Gastroenteritis

Overview

An unpleasant upset

Gastroenteritis is a general term for inflammation and infection of the digestive tract. This unpleasant condition produces such symptoms as chills, fever, loss of appetite, nausea and vomiting, cramps, and mild to severe diarrhea. Electrolytes, particularly sodium, potassium and bicarbonate, are lost along with body fluids, causing an imbalance that can result in life-threatening dehydration in the very young, the very ill, and the elderly.

Detailed Description

Gastroenteritis is an irritation or infection of the digestive tract that can accompany dysentery, typhoid fever, cholera, food poisoning, and "traveler's diarrhea." This condition can be caused by a number of unsavory things, including the following:

• Micro-organisms in contaminated water or food
• Bacteria that invade the lining of the intestine (E. coli and salmonella, for example)
• Viruses that affect the lungs as well as the stomach and intestine
• Intestinal parasites, particularly Giardia lamblia, that live in contaminated water

Gastroenteritis may also result from ingesting chemical toxins or heavy metals found in food and water supplies.

Characteristics of Gastroenteritis

While gastroenteritis can have many causes, the symptoms are similar:

• Fever
• Nausea and vomiting
• Loss of appetite
• Abdominal cramps
• Diarrhea

How Common Is Gastroenteritis?

All ages are susceptible to this disease. Both males and females are equally likely to develop gastroenteritis.

What You Can Expect

Gastroenteritis is usually self-limiting, with recovery in 24 to 36 hours. Persistent and untreated, however, it can cause complications that include severe dehydration and crucial electrolyte losses, which can lead to shock, vascular collapse, and renal failure. Infants, the elderly, and debilitated people are particularly at risk.

Conventional Treatment

Goals of Treatment

Gastroenteritis usually resolves itself within 24 to 36 hours — five days at most. Replacing lost water and electrolytes to avoid dehydration are important at this point. Medication is normally not necessary, although it may be used to help relieve symptoms. If the gastroenteritis is a symptom of a more serious condition, identifying, diagnosing, and treating the condition is critical.

Treatment Overview

Because gastroenteritis typically passes within a few days, avoiding dehydration is usually the main goal of treatment. When trying to replenish lost electrolytes (sodium and potassium), remember that water and soda do not contain these necessary elements. Special electrolyte solutions (such as Gatorade and Pedialyte) are available, and liquids like bouillon and vegetable juices will also do the trick.

Drug Therapy

While in the past doctors have often recommended immediately turning to an antidiarrheal medicine to alleviate this condition, many now recommend letting it run its course. Diarrhea is the body's natural way of ridding itself of toxins, and inhibiting this process may cause prolonged suffering. However, if you would like to stop the problem temporarily for personal reasons (important meetings, travel, or so on), antidiarrheal medicines include Imodium, Kaopectate II, and Lomotil. They are safe to use unless there's a fever, or blood present in the diarrhea.

If symptoms persist for more than five days, or a bacterial or parasitic organism has been identified as the cause, your doctor may prescribe antibiotics. They may include the following:

doxycycline
Principen
Floxin
Noroxin
erythromycin
Buy Ciprofloxacin
Zofran

Appropriate Healthcare Setting

Outpatient care is usually sufficient unless severe dehydration has occurred, in which case hospitalization may be necessary.

Healthcare Professionals Who May Be Involved in Treatment

Unless severe dehydration results in your hospitalization, your primary care provider should be able to treat this condition. Gastroenterologists may be involved in making the diagnosis.

Activity and Diet Restrictions

• Drink plenty of fluids. An electrolyte replenisher or rehydration liquid may be helpful.
• After diarrhea and vomiting stop, drink small amounts of clear liquid such as tea, broth, and flat ginger ale or lemon/lime soda.
• After tolerating liquids for 12 hours, eat small amounts of soft food such as cooked cereal, rice, eggs, custard, baked potato, yogurt, bananas, apple sauce, and toast.
• After tolerating soft food for two or three days, gradually return to a normal diet. However, for several more days, avoid alcohol, spicy foods (that includes pizza!), gravy, raw vegetables and fruits, salad dressing, coffee, and milk.

Quality of Life

You don't want to get sick at home or abroad, so be careful what you eat and drink and observe the rules of safe food preparation and storage. Don't overdo alcohol. Wash your hands after going to the bathroom and before eating. Finally, be aware of any side effects your medications may have.

Considerations for Women

Pregnancy

Some research has shown that ciprofloxacin and metronidazole (antibiotics used to treat gastroenteritis) given in early stages of pregnancy may lead to birth defects. Discuss the use of these drugs with your doctor.

Be sure to keep well hydrated.

Nursing mothers

Metronidazole and ciprofloxacin are excreted in breast milk. If these antibiotics are prescribed, discontinue breast-feeding for approximately 24 hours. Discuss this with your doctor first.

Considerations for Children and Adolescents

Infants are particularly susceptible to dehydration and electrolyte imbalance as a result of gastroenteritis. If your child has severe or persistent vomiting or diarrhea, see your doctor immediately.

Considerations for Older People

Like the young, elderly people are at higher risk for gastric disorders than healthy adults. With age comes decreased effectiveness of the immune system, opening the way for infections like gastroenteritis. Many elderly people don't drink enough water on a daily basis and so risk dehydration, a condition seriously exacerbated by gastroenteritis. An improperly balanced diet and the use of such drugs as aspirin, nonsteroidal anti-inflammatories (NSAIDs), antibiotics, cortisone, and laxatives can cause intestinal problems.

Alternative care

Supplements

Vitamin C: If you are taking it, cut back until you're better. Large doses of vitamin C can cause diarrhea. The triggering dose varies, but if you take more than a 2,000 mg of vitamin C a day, take less or stop taking it until you're better.

Herbs

• Chamomile: Tea made from this herb gently soothes the digestive tract.
• Herbal teas: Tea made with raspberry, blackberry, or blueberry leaves can help treat diarrhea. They contain astringent compounds (tannins) that soothe the digestive tract.

Homeopathy

Homeopathic medicine is based on the idea that some conditions can be cured by administering tiny amounts of drugs or substances that, in a healthy person, would produce symptoms like that of the disease — thereby working with, not against, the body's natural defense systems.

Purchase commercially prepared homeopathic medicines, or visit a professional; do not attempt to mix your own, as many of the substances are dangerous in more than tiny amounts.

In a study of infectious diarrhea, a condition very similar to gastroenteritis, University of Washington researchers compared administering just rehydration fluid versus administering rehydration fluid plus homeopathic medicine. The combination treatment worked better. The medicines included the following: Arsenicum (arsenic), Chamomilla (chamomile), Mercurius (mercury), Sulphur (sulphur), or Podophyllum (mayapple).