Familiar to almost everyone disease of the gastrointestinal tract can be both an independent disease and a symptom of another, more serious pathology, but you help Ametik
What is gastroenteritis, its causes
Gastroenteritis is a very common inflammatory disease of the stomach and intestines. Vomiting, diarrhea, colic, weakness, and sometimes fever are its basic and familiar symptoms.
The causative agents of infectious and parasitic diseases are excreted into the external environment with the feces, often in huge quantities. That’s why earlier epidemics of intestinal infections (cholera, diphtheria, typhoid) spread so quickly and took a huge number of lives. In the human body they enter with contaminated food and water. Therefore, failure to follow basic rules of personal hygiene (careful hand washing after toileting, before eating) and visiting catering establishments that violate sanitary norms greatly increases the chances of encountering gastroenteritis.
Classification of gastroenteritis
Gastroenteritis is divided into two large groups: infectious and non-infectious. Infectious (contagious) gastroenteritis is caused by pathogens – viruses (50-70%), bacteria (15-20%), parasites (10-15%). You can catch such a disease: not washing your hands, using common with the sick person utensils and food, eating unwashed fruits and vegetables. Viral gastroenteritis develops when infected with many types of viruses. Among them, the most common are rota-, noro-, adeno-, and coronavirus infections. They are all treated the same way, so the doctor does not need to distinguish between them. Among the many causative agents of bacterial gastroenteritis, the most common are Salmonella, Campylobacter, Shigella, Escherichia coli, and Clostridium difficile. Lamblia and Cryptosporidium are single-celled parasites that cause, as you can easily guess, parasitic gastroenteritis.
Non-infectious gastroenteritis is less common than infectious gastroenteritis. Inflammation of the stomach and intestines can provoke an improper diet, some medications, chemo- and radiotherapy, microbiological toxins, allergies to food components. Some diseases (AIDS, certain types of cancer, peptic ulcer disease, Crohn’s disease) are also accompanied by gastroenteritis as a symptom, sometimes the main one.
Gastroenteritis can be acute or chronic. Infectious processes are acute; they begin abruptly; symptoms are pronounced; the duration of the disease is relatively short. Non-infectious gastroenteritis can be acute or chronic. Chronic ones last a long time; periods of exacerbation alternate with asymptomatic ones.
The ICD-10 code for gastroenteritis of infectious origin is A00 to A09 depending on the causative agent, non-infectious K50 to K52 depending on the cause.
Gastroenteritis in children
Infectious gastroenteritis is one of the most typical diseases in children. Infected gastroenteritis is most common in babies under five years of age, in children under one year old, and in children under six months of age it is very serious. The immune system being formed, frequent visits to large groups of the same age (kindergartens, schools) and even imperfect hygiene habits (putting everything into their mouth, not always washing their hands) contribute greatly to the rapid spread of intestinal infections among children.
While for an average adult infectious gastroenteritis is usually an unpleasant thing, but not dangerous, for the health of children they are a real threat. In children, diarrhea and vomiting very quickly disrupt the water-electrolyte balance, which can lead to shock, coma, and even death. Today, it is these diseases that take the greatest number of children’s lives. Therefore, parents need to be very careful. If the child against the background of infection is drowsiness, very little urination, hands or feet are cold, the fontanel is sunken, breathing is frequent – it is necessary to seek help as soon as possible.
Symptoms and signs of gastroenteritis
Symptoms of gastroenteritis vary depending on the cause of the disease. Infectious gastroenteritis usually begins suddenly. Vomiting, diarrhea (diarrhea) with or without blood and mucus, intestinal cramps, weakness, fever (moderate or high) are classic signs of an intestinal infection. The disease may also be accompanied by muscle pain and prostration.
Parasitic gastroenteritis is usually manifested by chronic diarrhea, in most cases without blood, with the exception of amebic dysentery. Weakness and weight loss are seen when diarrhea is severe.
Non-infectious gastroenteritis is mainly accompanied by digestive disorders. Their manifestations may be very slight (soft stool, flatulence) or pronounced (severe diarrhea, colic, weakness, weight loss, deterioration of the general condition).
