BACTERIAL DISEASES OF THE

UPPER ALIMENTARY SYSTEM

1. Tooth Decay (Dental Caries)

Symptoms: severe throbbing pain of a toothache is the first
symptom. Sometimes noticeable discoloration, roughness,
or defect, and a tooth can break during chewing.
Causative Agent: Streptococcus mutans
Prevention & Treatment: Restriction to sucrose and other
refined dietary carbohydrates. Trace amounts of fluoride are
required for teeth to resist the acid of cariogenic plaques.
Fluoride makes tooth enamel harder and more resistant to
dissolving in acid. Mechanical removal of plaque by
tooth brushing and use of dental floss reducing the incidence
of dental caries by 50%.
2. Periodontal Disease
. is a chronic inflammatory process involving the gums and tissues
around the roots o the teeth. Common cause of tooth loss from
middle age onward.
Symptoms: bleeding gums, sensitivity of the gums, bad breath, and
loosening of the teeth. Discoloration, ranging from yellowish to
black, occurs at the base of the teeth. The gums generally recede
and expose the roots of the teeth to dental caries.
Causative Agent: caused by dental plaque that forms at the point
where the gum joins the tooth.
Prevention & Treatment: Careful flossing and tooth brushing can
prevent periodontal disease, specially if combined with twice
yearly polishing and removal of calculus or tartar (calcium salts
deposited in the plaque which is difficult to remove)
3. Trench Mouth (Vincent’s disease or acute necrotizing ulcerative
gingivitis)
. a severe, acute condition that was rampant among soldiers living
in trenches during WWI because they were unable to attend to
mouth care.
Symptoms: characterized by abrupt onset, fever, bleeding and
painful gums and a foul odor.
Causative Agent: spirochete of the Treponema genus
Prevention & Treatment: Daily brushing and flossing and twice
yearly cleaning are preventive measures. Antibacterial
treatment directed against spirochetes rapidly relieves the
acute symptoms followed by extensive removal od plaque and
calculus
4. Gastritis
. inflammation of the stomach. These ulcers occur in the stomach
and uppermost part of the duodenum
Symptoms: initial infection can cause symptoms ranging from
belching to vomiting. Localized abdominal pain, tenderness,
and bleeding are manifestations of complications
Causative Agent: Helicobacter pylori
Epidemiology: transmission occurs by the fecal-oral route, and
the bacteria have been found in well water.
Prevention & Treatment: Combined treatment with 2 antibiotics
and a medication that inhibits stomach acid production with
complete clearing of the gastritis and healing of ulcers.
 VIRAL DISEASE OF THE
UPPER ALIMENTARY SYSTEM

1. Herpes Simplex
Symptoms: Begins during childhood with fever and blisters and
ulcers in the mouth and throat so painful that it is difficult
to eat or drink. The first lesions are small blisters that break
within a day or two, leaving superficial painful ulcers that
heal without treatment within 10 days. Thereafter, the infection
becomes latent and the affected person may suffer the recurrent
disease, herpes simplex labialis, otherwise known as ‘cold sores”
or “fever blisters”. The symptoms of recurrences usually begin
on the lips and include a tingling, itching, burning, or painful
sensation. Blisters then appear, followed by painful ulcerations.
Healing occurs within 7 to 10 days.
Causative Agent: herpes simplex virus
Epidemiology: The virus is transmitted primarily by close physical
contact with lesions or saliva from patients within a few days of
disease onset.
Prevention & Treatment: Acyclovir are useful for treating severe
cases and for preventing disabling recurrences
2. Mumps
. is an acute viral illness that attacks parotid glands.
Symptoms: The onset of mumps is marked by fever, loss of appetite,
and headache. These symptoms are followed by painful swelling
of one or both parotid glands. Spasm of the underlying muscle
makes it difficult to chew or talk.
Causative Agent:Virus of the paramyxovirus family
Prevention & Treatment: An effective attenuated vaccine has been
used since 1967.
 BACTERIAL DISEASE OF THE
LOWER ALIMENTARY SYSTEM

