Gastroenteritis

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Gastroenteritis
Other namesGastro, stomach bug, stomach virus, stomach flu, gastric flu, gastrointestinitis, flu bug
Gastroenteritis viruses.jpg
Gastroenteritis viruses: A = rotavirus, B = adenovirus, C = norovirus and D = astrovirus. The virus particles are shown at the same magnification to allow size comparison.
Specialty Infectious disease, gastroenterology
Symptoms Diarrhea, vomiting, abdominal pain, fever [1] [2]
Complications Dehydration [2] [3]
Causes Viruses, bacteria, parasites, fungus [2] [4]
Diagnostic method Based on symptoms, occasionally stool culture [2]
Differential diagnosis Inflammatory bowel disease, malabsorption syndrome, lactose intolerance [5]
Prevention Hand washing, drinking clean water, proper disposal of human waste, breastfeeding [2]
Treatment Oral rehydration solution (combination of water, salts, and sugar), intravenous fluids [2]
Frequency2.4 billion (2015) [6]
Deaths1.3 million (2015) [7]

Gastroenteritis, also known as infectious diarrhea, is an inflammation of the gastrointestinal tract including the stomach and intestine. [8] Symptoms may include diarrhea, vomiting, and abdominal pain. [1] Fever, lack of energy, and dehydration may also occur. [2] [3] This typically lasts less than two weeks. [8] Although it is not related to influenza, in the U.S. and U.K., it is sometimes called the "stomach flu". [9]

Contents

Gastroenteritis is usually caused by viruses; [4] however, gut bacteria, parasites, and fungi can also cause gastroenteritis. [2] [4] In children, rotavirus is the most common cause of severe disease. [10] In adults, norovirus and Campylobacter are common causes. [11] [12] Eating improperly prepared food, drinking contaminated water or close contact with a person who is infected can spread the disease. [2] Treatment is generally the same with or without a definitive diagnosis, so testing to confirm is usually not needed. [2]

For young children in impoverished countries, prevention includes hand washing with soap, drinking clean water, breastfeeding babies instead of using formula, [2] and proper disposal of human waste. The rotavirus vaccine is recommended as a prevention for children. [2] [10] Treatment involves getting enough fluids. [2] For mild or moderate cases, this can typically be achieved by drinking oral rehydration solution (a combination of water, salts and sugar). [2] In those who are breastfed, continued breastfeeding is recommended. [2] For more severe cases, intravenous fluids may be needed. [2] Fluids may also be given by a nasogastric tube. [13] Zinc supplementation is recommended in children. [2] Antibiotics are generally not needed. [14] However, antibiotics are recommended for young children with a fever and bloody diarrhea. [1]

In 2015, there were two billion cases of gastroenteritis, resulting in 1.3 million deaths globally. [6] [7] Children and those in the developing world are affected the most. [15] In 2011, there were about 1.7 billion cases, resulting in about 700,000 deaths of children under the age of five. [16] In the developing world, children less than two years of age frequently get six or more infections a year. [17] It is less common in adults, partly due to the development of immunity. [18]

Signs and symptoms

Bristol stool chart BristolStoolChart.png
Bristol stool chart

Gastroenteritis usually involves both diarrhea and vomiting. [18] Sometimes, only one or the other is present. [1] This may be accompanied by abdominal cramps. [1] Signs and symptoms usually begin 12–72 hours after contracting the infectious agent. [15] If due to a virus, the condition usually resolves within one week. [18] Some viral infections also involve fever, fatigue, headache and muscle pain. [18] If the stool is bloody, the cause is less likely to be viral [18] and more likely to be bacterial. [19] Some bacterial infections cause severe abdominal pain and may persist for several weeks. [19]

Children infected with rotavirus usually make a full recovery within three to eight days. [20] However, in poor countries treatment for severe infections is often out of reach and persistent diarrhea is common. [21] Dehydration is a common complication of diarrhea. [22] Severe dehydration in children may be recognized if the skin color and position returns slowly when pressed. [23] This is called "prolonged capillary refill" and "poor skin turgor". [23] Abnormal breathing is another sign of severe dehydration. [23] Repeat infections are typically seen in areas with poor sanitation, and malnutrition. [15] Stunted growth and long-term cognitive delays can result. [17]

