What are the main symptoms of viral gastroenteritis. How does stomach flu differ from influenza. What causes viral gastroenteritis and how is it transmitted. When should you seek medical attention for gastroenteritis symptoms. How can viral gastroenteritis be prevented and managed.

What is Viral Gastroenteritis?

Viral gastroenteritis, commonly known as stomach flu, is an intestinal infection that causes inflammation of the stomach, small intestine, and large intestine (colon). Despite its nickname, it is not related to influenza, which affects the respiratory system. Gastroenteritis is characterized by a range of uncomfortable digestive symptoms that can significantly impact daily life.

Key Characteristics of Viral Gastroenteritis

• Affects the digestive tract, not the respiratory system
• Caused by various viruses, not bacteria or parasites
• Highly contagious and can spread quickly in confined spaces
• Usually self-limiting but can be severe in certain populations

Recognizing the Symptoms of Stomach Flu

The symptoms of viral gastroenteritis typically appear within 1-3 days after infection and can range from mild to severe. Understanding these symptoms is crucial for proper management and knowing when to seek medical attention.

Common Symptoms of Viral Gastroenteritis

• Watery, nonbloody diarrhea
• Nausea and vomiting
• Abdominal cramps and pain
• Occasional muscle aches or headache
• Low-grade fever

How long do gastroenteritis symptoms typically last? In most cases, symptoms persist for 1-2 days, but they can occasionally last up to 14 days. The duration and severity of symptoms can vary depending on the specific virus causing the infection and the individual’s overall health.

Distinguishing Viral Gastroenteritis from Other Infections

It’s important to differentiate viral gastroenteritis from other infections that may cause similar symptoms. Bacterial infections like Clostridioides difficile, salmonella, and Escherichia coli, as well as parasitic infections such as giardia, can present with comparable digestive issues.

Key Differences Between Viral and Bacterial Gastroenteritis

1. Presence of blood in stool: Viral gastroenteritis typically causes nonbloody diarrhea, while bloody diarrhea is more common in bacterial infections.
2. Duration of symptoms: Viral infections usually resolve faster than bacterial ones.
3. Response to antibiotics: Viral gastroenteritis does not respond to antibiotic treatment, unlike bacterial infections.

Causes and Transmission of Viral Gastroenteritis

Viral gastroenteritis is highly contagious and can spread through various routes. Understanding the causes and transmission methods is essential for prevention and control of outbreaks.

Common Viruses Causing Gastroenteritis

• Noroviruses: The most common cause of foodborne illness worldwide
• Rotavirus: Primarily affects children and is a leading cause of severe diarrhea in infants

How is viral gastroenteritis transmitted? The most common ways include:

• Consuming contaminated food or water
• Close contact with an infected person
• Touching contaminated surfaces and then touching your mouth
• Sharing utensils, towels, or food with someone who has the virus

When to Seek Medical Attention for Gastroenteritis

While most cases of viral gastroenteritis resolve on their own, certain symptoms warrant immediate medical attention. Recognizing these warning signs is crucial, especially for vulnerable populations such as infants, older adults, and those with compromised immune systems.

Warning Signs for Adults

• Inability to keep liquids down for 24 hours
• Vomiting or diarrhea lasting more than two days
• Vomiting blood
• Signs of dehydration (excessive thirst, dry mouth, deep yellow urine, severe weakness)
• Blood in bowel movements
• Severe stomach pain
• Fever above 104째F (40째C)

Warning Signs for Infants and Children

• Fever of 102째F (38.9째C) or higher
• Extreme irritability or fatigue
• Severe discomfort or pain
• Bloody diarrhea
• Signs of dehydration (dry mouth, lack of tears, decreased urination)

Is vomiting in infants always a cause for concern? While occasional spitting up is normal for babies, frequent vomiting, especially when accompanied by other symptoms, requires immediate medical attention.

Prevention and Management of Viral Gastroenteritis

Since there’s no specific treatment for viral gastroenteritis, prevention is key. Implementing proper hygiene practices and being cautious about food and water consumption can significantly reduce the risk of infection.

Preventive Measures

• Wash hands thoroughly and frequently, especially before handling food and after using the bathroom
• Avoid consuming untreated water or ice cubes in areas with poor sanitation
• Be cautious with raw or undercooked foods, particularly in unfamiliar settings
• Clean and disinfect contaminated surfaces promptly
• Avoid close contact with infected individuals when possible

Management Strategies

1. Stay hydrated: Replenish fluids and electrolytes lost through diarrhea and vomiting
2. Rest: Allow your body time to recover and fight the infection
3. Gradually reintroduce food: Start with bland, easily digestible foods as symptoms improve
4. Avoid certain substances: Steer clear of dairy products, caffeine, alcohol, and high-fat foods until fully recovered

Can over-the-counter medications help manage gastroenteritis symptoms? While some anti-diarrheal medications may provide relief, they’re not always recommended as they can prolong the infection. Consult a healthcare provider before using any medications.