1. Cholera (Rice water stool)

Symptoms: The diarrheal fluid can amount to 20 liters a day.
Vomiting occurs at the onset of the disease, and many people
suffer muscle cramps caused by fluid loss and electrolytes
Causative Agent: Vibrio cholerae
Epidemiology: Fecally contaminated water is the most common
source of infection, although foods such as crab and vegetables
fertilized with human feces have also been implicated.
Prevention & Treatment: Adequate sanitation and the availability
of safe, clean water supplies. Travelers to areas where cholera
is occurring are advised to cook food immediately before eating
it. Crabs should be cooked for nlt 10 minutes. No fruit should be
eaten unless peeled personally by the traveler, and ice should be
avoided unless it is known to be made from boiled water.
Treatment of cholera depends on the rapid replacement of
electrolytes and water before irreversible damage to vital organs
can occur.
2. Shigellosis
Symptoms: Classic symptoms is dysentery. Other symptoms are
headache, vomiting, fever, stiff neck, convulsions and joint pain.
Causative Agent: Shigella flexneri, Shigella boydii, Shigella sonnei,
Shigella dysenteriae
Epidemiology: Transmitted by the fecal-oral route. Transmission
occurs most readily in overcrowded population with poor
sanitation. Fecally contaminated food and water have also caused
outbreaks
Prevention & Treatment: Sanitary measures and surveillance of
food handlers and water supplies.. Antimicrobial medications
such as ampicillin and cotrimoxazole shortens the duration of
symptoms
3. Gastroenteritis (Traveler’s diarrhea)
Symptoms: Symptoms range from vomiting and a few loose bowel
movements, to profuse watery diarrhea, to severe cramps and
bloody diarrhea
Causative Agent: Escherichia coli
Epidemiology: Transmission from person-to-person spread, from
contamination of foods, unpasteurized milk and juices, and
water sources contaminated with feces.
Prevention & Treatment: Handwashing, pasteurization of drinks,
and thorough cooking of food. Treatment includes replacing
the fluid loss from vomiting and diarrhea. Infants may require
antibiotics such as gentamicin or polymyxin for a few days.
Traveler’s diarrhea can be prevented with bismuth preparations
or antibacterial medication such as fluoroquinolone if the E. coli
strains are sensitive to the antibiotic.
4. Salmonellosis
. disease contracted from animal sources
Symptoms: Characterized by diarrhea, abdominal pain, nausea,
vomiting and fever. The symptoms are usually short-lived and
mild.
Causative Agent: Salmonella enterica
Epidemiology: Children are commonly infected by seemingly
healthy pets that discharge salmonellas in their feces such as
iguanas, baby chickens and ducks. Eggs and poultry are often
contaminated.
Prevention & Treatment: Sanitary handling of animal carcasses,
treating animal products with pasteurization and irradiation and
testing them for contamination.
5. Campylobacteriosis
Symptoms: Fever, vomiting, diarrhea, and abdominal cramps are
typical.
Causative Agent: Campylobacter jejuni
Epidemiology: Poultry is a common source of infection because
it lives in the intestines this domestic animal. Other sources
includes ingesting unpasteurized cow and goat milk and from
drinking non-chlorinated surface water.
Prevention & Treatment: Prevention depends mostly on
pasteurization of milk and on chlorination of water. Proper
cooking and handling of raw poultry to avoid contamination
of hands and kitchen surfaces can also prevent spreading of
the disease. Chicken should be cooked until it is no longer
pink.

VIRAL DISEASES OF THE

LOWER ALIMENTARY SYSTEM

1. Rotaviral Gastroenteritis
Symptoms: Illness begins abruptly with vomiting and slight fever,
followed in a short time by profuse watery diarrhea. Symptoms
generally are gone in about a week.
Causative Agent: Rotaviruses
Epidemiology: Rotaviruses spread by the fecal-oral route.
Prevention & Treatment: Handwashing, disinfectant use, and other
sanitary measures help limit the spread of rotavirus.
2. Norwalk Virus Gastroenteritis
Symptoms: The symptoms of nausea and vomiting of abrupt onset
are identical to those with rotaviruses. Infections generally last
only 1 to 2 days
Causative Agent: Rotaviruses
Epidemiology: Transmission is by fecal-oral route.
Prevention & Treatment: Handwashings, disinfectants and other
sanitary measures can minimize transmission.
3. Hepatitis A (infectious hepatitis)
Symptoms: Typical symptoms include fatigue, fever, loss of appetite,
nausea, right-sided abdominal pain, dark-colored urine, clay-
colored feces and jaundice.
Causative Agent: Hepatitis A virus (picomavirus)
Epidemiology:Hepatitis A virus spreads principally through fecal
contamination of hands, food or water. The disease have
originated from restaurants because food handlers who carried
the virus failed to wash their hands. Eating raw shellfish
is a frequent source of infection since these animals
concentrate the hepatitis A virus from fecally polluted seawater.
Prevention & Treatment: Gamma globulin containing antibody
to HAV can be given by injection for passive immunization
of people exposed to the virus. Victims of the disease are advised
to avoid alcohol and other hepatic toxins
4. Hepatitis B (serum hepatitis)
Symptoms: Symptoms of Hepatitis A and B are similar but Hepatitis
B tends to be more severe than Hepatitis A.
Causative Agent: Hepatitis B virus (hepadnavirus)
Epidemiology: Sexual intercourse is responsible for transmission of
Hepatitis B virus. Infections also result from sharing of needles
by drug abusers. Unsterile tattooing and ear-piercing instruments
and shared toothbrushers, razors or towels can also transmit the
virus. HBV is spread mainly by blood, blood products, and semen
Blood and other body fluids can be infectious by mouth, the virus
probably infecting the recipient through small scratches or
abrasions.
Prevention & Treatment: Passive immunization with hepatitis B
immune globulin (HBIG) offers immediate, partial protection
against HBV infection until active immunity is achieved from
the vaccine. Those likely to be exposed to blood are taught
to wash their hands contaminated with blood, to wear gloves and
protective clothing, and to handle contaminated sharp objects
such as needles, scalpel blades carefully. Victims are advised to
avoid alcohol and hepatic toxins.
5. Hepatitis C
Symptoms: Symptoms of hepatitis C are the same as hepatitis A and
B except generally milder.
Causative Agent: Flavivirus
Epidemiology: Sharing toothbrushes, razors, and towels is
responsible to exposure. Tattoos and body piercing with unclean
instruments have transmitted the disease. Transmission by
sexual intercourse usually occur among those with multiple sex
partners and sexually transmitted diseases.
Prevention & Treatment: Vaccination against hepatitis A and B is
recommended to help avoid dual infections that might severely
damage the liver. Avoidance of alcoholic beverages is
recommended. No vaccine is available for preventing hepatitis
C but interferon injection combined with ribavirin may prevent
the chronic disease.

