Gastroenteritis, also commonly referred to as the stomach flu or gastric flu, is an inflammation of the gastrointestinal tract (primarily the stomach and intestines) resulting in diarrhea, vomiting, abdominal cramps and even fever in certain cases. Common causes of gastroenteritis include parasitic, bacterial and viral infections. Gastroenteritis can also result from non-infectious causes such as food allergies or toxins.
Gastroenteritis occurs when your immune system becomes active to protect your stomach and intestines from potential harm, sending inflammatory cells to combat infections and repair damaged tissues. Typically, this response is temporary and aimed at addressing a short-term threat or injury. Prolonged or persistent gastroenteritis is uncommon.
Types of gastroenteritis
Gastroenteritis can be caused by a variety of things but the most common culprits are viruses, bacteria and parasites. Here are the main types of gastroenteritis based on their causes :
1. Viral Gastroenteritis
: Viruses are the most common cause of gastroenteritis. It accounts for about 60% of cases. It's often called the stomach flu even though it's not related to the influenza virus. Common gastroenteritis causing viruses include:
Norovirus : Norovirus stands as one of the predominant causes of viral gastroenteritis, particularly among adults. It spreads easily in densely populated environments like schools, cruise ships, and nursing homes. Contamination of food, water, surfaces, or direct contact with an infected individual can transmit the virus. Symptoms typically manifest within 12 to 48 hours after exposure and include sudden onset of vomiting, diarrhea, stomach cramps, nausea, and occasionally low-grade fever.
Rotavirus : Rotavirus represents a common source of viral gastroenteritis among infants and young children. It is highly contagious and primarily spreads through fecal-oral transmission, often occurring in daycare settings or within families. Typical symptoms encompass severe diarrhea, vomiting, fever, abdominal pain, and dehydration. Routine rotavirus vaccination has substantially decreased the occurrence of rotavirus gastroenteritis in countries where vaccination is prevalent.
Adenovirus : Certain strains of adenovirus, particularly types 40 and 41, can induce gastroenteritis, particularly in young children. Adenovirus-related gastroenteritis usually exhibits symptoms akin to those of other viral gastroenteritis viruses, including diarrhea, vomiting, abdominal pain, and fever.
Astrovirus : Astrovirus stands as another prevalent source of viral gastroenteritis, particularly among young children. Transmission occurs through the fecal-oral route, leading to symptoms such as diarrhea, vomiting, abdominal pain, and occasionally fever.
Sapovirus : Like norovirus, Sapovirus belongs to the Caliciviridae family and is capable of inducing gastroenteritis, primarily affecting both children and adults. It spreads through contaminated food, water, or direct contact with an infected individual, resulting in symptoms such as diarrhea, vomiting, abdominal pain, and occasionally fever.
Viral gastroenteritis caused by norovirus and rotavirus is also linked with a considerable mortality rate if not managed appropriately.
2. Bacterial Gastroenteritis
: Bacteria ingested through contaminated food or water can also cause gastroenteritis. While Bacterial Gastroenteritis is less common than viral gastroenteritis, it can be more serious. Bacterial gastroenteritis is responsible for about 10 to 20% of all infectious gastroenteritis cases. Bacterial gastroenteritis is more common during the summer season and rainy season
Common bacterial causes of gastroenteritis include:
Salmonella : Salmonella bacteria are a prevalent source of foodborne illness. Typically, they spread through contaminated poultry, eggs, meat, dairy products, and fruits or vegetables tainted by animal waste. Symptoms of Salmonella-induced gastroenteritis encompass diarrhea, abdominal cramps, fever, and occasional vomiting.
Campylobacter : Campylobacter Jejuni ranks among the most widespread bacterial culprits behind gastroenteritis globally. It is commonly found in undercooked poultry, unpasteurized milk, and contaminated water. Symptoms of Campylobacter-induced gastroenteritis include diarrhea (often with blood), abdominal pain, fever, and sometimes vomiting.
Escherichia coli or E. coli : While the majority of E. coli strains are harmless, specific strains, such as E. coli O157:H7, can provoke severe gastrointestinal illness. E. coli O157:H7 is frequently linked with tainted food, such as undercooked ground beef, raw vegetables, unpasteurized milk, and contaminated water. Symptoms of E. coli infection include intense abdominal cramps, diarrhea (often bloody), vomiting, and sometimes fever.
Shigella : Shigella bacteria trigger shigellosis, an infectious ailment marked by diarrhea (often bloody), abdominal cramps, fever, and occasionally vomiting. Typically, Shigella spreads through the fecal-oral route, often due to inadequate hygiene practices or contamination of food and water.