Special Considerations for High-Risk Groups

Certain populations are at higher risk of developing severe complications from viral gastroenteritis. These groups require special attention and may need more aggressive management strategies.

High-Risk Populations

• Infants and young children
• Older adults
• Individuals with compromised immune systems
• People with chronic health conditions

Why are these groups more vulnerable to severe gastroenteritis? These populations may have weaker immune responses, be more susceptible to dehydration, or have underlying conditions that can be exacerbated by the infection.

Additional Precautions for High-Risk Groups

1. Closer monitoring of symptoms and hydration status
2. Earlier intervention and medical consultation
3. Consideration of oral rehydration solutions or, in severe cases, intravenous fluids
4. Potential use of anti-emetics or other supportive medications under medical supervision

The Role of Vaccines in Preventing Viral Gastroenteritis

While there’s no universal vaccine for all types of viral gastroenteritis, significant progress has been made in developing vaccines against specific viruses, particularly rotavirus.

Rotavirus Vaccines

• Highly effective in preventing severe rotavirus infections in infants and young children
• Recommended as part of routine childhood immunization schedules in many countries
• Has significantly reduced hospitalizations and deaths from rotavirus gastroenteritis worldwide

Are rotavirus vaccines 100% effective in preventing gastroenteritis? While highly effective, these vaccines don’t provide complete protection against all strains of rotavirus or other gastroenteritis-causing viruses. However, they significantly reduce the risk of severe infections.

Ongoing Research and Development

Scientists continue to work on developing vaccines for other common causes of viral gastroenteritis, such as norovirus. These efforts aim to further reduce the global burden of gastroenteritis, especially in vulnerable populations and developing countries.

Impact of Viral Gastroenteritis on Public Health and Society

Viral gastroenteritis poses significant challenges to public health systems and has wide-ranging societal impacts. Understanding these broader implications is crucial for developing comprehensive strategies to combat the disease.

Public Health Challenges

• Rapid spread in confined settings (schools, cruise ships, nursing homes)
• Strain on healthcare resources during outbreaks
• Economic burden due to lost productivity and healthcare costs
• Potential for food safety concerns and recalls

Societal Impact

1. Disruption of daily activities and work attendance
2. Challenges in childcare and school attendance during outbreaks
3. Potential for widespread community transmission
4. Increased awareness and changes in hygiene practices

How can communities and institutions mitigate the impact of viral gastroenteritis outbreaks? Implementing robust hygiene protocols, providing education on prevention, and having clear outbreak response plans can significantly reduce the spread and impact of gastroenteritis in various settings.

Future Directions in Gastroenteritis Research and Treatment

The field of gastroenteritis research is continually evolving, with scientists and healthcare professionals working to improve prevention, diagnosis, and treatment strategies.

Emerging Research Areas

• Development of broad-spectrum antiviral medications
• Improved diagnostic tools for rapid and accurate identification of causative agents
• Investigation of the gut microbiome’s role in susceptibility and recovery
• Exploration of novel vaccine technologies for a wider range of gastroenteritis-causing viruses

Potential Future Developments

1. Personalized treatment approaches based on individual risk factors and gut microbiome profiles
2. Advanced surveillance systems for early detection and containment of outbreaks
3. Integration of artificial intelligence in predicting and managing gastroenteritis trends
4. Development of more effective and palatable oral rehydration solutions

How might advancements in gastroenteritis research impact global health? These developments have the potential to significantly reduce the global burden of gastroenteritis, particularly in resource-limited settings where the disease has the most severe impact.

Viral gastroenteritis (stomach flu) – Symptoms & causes

Overview

Viral gastroenteritis is an intestinal infection that includes signs and symptoms such as watery diarrhea, stomach cramps, nausea or vomiting, and sometimes fever.

The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by consuming contaminated food or water. If you’re otherwise healthy, you’ll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly.

There’s no effective treatment for viral gastroenteritis, so prevention is key. Avoid food and water that may be contaminated and wash your hands thoroughly and often.

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Symptoms

Although it’s commonly called stomach flu, gastroenteritis isn’t the same as influenza. The flu (influenza) affects only your respiratory system — your nose, throat and lungs. Gastroenteritis, on the other hand, attacks your intestines, causing signs and symptoms such as:

• Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
• Nausea, vomiting or both
• Stomach cramps and pain
• Occasional muscle aches or headache
• Low-grade fever

Depending on the cause, viral gastroenteritis symptoms may appear within 1-3 days after you’re infected and can range from mild to severe. Symptoms usually last just a day or two, but occasionally they may last up to 14 days.