Reactive arthritis occurs in 1% of people following infections with Campylobacter species. [19] Guillain–Barré syndrome occurs in 0.1%. [19] Hemolytic uremic syndrome (HUS) may occur due to infection with Shiga toxin-producing Escherichia coli or Shigella species. [24] HUS causes low platelet counts, poor kidney function, and low red blood cell count (due to their breakdown). [24] Children are more predisposed to getting HUS than adults. [17] Some viral infections may produce benign infantile seizures. [1]

Cause

Viruses (particularly rotavirus (in children) and norovirus (in adults)) and the bacteria Escherichia coli and Campylobacter species are the primary causes of gastroenteritis. [15] [25] There are, however, many other infectious agents that can cause this syndrome including parasites and fungus. [17] [4] Non-infectious causes are seen on occasion, but they are less likely than a viral or bacterial cause. [1] Risk of infection is higher in children due to their lack of immunity. [1] Children are also at higher risk because they are less likely to practice good hygiene habits. [1] Children living in areas without easy access to water and soap are especially vulnerable. [1]

Viral

Rotaviruses, noroviruses, adenoviruses, and astroviruses are known to cause viral gastroenteritis. [26] Rotavirus is the most common cause of gastroenteritis in children, [25] and produces similar rates in both the developed and developing world. [20] Viruses cause about 70% of episodes of infectious diarrhea in the pediatric age group. [13] Rotavirus is a less common cause in adults due to acquired immunity. [27] Norovirus is the cause in about 18% of all cases. [28] Generally speaking, viral gastroenteritis accounts for 21–40% of the cases of infectious diarrhea in developed countries. [29]

Norovirus is the leading cause of gastroenteritis among adults in America accounting for about 90% of viral gastroenteritis outbreaks. [18] These localized epidemics typically occur when groups of people spend time proximate to each other, such as on cruise ships, [18] in hospitals, or in restaurants. [1] People may remain infectious even after their diarrhea has ended. [18] Norovirus is the cause of about 10% of cases in children. [1]

Bacterial

Salmonella enterica serovar Typhimurium (ATCC 14028) as seen with a microscope at 1000 fold magnification and following Gram staining Salmonella Typhimurium Gram.jpg
Salmonella enterica serovar Typhimurium (ATCC 14028) as seen with a microscope at 1000 fold magnification and following Gram staining

In some countries, Campylobacter jejuni is the primary cause of bacterial gastroenteritis, with half of these cases associated with exposure to poultry. [19] In children, bacteria are the cause in about 15% of cases, with the most common types being Escherichia coli , Salmonella , Shigella , and Campylobacter species. [13] If food becomes contaminated with bacteria and remains at room temperature for several hours, the bacteria multiply and increase the risk of infection in those who consume the food. [17] Some foods commonly associated with illness include raw or undercooked meat, poultry, seafood, and eggs; raw sprouts; unpasteurized milk and soft cheeses; and fruit and vegetable juices. [30] In the developing world, especially sub-Saharan Africa and Asia, cholera is a common cause of gastroenteritis. This infection is usually transmitted by contaminated water or food. [31]

Toxigenic Clostridioides difficile is an important cause of diarrhea that occurs more often in the elderly. [17] Infants can carry these bacteria without developing symptoms. [17] It is a common cause of diarrhea in those who are hospitalized and is frequently associated with antibiotic use. [32] Staphylococcus aureus infectious diarrhea may also occur in those who have used antibiotics. [33] Acute "traveler's diarrhea" is usually a type of bacterial gastroenteritis, while the persistent form is usually parasitic. [34] Acid-suppressing medication appears to increase the risk of significant infection after exposure to several organisms, including Clostridioides difficile, Salmonella, and Campylobacter species. [35] The risk is greater in those taking proton pump inhibitors than with H2 antagonists. [35]

Parasitic

A number of parasites can cause gastroenteritis. [13] Giardia lamblia is most common, but Entamoeba histolytica , Cryptosporidium spp., and other species have also been implicated. [13] [34] As a group, these agents comprise about 10% of cases in children. [24] [34] Giardia occurs more commonly in the developing world, but this type of illness can occur nearly everywhere. [36] It occurs more commonly in persons who have traveled to areas with high prevalence, children who attend day care, men who have sex with men, and following disasters. [36]

