites. Food that has spoiled may also cause
illness. Certain medications and excessive alcohol can irritate the digestive tract to the point of inducing
gastroenteritis. Regardless of the cause, the symptoms of gastroenteritis include diarrhea, nausea and vomiting, and
abdominal pain and cramps. Sufferers may also experience bloating, low fever, and overall tiredness. Typically, the
symptoms last only two to three days, but some viruses may last up to a week.
A usual bout of gastroenteritis shouldn't require a visit to the doctor. However, medical treatment is essential if
symptoms worsen or if there are complications. Infants, young children, the elderly, and persons with underlying
disease require special attention in this regard.
The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through diarrhea and vomiting can
upset the body's electrolyte balance, leading to potentially life-threatening problems such as heart beat abnormalities
(arrhythmia). The risk of dehydration increases as symptoms are prolonged. Dehydration should be suspected if
a dry mouth, increased or excessive thirst, or scanty urination is experienced.
If symptoms do not resolve within a week, an infection or disorder more serious than gastroenteritis may be
involved. Symptoms of great concern include a 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. These symptoms require prompt medical
attention.

Diagnosis
The symptoms of gastroenteritis are usually enough to identify the illness. 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 (pathogenic) bacteria, or parasites.

Treatment
Gastroenteritis is a self-limiting illness which will resolve by itself. However, for comfort and convenience, a person
may use over-the-counter medications such as Pepto Bismol to relieve the symptoms. These medications work by
altering the ability of the intestine to move or secrete spontaneously, absorbing toxins and water, or altering
intestinal microflora. Some over-the-counter medicines use more than one element to treat symptoms.
If over-the-counter medications are ineffective and medical treatment is sought, a doctor may prescribe a more
powerful anti-diarrheal drug, such as motofen or lomotil. Should pathogenic bacteria or parasites be identified in the
patient's stool sample, medications such as antibiotics will be prescribed.
It is important to stay hydrated and nourished during a bout of gastroenteritis. If dehydration is absent, the drinking
of generous amounts of nonalcoholic fluids, such as water or juice, is adequate. Caffeine, since it increases urine
output, should be avoided. 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. These recommendations are based on clinical experience and controlled
trials, but are not universally accepted.
Minimal to moderate dehydration is treated with oral rehydrating solutions that contain glucose and electrolytes.
These solutions are commercially available under names such as Naturalyte, Pedialyte, Infalyte, and Rehydralyte.
Oral rehydrating solutions are formulated based on physiological properties. Fluids that are not based on these
properties-such as cola, apple juice, broth, and sports beverages-are not recommended to treat dehydration. If
vomiting interferes with oral rehydration, small frequent fluid intake may be better tolerated. Should oral
rehydration fail or severe dehydration occur, medical treatment in the form of intravenous (IV) therapy is required.
IV therapy can be followed with oral rehydration as the patient's condition improves. Once normal hydration is
achieved, the patient can return to a regular diet.