Because the symptoms are similar, it’s easy to confuse viral diarrhea with diarrhea caused by bacteria, such as Clostridioides difficile, salmonella and Escherichia coli, or parasites, such as giardia.

Viral gastroenteritis

The stomach, small intestine and large intestine (colon) are part of your digestive tract, which processes the foods you eat. Viral gastroenteritis is an inflammation of these organs caused by a virus.

When to see a doctor

If you’re an adult, call your health care provider if:

• You’re not able to keep liquids down for 24 hours
• You’ve been vomiting or having diarrhea for more than two days
• You’re vomiting blood
• You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
• You notice blood in your bowel movements
• You have severe stomach pain
• You have a fever above 104 F (40 C)

For infants and children

See your child’s health care provider right away if your child:

• Has a fever of 102 F (38.9 C) or higher
• Seems tired or very irritable
• Is in a lot of discomfort or pain
• Has bloody diarrhea
• Seems dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them, and watching for signs such as a dry mouth, thirst and crying without tears

If you have an infant, remember that while spitting up may be an everyday occurrence for your baby, vomiting is not. Babies vomit for a variety of reasons, many of which may require medical attention.

Call your baby’s doctor right away if your baby:

• Has vomiting that is frequent
• Hasn’t had a wet diaper in six hours
• Has bloody stools or severe diarrhea
• Has a sunken soft spot (fontanel) on the top of his or her head
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy or unresponsive

Causes

You’re most likely to get viral gastroenteritis when you eat or drink contaminated food or water. You may also be likely to get gastroenteritis if you share utensils, towels or food with someone who has one of the viruses that cause the condition.

Many viruses can cause gastroenteritis, including:

• Noroviruses. Both children and adults are affected by noroviruses, the most common cause of foodborne illness worldwide. Norovirus infection can sweep through families and communities. It’s especially likely to spread among people in confined spaces.

  In most cases, you pick up the virus from contaminated food or water. But it can also spread between people who are in close contact or who share food. You can also get the virus by touching a surface that’s been contaminated with norovirus and then touching your mouth.

• Rotavirus. Worldwide, this is the most common cause of viral gastroenteritis in children, who are usually infected when they put their fingers or other objects contaminated with the virus into their mouths. It can also spread through contaminated food. The infection is most severe in infants and young children.

  Adults infected with rotavirus may not have symptoms, but can still spread the illness. This is of particular concern in institutional settings such as nursing homes because adults with the virus unknowingly can pass the virus to others. A vaccine against viral gastroenteritis is available in some countries, including the United States, and appears to be effective in preventing the infection.

Some shellfish, especially raw or undercooked oysters, also can make you sick. Contaminated drinking water is a cause of viral diarrhea. But in many cases the virus is passed when someone with a virus handles food you eat without washing his or her hands after using the toilet.

Risk factors

Gastroenteritis occurs all over the world and can affect people of all ages.

People who may be more susceptible to gastroenteritis include:

• Young children. Children in child care centers or elementary schools may be especially vulnerable because it takes time for a child’s immune system to mature.
• Older adults. Adult immune systems tend to become less efficient later in life. Older adults in nursing homes are vulnerable because their immune systems weaken. They also live in close contact with others who may pass along germs.
• Schoolchildren or dormitory residents. Anywhere that groups of people come together in close quarters can be an environment for an intestinal infection to get passed.
• Anyone with a weakened immune system. If your resistance to infection is low — for instance, if your immune system is compromised by HIV/AIDS, chemotherapy or another medical condition — you may be especially at risk.

Each gastrointestinal virus has a season when it’s most active. If you live in the Northern Hemisphere, for instance, you’re more likely to have rotavirus or norovirus infections in the winter and spring.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water and essential salts and minerals. If you’re healthy and drink enough to replace fluids you lose from vomiting and diarrhea, dehydration shouldn’t be a problem.

Infants, older adults and people with weakened immune systems may become severely dehydrated when they lose more fluids than they can replace. Hospitalization might be needed so that lost fluids can be replaced through an IV in their arms. Dehydration can rarely lead to death.

Prevention

The best way to prevent the spread of intestinal infections is to follow these precautions:

• Get your child vaccinated. A vaccine against gastroenteritis caused by the rotavirus is available in some countries, including the United States. Given to children in the first year of life, the vaccine appears to be effective in preventing severe symptoms of this illness.

• Wash your hands thoroughly. And make sure your children do, too. If your children are older, teach them to wash their hands, especially after using the toilet.

  Wash your hands after changing diapers and before preparing or eating food, too. It’s best to use warm water and soap and to rub hands well for at least 20 seconds. Wash around cuticles, beneath fingernails and in the creases of the hands. Then rinse thoroughly. Carry sanitizing wipes and hand sanitizer for times when soap and water aren’t available.

