Gastroenteritis is the inflammation of the gastrointestinal tract (or GIT) which comprises the stomach, small intestines, and large intestines. Gastroenteritis leads to symptoms like abdominal pain, diarrhoea, and vomiting. Gastroenteritis is commonly known as the stomach/intestinal flu, but it should be noted that it is not called that because it is caused by the influenza virus.
Gastroenteritis is commonly encountered in everyday life and medical practice. It can range from mild with barely noticeable symptoms, to moderate to severe with symptoms as well as complications like dehydration, sepsis, perforation, and bleeding of the gastrointestinal tract, which requires emergency medical intervention. Food poisoning is an example of gastroenteritis.
What are the causes of Gastroenteritis?
Viruses, like rotavirus and norovirus, are the most common causes of gastroenteritis. The route of transmission of these viruses is usually faeco-oral, which means that it is spread via contaminated food and water. Symptoms usually begin 24-72hrs after the ingestion of contaminated meals.
Although a lot of cases of gastroenteritis are caused by different strains of bacteria, the specific causative agent is not always identified. Salmonella, Shigella, and Campylobacter are the most common causes of bacterial gastroenteritis. In children, E. coli is a common cause. Other bacteria agents include vibrio cholera, Clostridium spp, Vibrio parahaemolyticus, etc.
Other microorganisms that may cause gastroenteritis are parasites (Entamoeba histolytica, Cryptosporidium spp, Giardia lamblia, etc), as well as different types of fungi. Most cases of gastroenteritis are as a result of the ingestion of contaminated food.
What does Gastroenteritis feel like?
The symptoms of gastroenteritis usually develop after an incubation period, usually 12 to 72 hours after ingestion of meal contaminated by causative agents (virus, bacteria, protozoa). Abdominal pain, diarrhoea, and vomiting are the most common and noticeable symptoms of gastroenteritis. Systemic symptoms such as fever, headache, general weakness, and muscle ache may also be noticed. These symptoms are less specific to gastroenteritis, as they can occur in almost any infectious condition. The onset of these symptoms may be gradual or sudden, depending on the microorganism.
Diarrhoea in gastroenteritis may be watery, it may also contain mucus and blood. The volume of stool may also be large or small, and the frequency may range from 5 times a day to more than 15 times a day. The quantity and quality of stool in gastroenteritis depends on the part of the GIT which is affected and the causative organism (For example, diarrhoea in cholera has a characteristic rice water quality. The stool is completely watery with almost no faecal matter). Vomiting may or may not be present, and the frequency also varies. Vomitus may contain chunks of food or bile. It may also contain streaks of blood.
Abdominal pain may be diffuse or it may be localized to a part of the abdominal region. In children, abdominal pain is usually diffused. The pain may be crampy or have a knife-like quality to it.
Complications like dehydration and shock may develop due to excessive loss of fluid in stool and vomiting, perforation of bowels due to severe inflammation, bleeding, kidney failure, stroke, sepsis, and shock.
How to manage Gastroenteritis
Mild, uncomplicated gastroenteritis, like food poisoning, can be managed at home using oral fluids, analgesics, and rest. The BRAT diet (Banana, Rice, Apple sauce, and Toast) is recommended because they?re considered to be binding agents that reduce the stool and vomit volume, thereby reducing fluid loss. Oral Re-hydration Solution (ORS) is a fluid solution used to treat dehydration. It is a mixture of salt, sugar, and water. This solution can be prepared easily at home, or a salt mixture can be purchased at a pharmacy. The use of ORS has greatly decreased the mortality from dehydration due to diarrhoea.
Severe cases of gastroenteritis, usually with signs of dehydration should be admitted to the hospital immediately and managed as inpatient cases. Patients with bleeding and perforation may require blood transfusion as well as surgical correction. Consult with a surgeon.
Many cases of gastroenteritis could have been prevented because they occur in underdeveloped areas with little to no amenities, poor education, and decreased awareness, so the spread of infectious diseases is facilitated.
Ways in which we can prevent gastroenteritis and decrease mortality include:
- Wash hands appropriately and regularly, especially
after using the toilet and before handling food materials
- Wash vegetables and fruits, meals should be cooked and
- Keep sick people away from food sources
- Maintain proper environmental hygiene
- Use water from good sources for all cooking and drinking
- Don?t use human wastes as manure during farming.
- Maintain an appropriate distance between the toilet and the source of water during the construction of buildings.
Article By: Dr Tamara Doubra Odiki