Clostridium perfringens : Clostridium perfringens is a bacterium commonly found in soil and the gastrointestinal tracts of humans and animals. It can generate toxins in food, particularly in large batches of cooked food that remain at room temperature for an extended period before consumption. Symptoms of Clostridium perfringens gastroenteritis include abdominal cramps and diarrhea, typically occurring within 6 to 24 hours after ingesting contaminated food.
Vibrio species : Vibrio bacteria, comprising Vibrio cholerae and Vibrio parahaemolyticus, are linked with seafood-associated gastroenteritis. Vibrio cholerae causes cholera, a severe diarrheal illness, while Vibrio parahaemolyticus can induce gastroenteritis typified by watery diarrhea, abdominal cramps, nausea, vomiting, fever, and chills.
3. Parasitic Gastroenteritis
: Parasites ingested through contaminated water or food can cause gastroenteritis. Common gastroenteritis causing parasites include:
Giardia lamblia : Giardia lamblia is a parasite that infects the small intestine and is a common cause of waterborne gastroenteritis, particularly in regions lacking proper sanitation or with contaminated water sources. Giardiasis, the illness resulting from Giardia infection, typically exhibits symptoms like diarrhea (which may be watery or oily), abdominal cramps, bloating, flatulence, nausea, and weight loss.
Cryptosporidium : Cryptosporidium is a protozoan parasite that can induce cryptosporidiosis, a diarrheal condition. It is often transmitted through tainted water, recreational water sources (such as swimming pools and lakes), or food contaminated by infected individuals. Symptoms of cryptosporidiosis include watery diarrhea, stomach cramps or discomfort, nausea, vomiting, fever, and weight loss. This illness can be particularly severe in individuals with weakened immune systems.
Entamoeba histolytica : Entamoeba histolytica is a protozoan parasite accountable for amoebiasis, an intestinal infection. Transmission usually occurs through ingestion of food or water contaminated with fecal matter containing the parasite. Symptoms of amoebiasis include diarrhea (which may contain blood), abdominal pain, cramping, fever, and weight loss. In severe cases, the parasite can penetrate the intestinal wall, leading to complications such as liver abscesses or systemic dissemination.
Cyclospora cayetanensis : Cyclospora cayetanensis is a protozoan parasite responsible for causing cyclosporiasis, an intestinal infection. Transmission usually happens through the consumption of food or water contaminated with fecal matter containing the parasite. Symptoms of cyclosporiasis encompass watery diarrhea, frequent bowel movements, abdominal cramps, bloating, nausea, fatigue, and weight loss. If untreated, these symptoms can persist for weeks to months.
Trichuris trichiura or Whipworm : Whipworm, also known as Trichuris trichiura, is a soil-transmitted helminth parasite that primarily infects the large intestine. Infection typically occurs following the ingestion of food or water contaminated with soil containing whipworm eggs. Symptoms of whipworm infection may include abdominal pain, diarrhea, bloody stool, anemia, and weight loss.
Gastroenteritis can also be classified based on the duration of illness. Here are the three main types of Gastroenteritis based on the duration:
Acute gastroenteritis : This is the most common type of Gastroenteritis and it lasts less than 2 weeks or 14 days. It's usually caused by a viral or bacterial infection and resolves on its own with minimal to no medical interventions or treatment. Staying hydrated is important for acute gastroenteritis.
Persistent gastroenteritis : his type of gastroenteritis lasts between 2 and 4 weeks or 14 to 30 days. It can be caused by viruses, bacteria or parasites. Persistent gastroenteritis may need medication or other forms of treatments to resolve.
Chronic gastroenteritis : This is the least common type of gastroenteritis and lasts longer than 4 weeks or 30 days. It can be caused by various factors,including infections, autoimmune diseases and inflammatory bowel disease (IBD). Chronic gastroenteritis often requires ongoing medical management and interventions.
What are the signs and symptoms of gastroenteritis?
The signs and symptoms of gastroenteritis can vary depending on the cause and severity of the infection, but common signs of gastroenteritis include:
Diarrhea: Loose or watery stools that may be accompanied by urgency to use the bathroom.
Nausea and Vomiting (especially in the early stages of the illness)
mild to severe abdominal cramps and abdominal pain
Loss of appetite
While these are the core gastro symptoms, gastroenteritis can also come with some additional symptoms including:
Fever: Low grade fever may be present especially in the case of viral or bacterial gastroenteritis
Fatigue (brought on by dehydration): Dehydration is a serious concern especially in young children and elderly individuals. Please be on the lookout for signs of dehydration like dry mouth, dizziness, dark coloured urine and decreased urination.