• Use separate personal items around your home. Avoid sharing eating utensils, drinking glasses and plates. Use separate towels in the bathroom.
• Prepare food safely. Wash all your fruits and vegetables before eating them. Clean kitchen surfaces before preparing food on them. Avoid preparing food if you’re sick.
• Keep your distance. Avoid close contact with anyone who has the virus, if possible.
• Disinfect hard surfaces. If someone in your home has viral gastroenteritis, disinfect hard surfaces, such as counters, faucets and doorknobs, with a mixture of 5-25 tablespoons (73 to 369 milliliters) of household bleach to 1 gallon (3.8 liters) of water.
• Avoid touching laundry that may have been exposed to a virus. If someone in your home has viral gastroenteritis, wear gloves while touching laundry. Wash clothing and bedding in hot water and dry them on the hottest setting. Wash your hands well after touching laundry.
• Check out your child care center. Make sure the center has separate rooms for changing diapers and preparing or serving food. The room with the diaper-changing table should have a sink as well as a sanitary way to dispose of diapers.

Take precautions when traveling

When you’re traveling in other countries, you can become sick from contaminated food or water. You may be able to reduce your risk by following these tips:

• Drink only well-sealed bottled or carbonated water.
• Avoid ice cubes because they may be made from contaminated water.
• Use bottled water to brush your teeth.
• Avoid raw food — including peeled fruits, raw vegetables and salads — that has been touched by human hands.
• Avoid undercooked meat and fish.

More Information

Gastroenteritis – Better Health Channel

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Summary

Read the full fact sheet

• Gastroenteritis is a short-term illness triggered by the infection and inflammation of the digestive system.  Symptoms can include abdominal cramps, diarrhoea and vomiting. 
• Some of the causes of gastroenteritis include viruses, bacteria, bacterial toxins, parasites, particular chemicals and some drugs.
• Good old-fashioned handwashing with soap and water is still the best defence against spreading the bug.
• Clean kitchen tops, toys, toilet seats, nappy change tables and taps to ensure you don’t spread the infection to others at home.
• If you or anyone in your household is ill, stay home for 48 hours after symptoms have stopped to ensure you are clear of infection.

Gastroenteritis is an illness triggered by the infection and inflammation of the digestive system. Typical symptoms include abdominal cramps, diarrhoea and vomiting. In many cases, the condition heals itself within a few days.

The main complication of gastroenteritis is dehydration, but this can be prevented if the fluid lost in vomit and diarrhoea is replaced. A person suffering from severe gastroenteritis may need fluids administered intravenously (directly into the bloodstream via a vein – the setup is often referred to as a ‘drip’). Some of the causes of gastroenteritis include viruses, bacteria, bacterial toxins, parasites, particular chemicals and some drugs.

Symptoms of gastroenteritis

The symptoms of gastroenteritis can include:

• loss of appetite
• bloating
• nausea
• vomiting
• abdominal cramps
• abdominal pain
• diarrhoea
• bloody stools (poo) – in some cases
• pus in the stools – in some cases
• generally feeling unwell – including lethargy and body aches.

Causes of gastroenteritis

There are many things that can cause gastroenteritis, including:

• viruses – such as norovirus, calicivirus, rotavirus, astrovirus and adenovirus
• bacteria – such as the Campylobacter bacterium
• parasites – such as Entamoeba histolytica, Giardia lamblia and Cryptosporidium
• bacterial toxins – the bacteria themselves don’t cause illness, but their poisonous by-products can contaminate food. Some strains of staphylococcal bacteria produce toxins that can cause gastroenteritis
• chemicals – lead poisoning, for example, can trigger gastroenteritis
• medication – certain medication (such as antibiotics), can cause gastroenteritis in susceptible people.

Infectious gastroenteritis

Infectious gastroenteritis is caused by viruses, bacteria or parasites. In each case, infection occurs when the agent is ingested, usually by eating or drinking. Some of the common types of infectious gastroenteritis include:

• Escherichia coli infection – this is a common problem for travellers to countries with poor sanitation. Infection is caused by drinking contaminated water or eating contaminated raw fruits and vegetables.
• Campylobacter infection – the bacteria are found in animal faeces (poo) and uncooked meat, particularly poultry. Infection is caused by, for example, consuming contaminated food or water, eating undercooked meat (especially chicken), and not washing your hands after handling infected animals.
• Cryptosporidium infection – parasites are found in the bowels of humans and animals. Infection is caused by, for example, swimming in a contaminated pool and accidentally swallowing water, or through contact with infected animals. An infected person may spread the parasites to food or surfaces if they don’t wash their hands after going to the toilet.
• Giardiasis – parasite infection of the bowel. Infection is caused by, for example, drinking contaminated water, handling infected animals or changing the nappy of an infected baby and not washing your hands afterwards.
• Salmonellosis – bacteria are found in animal faeces. Infection is caused by eating contaminated food or handling infected animals. An infected person may also spread the bacteria to other people or surfaces by not washing their hands properly.
• Shigellosis – bacteria are found in human faeces. An infected person may spread the bacteria to food or surfaces if they don’t wash their hands after going to the toilet.
• Viral gastroenteritisExternal Link – infection is caused by person-to-person contact such as touching contaminated hands, faeces or vomit, or by drinking contaminated water or food.