Transmission

Transmission may occur from drinking contaminated water or when people share personal objects. [15] Water quality typically worsens during the rainy season and outbreaks are more common at this time. [15] In areas with four seasons, infections are more common in the winter. [17] Worldwide, bottle-feeding of babies with improperly sanitized bottles is a significant cause. [15] Transmission rates are also related to poor hygiene, (especially among children), [18] in crowded households, [37] and in those with poor nutritional status. [17] Adults who have developed immunities might still carry certain organisms without exhibiting symptoms. [17] Thus, adults can become natural reservoirs of certain diseases. [17] While some agents (such as Shigella) only occur in primates, others (such as Giardia) may occur in a wide variety of animals. [17]

Non-infectious

There are a number of non-infectious causes of inflammation of the gastrointestinal tract. [1] Some of the more common include medications (like NSAIDs), certain foods such as lactose (in those who are intolerant), and gluten (in those with celiac disease). Crohn's disease is also a non-infectious cause of (often severe) gastroenteritis. [1] Disease secondary to toxins may also occur. Some food-related conditions associated with nausea, vomiting, and diarrhea include: ciguatera poisoning due to consumption of contaminated predatory fish, scombroid associated with the consumption of certain types of spoiled fish, tetrodotoxin poisoning from the consumption of puffer fish among others, and botulism typically due to improperly preserved food. [38]

In the United States, rates of emergency department use for noninfectious gastroenteritis dropped 30% from 2006 until 2011. Of the twenty most common conditions seen in the emergency department, rates of noninfectious gastroenteritis had the largest decrease in visits in that time period. [39]

Pathophysiology

Gastroenteritis is defined as vomiting or diarrhea due to inflammation of the small or large bowel, often due to infection. [17] The changes in the small bowel are typically noninflammatory, while the ones in the large bowel are inflammatory. [17] The number of pathogens required to cause an infection varies from as few as one (for Cryptosporidium) to as many as 108 (for Vibrio cholerae). [17]

Diagnosis

Gastroenteritis is typically diagnosed clinically, based on a person's signs and symptoms. [18] Determining the exact cause is usually not needed as it does not alter the management of the condition. [15]

However, stool cultures should be performed in those with blood in the stool, those who might have been exposed to food poisoning, and those who have recently traveled to the developing world. [13] It may also be appropriate in children younger than 5, old people, and those with poor immune function. [40] Diagnostic testing may also be done for surveillance. [18] As hypoglycemia occurs in approximately 10% of infants and young children, measuring serum glucose in this population is recommended. [23] Electrolytes and kidney function should also be checked when there is a concern about severe dehydration. [13]

Dehydration

A determination of whether or not the person has dehydration is an important part of the assessment, with dehydration typically divided into mild (3–5%), moderate (6–9%), and severe (≥10%) cases. [1] In children, the most accurate signs of moderate or severe dehydration are a prolonged capillary refill, poor skin turgor, and abnormal breathing. [23] [41] Other useful findings (when used in combination) include sunken eyes, decreased activity, a lack of tears, and a dry mouth. [1] A normal urinary output and oral fluid intake is reassuring. [23] Laboratory testing is of little clinical benefit in determining the degree of dehydration. [1] Thus the use of urine testing or ultrasounds is generally not needed. [42]

Differential diagnosis

Other potential causes of signs and symptoms that mimic those seen in gastroenteritis that need to be ruled out include appendicitis, volvulus, inflammatory bowel disease, urinary tract infections, and diabetes mellitus. [13] Pancreatic insufficiency, short bowel syndrome, Whipple's disease, coeliac disease, and laxative abuse should also be considered. [43] The differential diagnosis can be complicated somewhat if the person exhibits only vomiting or diarrhea (rather than both). [1]

Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases. [1] This is in contrast to the large amount of diarrhea that is typical of gastroenteritis. [1] Infections of the lungs or urinary tract in children may also cause vomiting or diarrhea. [1] Classical diabetic ketoacidosis (DKA) presents with abdominal pain, nausea, and vomiting, but without diarrhea. [1] One study found that 17% of children with DKA were initially diagnosed as having gastroenteritis. [1]

Prevention

Percentage of rotavirus tests with positive results, by surveillance week, United States, July 2000 - June 2009 RotavirusV2009.gif
Percentage of rotavirus tests with positive results, by surveillance week, United States, July 2000 – June 2009