Chills
Malaise and muscle pain
Headache (brought on by dehydration)
It's important to note that symptoms can vary from person to person and may be more severe in certain groups of the population such as young children, older adults, and individuals with weakened immune systems. In certain cases, particularly if the infection is caused by certain bacteria or parasites, symptoms may persist or worsen over time, requiring medical attention.
If you experience severe or persistent symptoms such as dehydration, bloody stools, high fever or signs of confusion then it's important to seek medical attention promptly.
How often do people get gastroenteritis?
Gastroenteritis, especially viral gastroenteritis, is very common worldwide. Estimates suggest hundreds of millions of people contract gastroenteritis annually. For instance, norovirus, a major culprit, infects millions globally each year. Gastroenteritis is so common that many people experience at least one episode of gastroenteritis during their lifetime. It's difficult to pinpoint an exact frequency of gastroenteritis since many cases go unreported. Several factors make it challenging to get a precise count. A few of the factors include:
Many people experience mild gastroenteritis and don't seek medical attention, so they aren't reported.
For viral gastroenteritis, specific tests aren't always performed, leading to underdiagnosis.
Certain groups are more prone to getting gastroenteritis, such as young children, older adults, and people traveling to areas with poor sanitation. These factors can contribute to a higher frequency within these populations.
How is gastroenteritis diagnosed?
Your doctor or gastroenterologist will likely conduct a physical exam and ask you detailed questions about your medical history and symptoms including:
The types and severity of symptoms such as diarrhea, vomiting and cramps
How long you've been experiencing symptoms
Any recent travel or potential exposure to contaminated food or water
Underlying medical conditions
The physical exam can help look for signs of dehydration, abdominal tenderness and other symptoms.
Diagnostic Tests:
1.Stool Tests : A stool sample may be collected and sent to a laboratory for analysis. This test can help identify the presence of infectious agents such as viruses, parasites or bacteria that could be the cause of gastroenteritis. Stool samples may also be tested for the presence of pathogens, blood or other abnormalities.
Stool tests may not always be required but they may be ordered if:
You have persistent symptoms or if they worsen over time
Your doctor suspects a bacterial or viral gastroenteritis
You have a weakened immune system
Generally, for most uncomplicated cases of viral gastroenteritis, extensive diagnostic testing isn't necessary. Depending on the suspected cause of gastroenteritis and the severity of your symptoms, additional diagnostic tests may be ordered. These diagnostic tests may include:
2. Blood Tests : Blood tests may be performed to assess for signs of dehydration, electrolyte imbalances and other abnormalities.
3. Imaging Studies : In certain cases, imaging studies such as abdominal X-rays, CT scan or ultrasound may be ordered to evaluate the gastrointestinal tract for signs of inflammation, obstruction or other abnormalities.
4. Endoscopy : In case of severe or persistent gastroenteritis, an endoscopy may be performed to directly visualize the lining of your stomach and intestines. Tissue samples of your stomach and intestines may also be procured for further microscopic and laboratorical analysis.
Gastroenteritis symptoms typically overlap with symptoms of other gastrointestinal conditions, such as inflammatory bowel disease (IBD), food allergies or appendicitis. Your doctor or gastroenterologist may consider these alternative diagnoses and perform additional tests if necessary to rule out the other conditions.
Treatment for Gastroenteritis
Treatment of gastroenteritis typically focuses on relieving symptoms, preventing dehydration, and supporting the body's recovery. Here are some common treatment approaches:
Hydration : Preventing dehydration is the primary objective. Oral rehydration solutions (ORS) containing electrolytes and glucose are recommended, as they help replace lost fluids and maintain electrolyte balance. Sipping small amounts of fluid frequently is often more effective than trying to drink large amounts at once.
Dietary modifications : Stick to a bland diet consisting of easily digestible foods such as bananas, rice, idlis, applesauce and toast may help alleviate symptoms. Avoiding spicy, processed or fiber rich foods that may worsen discomfort and symptoms is also advisable.
Over-the-counter medications such as anti diarrheal and Antiemetics may be used to manage specific symptoms of gastroenteritis such as diarrhea and nausea respectively.
Probiotics : Taking probiotics which contain beneficial bacteria may help shorten the duration of gastroenteritis and reduce the severity of symptoms in some cases.
Avoid Certain Substances : Avoid consuming alcohol, caffeine, smoking, sugary food and carbonated drinks
Rest : Getting adequate rest and allowing the body time to recover is important. Avoiding strenuous activities and getting plenty of rest can help conserve energy and support the body's immune response.