Diagnosis of gastroenteritis

It is important to establish the cause, as different types of gastroenteritis respond to different treatments. Diagnostic methods may include:

• medical history
• physical examination
• blood tests
• stool tests.

Treatment for gastroenteritis

Treatment depends on the cause, but may include:

• Plenty of fluids.
• Oral rehydration drinks, available from your pharmacist.
• Admission to hospital and intravenous fluid replacement, in severe cases.
• Antibiotics, if bacteria are the cause.
• Drugs to kill the parasites, if parasites are the cause.
• Avoiding anti-vomiting or anti-diarrhoea drugs unless prescribed or recommended by your doctor, because these medications will keep the infection inside your body.

Prevention of gastroenteritis

Good old-fashioned handwashing with soap and water is still the best defence against spreading the bug.

Gastroenteritis is highly contagious, general suggestions on how to reduce the risk of infection include:

• Stay home while sick, until 48 hours after symptoms have stopped. If symptoms persist, visit your GP.
• Wash hands thoroughly with soap and water after going to the toilet or changing nappies, after smoking, after using a handkerchief or tissue, or after handling animals.
• Wash your hands thoroughly with soap and water before preparing food or eating.
• Use disposable paper towels to dry your hands rather than cloth towels, since the bacteria can survive for some time on objects.
• Do not handle raw and cooked foods with the same implements (tongs, knives, cutting boards), unless they have been thoroughly washed between uses.
• Keep all kitchen surfaces and equipment clean.
• Keep cold food cold (below 5 °C) and hot food hot (above 60 °C) to discourage the growth of bacteria.
• Make sure foods are thoroughly cooked.
• Clean kitchen tops, toys, toilet seats, nappy change tables and taps to ensure you don’t spread the infection to others at home.
• Clean the toilet and bathroom regularly (especially the toilet seat, door handles and taps).
• Clean baby change tables regularly.
• When travelling overseas to countries where sanitation is suspect, only drink bottled water. Don’t forget to brush your teeth in bottled water too. Avoid food buffets, uncooked foods or peeled fruits and vegetables, and ice in drinks.

Note: Wash hands with soap and water as this is the best way to prevent infection. Alcohol-based hand sanitisers while effective against some viruses (such as coronavirus), are not effective against gastroenteritis.

Learn more about gastroenteritis in children and how to be a Soapy Hero!

Where to get help

• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Your local council health department
• Communicable Disease Epidemiology and Surveillance Unit, Department of Health, Victorian GovernmentExternal Link Tel. 1300 651 160

• Gastroenteritis – viral pamphletExternal Link, 2013, Department of Health, Victorian Government.
• ShigellosisExternal Link, Communicable Disease Epidemiology and Surveillance, Department of Health, Victorian Government.
• RotavirusExternal Link, Communicable Disease Epidemiology and Surveillance, Department of Health, Victorian Government.
• Viral gastroenteritis (not rotavirus)External Link, Communicable Disease Epidemiology and Surveillance, Department of Health, Victorian Government.

This page has been produced in consultation with and approved
by:

Department of Health – Public Health – Infectious Diseases

This page has been produced in consultation with and approved
by:

Department of Health – Public Health – Infectious Diseases

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Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 11-03-2021

Gastroenteritis. What is Gastroenteritis?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Gastroenteritis is an inflammatory process in the stomach and small intestine, which can be caused by bacterial (including Helicobacter pylori), viral or protozoal damage, the action of chemical and physical factors, and the development of allergic reactions. The leading clinical signs are dyspeptic, pain syndrome, with acute infectious gastroenteritis – dehydration. Diagnosis consists in studying the history of the disease, the epidemiological situation, identifying the pathogen, conducting endoscopic and other additional research methods. Treatment is conservative, determined by the form of pathology.

• Causes of gastroenteritis
• Classification
• Symptoms of gastroenteritis
• Diagnostics
• Treatment of gastroenteritis
• Prognosis and prevention
• Prices for treatment

General

Gastroenteritis is an inflammatory process localized in the mucous membrane of the stomach and small intestine, leading to impaired secretory, digestive-transport function, secondary immune and metabolic changes. The disease can occur in two forms – acute and chronic, which have fundamental differences in etiology, manifestations and methods of treatment.

