Gastroenteritis is the inflammation of the stomach and intestines, both small and large, resulting in vomiting and diarrhea. Most cases of gastroenteritis are due to infections, mainly by viruses and bacteria, although there are immune related causes of gastroenteritis like eosinophilic gastroenteritis which is not caused by any microorganism. Gastroenteritis is known by many common names including :
- Gastric flu
- Stomach bug
- Tummy flu
- Intestinal flu
Even food poisoning is a type of gastroenteritis that is caused by the toxins of bacteria which is found in food.
What causes gastroenteritis?
Causes of Gastro
Most cases of gastroenteritis are due to viruses, particularly the rotavirus and norovirus. The norovirus can be spread via airborne transmission and is responsible for small outbreaks of the gastric flu. Rotaviruses are usually spread through contaminated food and water.
Bacteria are also responsible for gastroenteritis. Some bacteria secrete toxins into foods which when ingested, irritate the lining of the stomach and intestine thereby leading to gastroenteritis. In these cases, the bacteria itself does not have to be ingested – food poisoning/intoxication. Other bacteria enter the body and secrete their toxins into the lumen of the gut or enter stomach and intestinal cells, causing ulcerations and triggering the intestinal lining from secreting chloride and water into the gut – food infection.
Protozoa may also cause gastroenteritis and conditions like amebiasis and giardiasis are typical examples of protozoal gastroenteritis. Protozoal gastroenteritis can be quite severe and last for long periods of time.
Most cases of gastroenteritis are acute and will resolve after a few days without any treatment. However people with impaired immune systems like HIV/AIDS patients have to be cautious as the gastroenteritis can be prolonged and even lead to death. Gastroenteritis is one of the leading causes of death in the developing world, especially in babies, and is associated with poor sanitary practices, a lack of clean drinking water and contaminated food. Traveler’s are therefore prone to contracting gastroenteritis while holidaying abroad, especially in developing nations.
Another types of gastroenteritis is eosinophilic gastroenteritis. This is sometimes referred to as immune or allergic gastroenteritis. The exact cause is unknown but it seems more likely to occur in a person with immune-mediated hypersensitivity (allergies) like asthma, hay fever and eczema. Eosinophils are a type of white blood cell and are found in high concentrations within the stomach and intestinal lining of a person with eosinophilic gastroenteritis where it triggers inflammation and impairs gastrointestinal function.
What are the symptoms of gastroenteritis?
Signs and Symptoms of Gastro
The main symptoms include :
- Abdominal pains – intestinal cramps
- Fever – may not be present in every case
- Excess intestinal gas leading to belching and flatulence
- Abdominal bloating
What are the complications of gastroenteritis?
Dangers of Gastro
If left untreated, most cases of gastroenteritis will lead to dehydration. This will be seen as a drop in the blood pressure, increased heart rate, sunken eyes, changes in skin turgor and extreme fatigue. Other symptoms associated with dehydration may also be present including headaches, reduced urine output (oliguria), weakness and confusion. Gastroenteritis can be fatal if it is persistent and left untreated.
What is the treatment for gastroenteritis?
Most cases of gastroenteritis do not require any treatment. Oral rehydration therapy with an appropriate oral rehydration solution (ORS) is the cornerstone of maintaining a person with gastroenteritis. Since most cases are self-limiting and resolve spontaneously, no further treatment apart from appropriate rehydration is necessary.
- Antibiotics may be used only in certain cases of bacterial gastroenteritis. It is important to first identify the causative organism before starting antibiotics or this can lead to further complications including C.difficile infection.
- Antidiarrheal drugs should be avoided unless required for short periods of time. Using antidiarrheal agents can also lead to complications as the bowels are not able to evacuate the causative organism and toxins.
- Probiotics containing Lactobacillus casei and Saccharomyces boulardii may help in restoring the normal intestinal flora (good bowel bacteria).
If there are any signs of dehydration and the person is not responding to oral rehydration, hospitalization is necessary for an IV saline drip to be set up.
What foods can be eaten during and after gastroenteritis?
Gastric Flu Diet
It is best to avoid solid foods while the nausea and vomiting is present and rather just remain on fluids..Once this settles, a person can start with the BRAT diet.
- Bananas, mashed
- Rice, soft
- Applesauce or grated apples
- Toast, plain
If these foods are well tolerated and there is no vomiting, a person can then progress to a normal diet of bland foods even if the diarrhea has not stopped. An oral rehydration solution should be continued throughout the episode as well as for a short time afterwards to replenish the body with the necessary electrolytes.