Children, the elderly, and patients with immune disorders may be especially ill. Severe vomiting can cause severe dehydration, leading to severe complications including death. In moderate dehydration, symptoms such as dry mouth, inconsistent urination, and weakness are observed. This degree can be corrected without hospitalization by drinking enough fluids. Alarming signs of severe dehydration (cold extremities, drowsiness, very little or no urination, frequent shallow breathing) require urgent medical attention.
Diagnosis of gastroenteritis
The clinical picture of many types of gastroenteritis is very clear. In order to make a diagnosis, it is sufficient for the doctor to ask the patient about his complaints and conduct a general examination. A palpation of the abdomen reveals bloated bowel loops. The doctor may also listen to the bowel movements. It is usually very active, accompanied by many sounds.
The most important thing is to establish the cause of the disease, as this determines the treatment plan. Therefore, in some cases, the doctor prescribes additional tests. For many infectious diseases, tests have been developed that can detect the causative agent; parasites and bacteria are detected by microscopy or stool cultures.
General and biochemical blood tests are prescribed for patients with severe disease, since in these cases the functioning of internal organs is impaired (for example, the kidneys are affected in gastroenteritis caused by E. coli).
Treatment of gastroenteritis
Gastroenteritis therapy works in two ways:
Eliminates the underlying cause, if possible;
corrects the symptoms and consequences.
There is no specific treatment for viral gastroenteritis. With moderate symptoms, rest and plenty of fluids are all that is needed for a successful recovery. Severe dehydration, lack of fluids and certain electrolytes are corrected by the introduction of intravenous solutions.
Bacterial gastroenteritis requires treatment with antibiotics, parasitic – with antihelminthics. When food intolerance is suspected, it is most important to exclude from the diet foods that may cause the painful condition. If gastroenteritis develops as a side effect of medications, the doctor may try to replace drugs from the current regimen with analogues. In cases where the inflammation is only a symptom, the way to get rid of it is to treat the underlying disease.
They are prescribed only to children over two years of age with watery diarrhea, and only after a fecal occult blood test.
Rehydration drinks are recommended for children and other people at risk for diarrhea and vomiting.
Diet for gastroenteritis
The most important thing in gastroenteritis is to drink. It should be done correctly: often, but a little at a time, small sips. Older children and adults in the acute course of the disease can try to suck ice. Vomiting and diarrhea releases a lot of minerals, especially calcium, sodium, potassium, magnesium. To compensate for the loss is shown to drink mineral water of alkaline composition.
Food intake should be resumed carefully. First try to eat something light: vegetable or chicken broth, oatmeal, banana, rice – all low-salted and without spices. If the vomiting comes back – again take a break without food (at least a few hours), then you can eat again. You will have to give up alcohol, fatty and spicy foods, dairy products, coffee, carbonated drinks. New products are added to the diet little by little, watching how you feel.
When gastroenteritis, provoked by intolerance of food components, the main treatment – diet. It can be very strict, to exclude even trace amounts of a particular food component or recommend reducing the consumption of certain products. It all depends on the diagnosis and the individual course of the disease.
Prevention of gastroenteritis
The best prevention of infectious gastroenteritis is to follow the elementary rules of personal hygiene that everyone is familiar with:
Wash your hands thoroughly after toileting and before eating;
Do not drink raw water, especially from unfamiliar sources and standing water;
avoid suspicious catering establishments;
if there is a sick person at home – give him/her individual dishes, do not share towels with him/her;
disinfect the places of swaddling and diaper changing, if a child is sick;
Travelers are advised to find out in advance about the peculiarities of the local cuisine and avoid potentially dangerous dishes. In the first place, this applies to visiting countries where native cuisine is very different from what you are used to, or where ingredients are used that are not heat-treated. It is better to buy bottled water.
A healthy diet and lifestyle can help prevent chronic gastroenteritis.
Children can be vaccinated against the most common intestinal virus – rotavirus. Ask your pediatrician if a vaccination is needed and for details.
Plenty of drinking is always necessary, and antipyretics are prescribed for fever. Antidiarrheals, such as Imodium, are not always welcome.
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