The prevalence is very high: in the structure of infectious diseases, acute gastroenteritis ranks second after respiratory infections, and chronic gastroenteritis occurs in more than half of schoolchildren and older age groups. The relevance of this pathology is due to the constant emergence of new strains of pathogens, the development of antibiotic resistance, the prevalence of such risk factors as poor nutrition, alcohol consumption and smoking, as well as extremely frequent cases of self-medication.

Gastroenteritis

Causes of gastroenteritis

The main reason for the development of acute inflammation is infection with bacteria, viruses, protozoa (shigella, salmonella, E. coli, enterotropic viruses, amoebae, etc.), as well as the effect on the mucous membrane of the stomach and small intestine of chemical or physical damaging factors (alcohol, certain drugs). , aggressive chemicals, ionizing radiation). Less commonly, the acute form occurs as a result of an unbalanced diet (eating too spicy, fatty foods) or individual intolerance to certain foods (allergic form).

The most common is acute infectious gastroenteritis, in which pathogenic flora enters the gastrointestinal tract, adhesion and invasion of microorganisms, and their production of enterotoxins. These processes are accompanied by an increase in the osmotic pressure of the intestinal contents and the secretion of a large amount of water and electrolytes into its lumen. The likelihood of acute infectious gastroenteritis increases with a violation of the intestinal microbiocenosis and low acidity of gastric juice.

Chronic gastroenteritis can form as a complication and continuation of an acute process, but in most cases it is caused by infection with Helicobacter pylori. Helicobacteria are acid-resistant microorganisms that have a tropism for the epithelial tissue of the stomach and have protective mechanisms that allow them to exist in an aggressive acidic environment.

The development of these bacteria leads to an increase in the acid-forming function, and as a result of the constant action of the acidic contents of the stomach on the mucous membrane of the small intestine, metaplasia of the intestinal epithelium, which is transformed into the gastric one. At the same time, the mucous membrane acquires favorable properties for the colonization of Helicobacteria. A chronic inflammatory process leads to insufficient production of digestive juices and inhibition of local immune mechanisms.

According to the observations of specialists in the field of practical gastroenterology, a chronic form of pathology is often observed in alcoholism. At the same time, there are atrophic changes in the mucous membrane of the gastrointestinal tract with severe disorders of food digestion and absorption of valuable nutrients.

Classification

Gastroenteritis is classified depending on the form (acute or chronic), the etiological factor and the predominant clinical syndrome. During acute gastroenteritis, three degrees of severity are distinguished. The former is characterized by infrequent diarrhea and vomiting, normal body temperature, and no symptoms of dehydration. The average severity is determined by vomiting and diarrhea up to ten times a day, signs of mild dehydration and fever up to 38.5ºС. Severe course is accompanied by severe dehydration, fever, impaired consciousness.

Chronic gastroenteritis is classified according to etiological factors (infectious, alimentary, caused by physical or chemical factors, diseases of the liver and pancreas), predominant functional changes (impaired membrane digestion, absorption or motor function), increased or decreased acidity. Depending on the anatomical and morphological changes, superficial gastroenteritis with damage to epithelial cells, chronic inflammation without atrophy, and chronic atrophic process are distinguished. During the chronic form, exacerbations and remissions are distinguished.

Symptoms of gastroenteritis

The clinical picture depends on the form of the disease. The acute process develops rapidly, due to frequent and profuse diarrhea and vomiting within a few hours, the patient’s condition may deteriorate significantly. If the cause of the pathology is an infectious process, the incubation period can last from 3-4 hours to several days. The most common first symptom is diarrhea, followed by nausea and vomiting. The severity of manifestations differs depending on the species of the pathogen.

With bacterial gastroenteritis, the course is usually more severe than with viral gastroenteritis, hyperthermia and intoxication syndrome are characteristic. A feature is damage to epithelial cells by toxins, therefore, in most cases, bacterial gastroenteritis is accompanied by severe spastic pain along the intestine. Viral infection is extremely rarely accompanied by abdominal pain, in young children the disease can quickly lead to significant dehydration. Viral gastroenteritis often occurs with signs of a respiratory infection.

In an acute process, the leading clinical syndrome requiring early correction is dehydration. Dehydration can reach a significant degree when the patient loses fluid in an amount of 10% of body weight or more. In this case, convulsions, impaired consciousness, severe weakness, tachycardia, and a decrease in blood pressure are possible. Patients feel intense thirst; the skin is dry, turgor is reduced. With significant dehydration, body temperature drops to 35 ºС, the amount of urine excreted decreases up to anuria.