Water, sanitation, hygiene

A supply of easily accessible uncontaminated water and good sanitation practices are important for reducing rates of infection and clinically significant gastroenteritis. [17] Personal hygiene measures (such as hand washing with soap) have been found to decrease rates of gastroenteritis in both the developing and developed world by as much as 30%. [23] Alcohol-based gels may also be effective. [23] Food or drink that is thought to be contaminated should be avoided. [44] Breastfeeding is important, especially in places with poor hygiene, as is improvement of hygiene generally. [15] Breast milk reduces both the frequency of infections and their duration. [1]

Vaccination

Due to both its effectiveness and safety, in 2009 the World Health Organization recommended that the rotavirus vaccine be offered to all children globally. [25] [45] Two commercial rotavirus vaccines exist and several more are in development. [45] In Africa and Asia these vaccines reduced severe disease among infants [45] and countries that have put in place national immunization programs have seen a decline in the rates and severity of disease. [46] [47] This vaccine may also prevent illness in non-vaccinated children by reducing the number of circulating infections. [48] Since 2000, the implementation of a rotavirus vaccination program in the United States has substantially decreased the number of cases of diarrhea by as much as 80 percent. [49] [50] [51] The first dose of vaccine should be given to infants between 6 and 15 weeks of age. [25] The oral cholera vaccine has been found to be 50–60% effective over two years. [52]

There are a number of vaccines against gastroenteritis in development. For example, vaccines against Shigella and enterotoxigenic Escherichia coli (ETEC), which are two of the leading bacterial causes of gastroenteritis worldwide. [53] [54]

Management

Gastroenteritis is usually an acute and self-limiting disease that does not require medication. [22] The preferred treatment in those with mild to moderate dehydration is oral rehydration therapy (ORT). [24] For children at risk of dehydration from vomiting, taking a single dose of the anti vomiting medication metoclopramide or ondansetron, may be helpful, [55] and butylscopolamine is useful in treating abdominal pain. [56]

Rehydration

The primary treatment of gastroenteritis in both children and adults is rehydration. This is preferably achieved by drinking rehydration solution, although intravenous delivery may be required if there is a decreased level of consciousness or if dehydration is severe. [57] [58] Drinking replacement therapy products made with complex carbohydrates (i.e. those made from wheat or rice) may be superior to those based on simple sugars. [59] Drinks especially high in simple sugars, such as soft drinks and fruit juices, are not recommended in children under five years of age as they may increase diarrhea. [22] Plain water may be used if more specific ORT preparations are unavailable or the person is not willing to drink them. [22] A nasogastric tube can be used in young children to administer fluids if warranted. [13] In those who require intravenous fluids, one to four hours' worth is often sufficient. [60]

Dietary

It is recommended that breast-fed infants continue to be nursed in the usual fashion, and that formula-fed infants continue their formula immediately after rehydration with ORT. [61] Lactose-free or lactose-reduced formulas usually are not necessary. [61] Children should continue their usual diet during episodes of diarrhea with the exception that foods high in simple sugars should be avoided. [61] The BRAT diet (bananas, rice, applesauce, toast and tea) is no longer recommended, as it contains insufficient nutrients and has no benefit over normal feeding. [61]

A Cochrane Review from 2020 concludes that probiotics make little or no difference to people who have diarrhea lasting 2 days or longer and that there is no proof that they reduce its duration. [62] They may be useful in preventing and treating antibiotic associated diarrhea. [63] Fermented milk products (such as yogurt) are similarly beneficial. [64] Zinc supplementation appears to be effective in both treating and preventing diarrhea among children in the developing world. [65]

Antiemetics

Antiemetic medications may be helpful for treating vomiting in children. Ondansetron has some utility, with a single dose being associated with less need for intravenous fluids, fewer hospitalizations, and decreased vomiting. [55] [66] [67] [68] Metoclopramide might also be helpful. [68] However, the use of ondansetron might possibly be linked to an increased rate of return to hospital in children. [69] The intravenous preparation of ondansetron may be given orally if clinical judgment warrants. [70] Dimenhydrinate, while reducing vomiting, does not appear to have a significant clinical benefit. [1]