PROTOZOAN DISEASES OF THE

LOWER ALIMENTARY SYSTEM

1. Giardiasis
Symptoms: Symptoms can range from mild (indigestion and
nausea) to severe (vomiting, explosive diarrhea, abdominal
cramps, fatigue and weight loss). Long term carriers,
unknowingly excreting infectious cysts with their feces.
Causative Agent: Giardia lamblia
Epidemiology: Transmission is via fecally contaminated water.
Known or suspected sources include beavers, raccoons,
dogs, cats and humans. The cysts can remain viable in cold
water for more than 2 months. Usual level of chlorination of
municipal water supplies are ineffective against the cysts, and
water filtration is necessary to remove them. Person to person
contact can transmit the disease especially in day care centers
where hands become contaminated in the process of diaper
changing. People who engage in anal intercourse are also prone
to contracting the disease.
 Prevention & Treatment: Filtration of community water supplies is
effective. Using a few drops per quart of water of household
sodium hypochlorite bleach,, tincture of iodine, or commercial
water-purifying tablets is also effective. Only an hour of boiling
may be necessary to treat warm water but many hours are
required to kill cysts in cold water. Quinacrine and
metronidazole can effectively treat giardiasis
2. Cryptosporidiosis
Symptoms: Characterized by fever, loss of appetite, nausea, crampy
abdominal pain and profuse watery diarrhea, beginning after an
incubation period of 4 to 12 days.
Causative Agent:Cryptosporidium parvum
Epidemiology: Domestic animals such as dogs, pigs, and cattle and
humans can be a host for Giardia and these host can contaminate
food and drinking water. Epidemics have arisen from drinking
water, swimming pools, a water slide, a zoo fountain, day care
centers, unpasteurized apple juice and other food and drink.
Prevention & Treatment: Careful monitoring of water supplies,
pasteurization of liquids for human consumption and sanitary
disposal of human and animal feces. Food handlers with
diarrhea should not handle food until symptom free and all
food handlers should adhere to handwashing and other sanitary
measures. Paromomycin and azithromycin combination has
helped control the disease in some AIDS patients
3. Cyclosporiasis
Symptoms: Fatigue, loss of appetite, slight fever, vomiting and
watery diarrhea, followed by weight loss begins after an average
incubation period of about 1 week.
Causative Agent: Cyclospora cayetanensis
Prevention & Treatment: No preventive measures are available
except boiling or filtering drinking water. Cotrimoxazole
effectively treats cyclosporiasis
4. Amebiasis
Symptoms: Amebiasis is commonly asymptomatics. Symptoms
ranging from chronic mild diarrhea lasting months or years to
acute dysentery and death can occur.
Causative Agent: Entamoeba histolytica
Epidemiology: Humans constitute the only resevoir. Common in
tropical areas where sanitation is poor. Transmission is fecal
-oral.
Prevention & Treatment: Sanitary measures and avoiding fecal
contamination of drinking water. Metronidazole, and
paromomycin are available for treatment.