The chronic form of the disease is accompanied by general symptoms and signs of local mucosal damage. General manifestations are characterized by weakness, asthenia, weight loss due to impaired absorption of nutrients, irritability, and insomnia. Most patients experience trophic changes in the nails (flaky, brittle nails), hair (brittle, split ends), skin and mucous membranes. Violation of calcium absorption can lead to paresthesia, spasms of small muscles.

Pain in chronic gastroenteritis occurs 1-2 hours after eating, accompanied by nausea, belching, and less often vomiting. Intestinal manifestations of the disease include diarrhea, polyfecal matter, bloating, and rumbling. In the clinic of a chronic process, periods of exacerbations and remissions alternate. Exacerbations have an autumn-spring seasonality, they are provoked by dietary disorders and concomitant diseases. With adequate therapy, symptoms regress in about ten days.

Diagnosis

In the case of an acute form of gastroenteritis, the leading role in the diagnosis is given to the study of complaints and anamnesis of the disease, the epidemiological situation in the region, risk factors, and methods for identifying the pathogen. The nature of changes in bowel movements and the degree of dehydration allow you to determine the start of treatment. An accurate diagnosis is made after the pathogen is identified, but these studies require a long time (7-10 days). On examination, dryness of the skin and a decrease in their turgor, abdominal pain on palpation are determined. The tongue is dry, coated with a grayish or white coating. Possible hyperthermia, impaired consciousness, with severe dehydration – hypothermia and convulsions.

A coprological study (coprogram) reveals impurities in stools of mucus, pus, blood, undigested fiber, muscle fibers, starch and fats. In a clinical blood test, leukocytosis and an acceleration of ESR are determined, and in case of dehydration, signs of hemoconcentration (a decrease in the liquid component of the blood) are determined. Detection of the pathogen is carried out by bacteriological and virological methods. Excrements, vomit, blood and urine are examined. The most informative serological diagnosis is a fourfold increase in the titer of specific antibodies in paired sera.

To verify chronic gastroenteritis, additional studies of the gastrointestinal tract are carried out. With esophagogastroduodenoscopy, the condition of the gastric mucosa and the initial sections of the small intestine is assessed, a biopsy of the altered sections of the mucosa is performed for subsequent histological analysis. This allows you to detect atrophy, metaplasia or hyperplasia. Antroduodenal manometry is used to detect dysmotility. Intragastric pH-metry is mandatory, since low and high acidity require a different approach to treatment. In order to detect Helicobacter pylori, PCR diagnostics, a respiratory urease test and a morphological study of biopsy specimens are carried out. To assess the condition of the liver and pancreas, ultrasound of the abdominal organs is performed.

Treatment of gastroenteritis

In an acute process, treatment can be carried out on an outpatient basis or in an infectious diseases hospital, in a chronic process, in the department of gastroenterology. The basis of therapy for the acute form is rehydration, diet therapy, in some cases, the use of antibiotics and adjuvants. Any severity of acute infectious gastroenteritis requires early initiation of oral rehydration therapy. This is especially true for young children, in whom dehydration develops very quickly. Even if there are no signs of exsicosis, plenty of fluids are required.

In the presence of thirst, dry skin, decreased urine volume, special oral saline solutions are used. The patient should drink liquid in a volume that exceeds losses by one and a half times. If thirst decreases and diuresis increases, then dehydration is compensated sufficiently. With significant losses of water and electrolytes, infusion rehydration with saline solutions is carried out.

Antibiotics in the case of acute gastroenteritis are indicated only for its bacterial etiology (the presence of mucus, pus and blood in the stool, severe hyperthermia). In case of viral infection, antibiotic therapy is contraindicated. To reduce diarrhea and remove toxins, enterosorbents are prescribed: activated carbon, dioctahedral smectite, polyphepan and others. In order to normalize the intestinal flora, probiotics and eubiotics are used.

Treatment of chronic gastroenteritis is determined by its form. In case of hyperacidity, antacids, proton pump inhibitors are used. The detection of Helicobacter pylori requires mandatory specific therapy: antibiotics, bismuth preparations and proton pump inhibitors are prescribed. With reduced acidity, natural gastric juice, enzymatic and reparative preparations are used. Be sure to restore the intestinal microflora. With severe pain syndrome, especially with solarite phenomena, physiotherapy is effective: electrophoresis with anesthetics, magnetotherapy.

In the acute and chronic form of the disease, diet is mandatory. Food should be chemically and mechanically sparing, extractives, fatty and spicy dishes are excluded. In order to reduce the risk of recurrence, patients are advised to exclude smoking, drinking alcohol, coffee and carbonated drinks. During the period of remission, sanatorium treatment is carried out. Therapy of gastroenteritis should not be carried out by patients on their own – the irrational use of symptomatic agents only reduces the manifestations, but does not lead to a cure.