Antibiotics

Antibiotics are not usually used for gastroenteritis, although they are sometimes recommended if symptoms are particularly severe [71] or if a susceptible bacterial cause is isolated or suspected. [72] If antibiotics are to be employed, a macrolide (such as azithromycin) is preferred over a fluoroquinolone due to higher rates of resistance to the latter. [19] Pseudomembranous colitis, usually caused by antibiotic use, is managed by discontinuing the causative agent and treating it with either metronidazole or vancomycin. [73] Bacteria and protozoans that are amenable to treatment include Shigella [74] Salmonella typhi , [75] and Giardia species. [36] In those with Giardia species or Entamoeba histolytica, tinidazole treatment is recommended and superior to metronidazole. [36] [76] The World Health Organization (WHO) recommends the use of antibiotics in young children who have both bloody diarrhea and fever. [1]

Antimotility agents

Antimotility medication has a theoretical risk of causing complications, and although clinical experience has shown this to be unlikely, [43] these drugs are discouraged in people with bloody diarrhea or diarrhea that is complicated by fever. [77] Loperamide, an opioid analogue, is commonly used for the symptomatic treatment of diarrhea. [78] Loperamide is not recommended in children, however, as it may cross the immature blood–brain barrier and cause toxicity. Bismuth subsalicylate, an insoluble complex of trivalent bismuth and salicylate, can be used in mild to moderate cases, [43] but salicylate toxicity is theoretically possible. [1]

Epidemiology

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Deaths due to diarrhoeal diseases per million persons in 2012
  0–2
  3–10
  11–18
  19–30
  31–46
  47–80
  81–221
  222–450
  451–606
  607–1799
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Disability-adjusted life year for diarrhea per 100,000 inhabitants in 2004

It is estimated that there were two billion cases of gastroenteritis that resulted in 1.3 million deaths globally in 2015. [6] [7] Children and those in the developing world are most commonly affected. [15] As of 2011, in those younger than five, there were about 1.7 billion cases resulting in 0.7 million deaths, [16] with most of these occurring in the world's poorest nations. [17] More than 450,000 of these fatalities are due to rotavirus in children under five years of age. [10] [79] Cholera causes about three to five million cases of disease and kills approximately 100,000 people yearly. [31] In the developing world, children less than two years of age frequently get six or more infections a year that result in significant gastroenteritis. [17] It is less common in adults, partly due to the development of acquired immunity. [18]

In 1980, gastroenteritis from all causes caused 4.6 million deaths in children, with the majority occurring in the developing world. [73] Death rates were reduced significantly (to approximately 1.5 million deaths annually) by 2000, largely due to the introduction and widespread use of oral rehydration therapy. [80] In the US, infections causing gastroenteritis are the second most common infection (after the common cold), and they result in between 200 and 375 million cases of acute diarrhea [17] [18] and approximately ten thousand deaths annually, [17] with 150 to 300 of these deaths in children less than five years of age. [1]

Society and culture

Gastroenteritis is associated with many colloquial names, including "Montezuma's revenge", "Delhi belly", "la turista", and "back door sprint", among others. [17] It has played a role in many military campaigns and is believed to be the origin of the term "no guts no glory". [17]

Gastroenteritis is the main reason for 3.7 million visits to physicians a year in the United States [1] and 3 million visits in France. [81] In the United States gastroenteritis as a whole is believed to result in costs of US$23 billion per year, [82] with rotavirus alone resulting in estimated costs of US$1 billion a year. [1]

Terminology

The first usage of "gastroenteritis" was in 1825. [83] Before this time it was commonly known as typhoid fever or "cholera morbus", among others, or less specifically as "griping of the guts", "surfeit", "flux", "colic", "bowel complaint", or any one of several other archaic names for acute diarrhea. [84] Cholera morbus is a historical term that was used to refer to gastroenteritis rather than specifically cholera. [85]

Other animals

Many of the same agents cause gastroenteritis in cats and dogs as in humans. The most common organisms are Campylobacter, Clostridioides difficile, Clostridium perfringens, and Salmonella. [86] A large number of toxic plants may also cause symptoms. [87]

Some agents are more specific to a certain species. Transmissible gastroenteritis coronavirus (TGEV) occurs in pigs resulting in vomiting, diarrhea, and dehydration. [88] It is believed to be introduced to pigs by wild birds and there is no specific treatment available. [89] It is not transmissible to humans. [90]

See also

Related Research Articles

<span class="mw-page-title-main">Diarrhea</span> Loose or liquid bowel movements

Diarrhea, also spelled diarrhoea or diarrhœa, is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.