Medical Attention : In severe cases of gastroenteritis, especially in infants, young children, elderly people and individuals with weakened immune systems, medical interventions may be necessary. Hospitalization may be required for intravenous fluids and additional supportive care if dehydration is severe or if complications arise.It's important to note that antibiotics are not routinely prescribed for viral gastroenteritis, as antibiotics are ineffective against viruses and may contribute to antibiotic resistance. However, if gastroenteritis is caused by a bacterial infection, such as Salmonella or Campylobacter, antibiotics may be prescribed in certain cases.
Medical Attention : In severe cases of gastroenteritis, especially in infants, young children, elderly people and individuals with weakened immune systems, medical interventions may be necessary. Hospitalization may be required for intravenous fluids and additional supportive care if dehydration is severe or if complications arise.It's important to note that antibiotics are not routinely prescribed for viral gastroenteritis, as antibiotics are ineffective against viruses and may contribute to antibiotic resistance. However, if gastroenteritis is caused by a bacterial infection, such as Salmonella or Campylobacter, antibiotics may be prescribed in certain cases.
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Frequently Asked Questions
Is gastroenteritis contagious?
Yes, gastroenteritis can be highly contagious if it is caused by bacterial, parasitic or viral infections. It can spread through close contact with infected individuals, consumption of contaminated food or water or even contact with contaminated surfaces. It is important to note that the contagiousness of gastroenteritis depends on its cause.
How do you catch gastroenteritis infections?
Gastroenteritis infections can be contracted through various means including:
Person-to-Person Transmission
Direct contact with gastroenteritis causing pathogens
Ingesting contaminated water or food
Environmental Contamination: Gastroenteritis causing pathogens can survive on environmental surfaces for extended periods. Touching contaminated surfaces, such as doorknobs, countertops or objects touched by infected individuals and then touching your eyes, mouth or nose can lead to gastroenteritis.
Fecal-Oral Route: Microscopic particles of fecal matter containing the infectious agent when ingested typically through contaminated food or water can cause gastroenteritis. Poor sanitation and hygiene practices such as inadequate handwashing after using the bathroom can contribute to the spread of gastroenteritis through the fecal-oral route
What are the risk factors for getting gastroenteritis?
There are several risk factors that can increase your chances of contracting gastroenteritis:
Poor Hygiene: Not washing your hands properly before cooking food, after using the restroom or changing diapers can increase your risk of contracting gastroenteritis
Infants and Children are more susceptible to gastroenteritis due to their developing immune systems
Individuals with weakened immune systems due to illness, age, certain medications or medical conditions such as AIDS are more prone to contracting gastroenteritis and experiencing more severe symptoms.
Certain medical conditions such as Cancer, peptic ulcers, kidney disease, inflammatory bowel disease (IBD) and autoimmune diseases can increase your susceptibility to gastroenteritis or worsen the symptoms if you do get it.
Living in crowded conditions can make it easier for infection causing pathogens to spread easily
Close contact with an infected person
Ingesting contaminated food or water
Traveling to areas with poor sanitation
What is the best way to get rid of gastroenteritis?
The treatment for gastroenteritis typically focuses on relieving symptoms, preventing dehydration and allowing the body to recover from the infection. Here are some tips and strategies that can help in managing and recovering from gastroenteritis:
Stay well hydrated
Take Oral Rehydration Solutions (ORS) to replenish electrolytes
Get plenty of rest
Consume bland and easily digestible foods such as bananas, rice, applesauce, toast and boiled potatoes.
Avoid spicy, processed, greasy or fiber rich food that may irritate the digestive system
Take probiotics to restore your gut microbiome: Individuals with weakened immune systems or underlying medical conditions should consult their doctor before taking probiotics
Avoid alcohol, smoking caffeine, sugary foods and carbonated drinks.
Practice Good Hygiene
Take your medications as instructed by your doctor. Antiemetic drugs which help control nausea and vomiting and antidiarrheal medications may provide symptom relief in some cases.
If symptoms are severe, persistent or accompanied by signs of dehydration (such as excessive thirst, dry mouth, dark urine, dizziness or lightheadedness), it is important to seek medical attention promptly.
What is the most common gastrointestinal issue?
The most common gastrointestinal issue varies depending on factors such as age, geographic location and individual health conditions. Some of the most prevalent gastrointestinal issues in the general population worldwide are constipation, diarrhea, heartburn and gastroesophageal reflux disease (GERD).
