A B C D E F G H I J K L M N O P R S T U V W

GASTROENTERITIS (ADULTS)

What is Gastroenteritis ?

Gastroenteritis is a very common cause of illness in the Western world. It is usually produced by an infection of the gut. The infection can be due to a virus or a bacterium and the main symptoms are vomiting and diarrhoea. The diarrhoea may be watery or contain blood with mucus. Other symptoms include nausea, shivering, headache, griping abdominal pain, and fever. The cause of the infection is often not very obvious. Gastroenteritis usually does not last for more than a few days. However, longer infections may occur. The infections can usually be managed at home but more severe symptoms, especially in the elderly, may need hospital care. This is because the elderly, or those with other chronic illnesses are more likely to suffer from the effects of dehydration. Diarrhoea can be caused by the direct effect of the virus or bacterium. Some germs, however, produce a chemical (called a toxin) which is the agent causing food poisoning and irritation to the stomach or bowel. The time between catching the infection and getting the first symptoms (the incubation period) varies from an hour (bacteria such as Staphylococcus ) to several days (bacteria such as Campylobacter ).

How does Gastroenteritis occur ?

Agents causing gastroenteritis are usually transmitted through contaminated food or water. Meat, poultry, dairy products, shellfish, parboiled rice are often the culprits. Inadequate re-heating of frozen or chilled foods often allows the organism to flourish. The irritation of the stomach or bowel causes a loss of fluid into the cavity of the bowel. The same irritation causes the muscle in the wall of the gut to contract. This causes vomiting (if mainly affecting the stomach ) or diarrhoea (if mainly affecting the bowel).

Why does Gastroenteritis occur ?

Poor nutrition and certain chronic illnesses make it much more likely for some people to get these infections. There is nothing to suggest a hereditary factor. Poor personal hygiene and food preparation are the biggest problems. The breaking of basic rules leads to most big outbreaks. Frozen food must be thawed completely before cooking (especially meat and poultry). Hot food should be eaten within one hour of cooking and recently cooked food should be cooled before storage (at less than 4 oC) within 90 minutes. Cooked and raw foods should be prepared and stored in different areas and sections of the refrigerator. Hands should be washed before cooking. Traveller's diarrhoea (a form of gastroenteritis) occurs because food is casually chosen; for example, contaminated drinking water is drunk or used to wash uncooked food.

Treatment Involved for Gastroenteritis

A stool sample is usually sent to the laboratory for analysis only if the condition is bad enough to justify hospital admission, or if the problem does not settle within a week. Because dehydration can be a serious problem, it is important that you maintain an adequate fluid intake. This is even more important for the very young and elderly. Fluid should be given often and in small amounts. The best way of correcting dehydration is with a preparation called Dioralyte. This is available on prescription and over the counter at chemists. One sachet of Dioralyte (which is a glucose and mineral mixture) is dissolved in 200 ml of water. In young children, one sachet is given for each kilogram of body weight per 24 hours. An alternative to Dioralyte is flat Coca-cola, which may be more acceptable. If fluids cannot be maintained it may be necessary to be admitted to hospital so that fluids can be given (by drip into a vein). Anti-diarrhoea drugs are not usually given to children but may be given to adults if symptoms are severe. Codeine, kaolin and morphine, and loperamide are often used. Sometimes anti-vomiting and anti-spasm drugs may be given. Antibiotics are only used rarely for severe infections. For traveller's diarrhoea abroad, try to ensure that food and water come from reliable sources, and that food is freshly and thoroughly cooked. Do not eat food bought in the street. Avoid buffets which will have been handled in preparation then displayed at room temperature. When buying drinks, ensure that bottles of water and even cap-top bottles have not been opened and refilled. Always wash fruit in water that has been sterilised with tablets, or peel it.

During Treatment for Gastroenteritis

Gastroenteritis due to most bacterial and virus infections improves in a few days. In some infections, abdominal pain, disturbed bowel habit, and general ill health may continue for 2 - 3 weeks. Hospital admission is occasionally needed if dehydration occurs. Contact the doctor if the diarrhoea or vomiting is uncontrollable. The doctor also needs to know if the treatment is not helping to control the symptoms or if the diarrhoea lasts more than 7 days. Careful personal hygiene is essential to avoid spread of the infection to others in the household.

After Treatment for Gastroenteritis

Most attacks of gastroenteritis do not recur. However, if diarrhoea returns, or if weight loss or pale floating stools occur, then further tests may be needed. Any unusual symptoms not mentioned above are a reason for letting the doctor know immediately.

If Gastroenteritis is Left Untreated

Most attacks of gastroenteritis will get better by themselves with no treatment other than plenty of fluids and rest.

Effects on Family of Gastroenteritis

The main concern should be to avoid any spread of the infection. Hygiene is all-important for them as well. If they prepare food, it is their responsibility to be sure that the basic rules of safe food preparation are followed.