<i>Campylobacter</i> Genus of gram-negative bacteria

Campylobacter is a type of bacteria that can cause a diarrheal disease in people. Its name means "curved bacteria", as the germ typically appears in a comma or "s" shape. According to its scientific classification, it is a genus of gram-negative bacteria that is motile.

<i>Rotavirus</i> Specific genus of RNA viruses

Rotaviruses are the most common cause of diarrhoeal disease among infants and young children. Nearly every child in the world is infected with a rotavirus at least once by the age of five. Immunity develops with each infection, so subsequent infections are less severe. Adults are rarely affected. Rotavirus is a genus of double-stranded RNA viruses in the family Reoviridae. There are nine species of the genus, referred to as A, B, C, D, F, G, H, I and J. Rotavirus A is the most common species, and these rotaviruses cause more than 90% of rotavirus infections in humans.

<span class="mw-page-title-main">Norovirus</span> Type of viruses that cause gastroenteritis

Norovirus, also known as Norwalk virus and sometimes referred to as the winter vomiting disease, is the most common cause of gastroenteritis. Infection is characterized by non-bloody diarrhea, vomiting, and stomach pain. Fever or headaches may also occur. Symptoms usually develop 12 to 48 hours after being exposed, and recovery typically occurs within one to three days. Complications are uncommon, but may include dehydration, especially in the young, the old, and those with other health problems.

<span class="mw-page-title-main">Enteritis</span> Inflammation of the small intestine

Enteritis is inflammation of the small intestine. It is most commonly caused by food or drink contaminated with pathogenic microbes, such as Serratia, but may have other causes such as NSAIDs, radiation therapy as well as autoimmune conditions like coeliac disease. Symptoms include abdominal pain, cramping, diarrhoea, dehydration, and fever. Related diseases of the gastrointestinal system involve inflammation of the stomach and large intestine.

<i>Campylobacter jejuni</i> Species of bacterium

Campylobacter jejuni is a species of pathogenic bacteria that is commonly associated with poultry, and is also often found in animal feces. This species of microbe is one of the most common causes of food poisoning in Europe and in the US, with the vast majority of cases occurring as isolated events rather than mass outbreaks. Active surveillance through the Foodborne Diseases Active Surveillance Network (FoodNet) indicates that about 20 cases are diagnosed each year for each 100,000 people in the US, while many more cases are undiagnosed or unreported; the CDC estimates a total of 1.5 million infections every year. The European Food Safety Authority reported 246,571 cases in 2018, and estimated approximately nine million cases of human campylobacteriosis per year in the European Union. Campylobacter jejuni infections are increasing at an alarming rate in Europe, North America, and Australia. In Africa, Asia, and the Middle East, data indicates that C. jejuni infections are endemic.

<span class="mw-page-title-main">Campylobacteriosis</span> Infection by Campylobacter bacteria

Campylobacteriosis is among the most common infections caused by a bacterium in humans, often as a foodborne illness. It is caused by the Campylobacter bacterium, most commonly C. jejuni. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, and usually cramps, fever and pain.

<span class="mw-page-title-main">Travelers' diarrhea</span> Stomach and intestinal infection

Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool while traveling. It may be accompanied by abdominal cramps, nausea, fever, headache and bloating. Occasionally bloody diarrhea may occur. Most travelers recover within three to four days with little or no treatment. About 12% of people may have symptoms for a week.

<span class="mw-page-title-main">Oral rehydration therapy</span> Type of fluid replacement used to prevent and treat dehydration

Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5. Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.

Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis. It is associated with species of bacteria from the family Enterobacteriaceae. The term is usually restricted to Shigella infections.

<span class="mw-page-title-main">BRAT diet</span> Diet for patients with gastrointestinal distress

The BRAT diet is a restrictive diet that was once recommended for people, particularly children, with gastrointestinal distress like vomiting, diarrhea, or gastroenteritis. Evidence, however, does not support a benefit. As of the 21st century, it is no longer recommended, as it is unnecessarily restrictive. The diet was first discussed in 1926.