Prognosis and prevention

With timely treatment, adherence to a diet, the prognosis is favorable. At the same time, self-treatment of acute gastroenteritis can lead to a chronic process. In the presence of risk factors (age up to 6 months and after 65 years, concomitant renal, cardiovascular and neurological diseases, diabetes mellitus, oncological pathology), acute pathology can be severe, while mortality is quite high.

In chronic gastroenteritis, clinical examination and regular examination are mandatory. gastroenterologist. Preventive measures include personal hygiene (washing hands after visiting the bathrooms and before eating), thorough washing of raw vegetables, herbs, sufficient heat treatment of products, a detailed examination of food industry workers with removal from production if an acute infectious process is detected.

Sources

1. treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

   Gastroenteritis: causes, symptoms, treatment, prevention

   Gastroenteritis is a disease of the gastrointestinal tract, which is expressed by inflammatory processes in the intestines and stomach. Gastroenteritis can be both acute and chronic.

   Acute gastroenteritis

   Acute gastroenteritis is an inflammation of the stomach or intestines, often caused by improper diet or ingestion of various types of viruses and infectious agents into the intestinal tract.

   Excessive overeating or frequent dry food, as well as an irregular diet, can also cause inflammation of the stomach. The symptoms of the disease manifest themselves sharply, while pain is in the nature of contractions. The main symptoms of acute gastroenteritis are severe pain in the abdomen, or in the navel area, nausea, vomiting, general weakness of the whole body, palpitations, pallor of the skin, loss of appetite, feeling of dizziness.

   In severe cases, the patient may experience fainting. In acute gastroenteritis, a change in stool is observed – the discharge becomes similar to mucus. With the manifestation of the disease, another visual symptom is the sharpening of facial features. If the first symptom of acute gastroenteritis occurs, the patient must be given first aid – rinse the stomach with warm water with the addition of potassium permanganate or with the addition of soda. After gastric lavage, it is necessary to consult a doctor and conduct a comprehensive examination of the gastrointestinal tract and identify the causative agent of gastroenteritis.

   Causes of gastroenteritis

   Gastroenteritis is divided into several types depending on what became the causative agent of the disease. Bacterial gastroenteritis is provoked by intestinal pathogens, bacteria, salmonella or staphylococci, which enter the esophagus with poor-quality food or with weakened immunity. Viral gastroenteritis is caused by rotavirus, an intestinal viral bacterium.

   Rotavirus exposure is caused by the problem of dirty hands, poor hygiene before and during meals, poor quality, unwashed food, poorly prepared food, or eating raw food such as seafood. Chronic gastroenteritis mainly appears as a consequence of untreated acute gastroenteritis, or on the background of oncological diseases. Gastroenteritis can also be attributed to “occupational” diseases.

   Symptoms of gastroenteritis

   The main symptoms of gastroenteritis are nausea, vomiting and changes in the stool, in more severe cases of inflammation, the stool may be accompanied by bloody discharge. Quite often, the patient has a fever, severe headaches, pain in the abdomen, especially in the navel. When a viral gastroenteritis occurs, the patient has a strong increase in body temperature. Pain in the abdomen is accompanied by its strong swelling.

   The main symptoms of gastroenteritis manifest themselves within a day or two after infection. If the patient has severe dizziness and deep fainting, you should immediately seek help from a doctor, as such symptoms indicate the neglect of the disease and the inability of the body to resist the disease. In especially severe cases, there are convulsions in the body.

   Gastroenteritis in children

   Gastroenteritis in children is a common disease, but in severe and advanced cases it can cause death. Gastroenteritis in children can be as a result of dysbacteriosis, influenza, or rotavirus entering the body. Symptoms of gastroenteritis in children are nausea when eating, bloating, colic, sleep disturbance, fever, diarrhea. When the first signs of gastroenteritis occur in a child, it is necessary to take measures to prevent dehydration of the body – give as much water to drink as possible.

   If vomiting does not stop within 24 hours after the discovery of the disease, consult a doctor immediately. If gastroenteritis is detected, the child must follow a diet to normalize the work of the stomach. It includes unsweetened vegetable or fruit purees, baked apples, boiled lean meats, lean soups, and fish. This diet is observed for a week, after which you can return to your usual diet. When treating gastroenteritis in children, it is necessary to exclude the use of dairy products for two weeks.

   Treatment of gastroenteritis

   When the first signs of the disease appear, the patient should refrain from eating for several hours to normalize bowel function. Drink as much liquid as possible – water or light juices without pulp. After the feeling of nausea disappears, you can eat some boiled rice, crackers or a banana. In the treatment of gastroenteritis, antibiotics are not taken. In the presence of severe pain, it is necessary to do a gastric lavage with a weak solution of potassium permanganate or soda.

   Diet for gastroenteritis includes lean boiled fish and meat, lean soups, cereals, vegetables, and as much liquid as possible – water, juices.