Enterocolitis is an inflammation of the digestive tract, involving enteritis of the small intestine and colitis of the colon. It may be caused by various infections, with bacteria, viruses, fungi, parasites, or other causes. Common clinical manifestations of enterocolitis are frequent diarrheal defecations, with or without nausea, vomiting, abdominal pain, fever, chills, and alteration of general condition. General manifestations are given by the dissemination of the infectious agent or its toxins throughout the body, or – most frequently – by significant losses of water and minerals, the consequence of diarrhea and vomiting.

Enterotoxigenic Escherichia coli (ETEC) is a type of Escherichia coli and one of the leading bacterial causes of diarrhea in the developing world, as well as the most common cause of travelers' diarrhea. Insufficient data exists, but conservative estimates suggest that each year, about 157,000 deaths occur, mostly in children, from ETEC. A number of pathogenic isolates are termed ETEC, but the main hallmarks of this type of bacterium are expression of one or more enterotoxins and presence of fimbriae used for attachment to host intestinal cells. The bacterium was identified by the Bradley Sack lab in Kolkata in 1968.

<span class="mw-page-title-main">Adenovirus infection</span> Medical condition

Adenovirus infection is a contagious viral disease, caused by adenoviruses, commonly resulting in a respiratory tract infection. Typical symptoms range from those of a common cold, such as nasal congestion, coryza and cough, to difficulty breathing as in pneumonia. Other general symptoms include fever, fatigue, muscle aches, headache, abdominal pain and swollen neck glands. Onset is usually two to fourteen days after exposure to the virus. A mild eye infection may occur on its own, combined with a sore throat and fever, or as a more severe adenoviral keratoconjunctivitis with a painful red eye, intolerance to light and discharge. Very young children may just have an earache. Adenovirus infection can present as a gastroenteritis with vomiting, diarrhoea and abdominal pain, with or without respiratory symptoms. However, some people have no symptoms.

<span class="mw-page-title-main">Sapovirus</span> Genus of viruses

Sapovirus is a genetically diverse genus of single-stranded positive-sense RNA, non-enveloped viruses within the family Caliciviridae. Together with norovirus, sapoviruses are the most common cause of acute gastroenteritis in humans and animals. It is a monotypic taxon containing only one species, the Sapporo virus.

The rotavirus vaccine is a vaccine used to protect against rotavirus infections, which are the leading cause of severe diarrhea among young children. The vaccines prevent 15–34% of severe diarrhea in the developing world and 37–96% of the risk of death among young children due to severe diarrhea. Immunizing babies decreases rates of disease among older people and those who have not been immunized.

Gastroenterocolitis is a condition characterized by inflammation of the stomach, small intestines, and colon.

Chronic diarrheaof infancy, also called toddler's diarrhea, is a common condition typically affecting up to 1.7 billion children between ages 6–30 months worldwide every year, usually resolving by age 4. According to the World Health Organization (WHO), diarrheal disease is the second greatest cause of death in children 5 years and younger. Diarrheal disease takes the lives of 525,000 or more children per year. Diarrhea is characterized as the condition of passing of three or more loose or watery bowel movements within a day sometimes with undigested food visible. Diarrhea is separated into three clinical categories; acute diarrhea may last multiple hours or days, acute bloody diarrhea, also known as dysentery, and finally, chronic or persistent diarrhea which lasts 2–4 weeks or more. There is normal growth with no evidence of malnutrition in the child experiencing persistent diarrhea. In chronic diarrhea there is no evidence of blood in the stool and there is no sign of infection. The condition may be related to irritable bowel syndrome. There are various tests that can be performed to rule out other causes of diarrhea that don't fall under the chronic criteria, including blood test, colonoscopy, and even genetic testing. Most acute or severe cases of diarrhea have treatment guidelines revolving around prescription or non prescription medications based on the cause, but the treatment protocols for chronic diarrhea focus on replenishing the body with lost fluids and electrolytes, because there typically isn't a treatable cause.

Probiotics are live microorganisms promoted with claims that they provide health benefits when consumed, generally by improving or restoring the gut flora. Probiotics are considered generally safe to consume, but may cause bacteria-host interactions and unwanted side effects in rare cases. There is little evidence that probiotics bring the health benefits claimed for them.

Human adenovirus 41(HAdV-F41), is an enteric Adenovirus, a nonenveloped virus with an icosahedral nucleocapsid containing a double-stranded DNA genome.

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