Monday, July 23, 2012

What Is Gastroenteritis? What Is Food Poisoning?

Gastroenteritis means irritation and inflammation of the gastrointestinal tract, which includes the stomach and small and large intestines. The condition is usually due to bacteria, food poisoning, parasites, or viruses, and it often results in diarrhea, abdominal pain, nausea, and vomiting. Gastroenteritis is commonly called gastric flu or stomach flu although it has no relation to the influenza virus.

What is the difference between gastroenteritis and food poisoning?

Specifically, gastroenteritis refers to infection/inflammation of the mucous membrane of the digestive tract, while food poisoning refers to a type of bacterial gastroenteritis that was caused by something the patient ate. Food poisoning can also refer to chemical food poisoning, as might happen if you ate a poisonous mushroom. In broad terms, gastroenteritis describes what the patient has, while food poisoning describes how the patient got it.

According to Medilexicon's medical dictionary, gastroenteritis is the "Inflammation of the mucous membrane of both stomach and intestine" , while food poisoning is "poisoning in which the active agent is contained in ingested food".

What causes gastroenteritis?

Gastroenteritis is caused by several factors, and viruses and bacteria are the most common. Viral causes, which account for about 35% of cases in children, include adenovirus, rotavirus (a leading cause in children), calicivirus, parvovirus, astrovirus, and norovirus (a leading cause in adults). Viral gastroenteritis is usually brought about by poor hand washing habits or close contact with an infected person.

Bacterial causes of gastroenteritis include E. Coli (from traveler's diarrhea, food poisoning, dysentery, colitis, or uremic syndrome), Salmonella (from typhoid or improperly handling poultry or reptiles), Campylobacter (from undercooked meat or unpasteurized milk), and Shigella (from dysentery). A study found that 10% of children's diarrhea cases are caused by E. Coli.

Additional causes of gastroenteritis arise from parasites or protozoans such as Giardia and Cryptosporidium, chemical toxins, heavy metals such as arsenic, lead, and mercury, and medications such as antibiotics, aspirin, caffeine, steroids, and laxatives. Lactose intolerance - the inability to digest the milk sugar lactose - is also a common cause of gastroenteritis.

Who gets gastroenteritis?

Although gastroenteritis occurs all over the world and affects every age group and race, some people are more likely to develop the condition that others. For example, very young children in day care centers and older adults in nursing home are more vulnerable to gastroenteritis. Living conditions, hygiene, and cultural habits are important factors in determining susceptibility to the disease. Gastroenteritis is likely to arise anywhere people congregate, such as schools, cruise ships, campgrounds, and dormitories. People who travel throughout the developing world are also likely to develop the condition due to food contamination or a lack of hygiene.

Gastroenteritis is estimated to causes between 5 and 10 million deaths each year around the world.

What are the symptoms of gastroenteritis?

Common symptoms of gastroenteritis include:
  • Low grade fever (100 F)
  • Nausea and/or vomiting
  • Loss of appetite
  • Diarrhea
  • Painful cramps or bloating
  • Headaches
  • Weakness
More serious cases may involve blood in vomit or stool, vomiting for more than two days, very high fever, and swelling in the abdomen. Frequent vomiting and diarrhea will lead to dehydration and a loss of important electrolytes. This may be signaled by little or no urine, extreme thirst, lack of tears, and dry mouth.

How is gastroenteritis diagnosed?

Typically, diarrhea and vomiting are indicative of gastroenteritis, and there are no specific diagnostic tests required for most patients with the condition. A doctor will often take a detailed history concerning medical treatments, diet changes or food preparation habits, and travel destinations in her efforts to find the underlying illness and nature of the pathogen. A physical examination will be employed to be sure that the symptoms are not due to an infection such as appendicitis, gallbladder disease, pancreatitis, diverticulitis, Crohn's disease, ulcerative colitis, or other condition that weakens the immune system.

If fever, bloody stools, or diarrhea is persistent for longer than two weeks, a physician may consider blood and stool tests to determine the source of the symptoms. This may include a complete blood count (CBC), electrolyte tests, kidney function tests, an examination of stool for toxins (like Clostridium difficile toxin), stool cultures for bacteria (such as Salmonella, Shigella, Campylobacter and enterotoxic Escherichia coli), and microscopy for parasites and their ova and cysts.

A study revealed that oral rehydration therapy is as effective as intravenous rehydration therapy for patients with diarrhea.

The National Institute for Health and Clinical Excellence (NICE), UK, and the National Collaborating Centre for Women's and Children's Health, UK, published a clinical guideline on assessing and managing diarrhoea and vomiting caused by gastroenteritis in children under the age of five.

How is gastroenteritis treated?

Since gastroenteritis tends to be a self-limiting and acute (not chronic or long-lasting) disease, it often does not require pharmacological therapy and the body usually is able to fight off the infection. Treatment is focused on rehydrating - replacing replace lost fluids and electrolytes, water and salts that are lost in the stools and vomit. Replenishing fluids is usually accomplished by oral rehydration therapy (ORT) or through intravenous delivery. An interesting study found that Gatorade is as effective as Pedialyte in correcting dehydration and improving bowel symptoms for children with diarrhea and vomiting related to acute viral gastroenteritis.

For severe symptoms or a suspected bacterial cause of the gastroenteritis, a doctor may prescribe antibiotics, fluoroquinolone, or macrolide. Antiemetics (to stop vomiting) may also be prescribed, but antimotility drugs (to stop diarrhea) generally are discouraged, especially in people with bloody diarrhea or diarrhea complicated by a fever.

Elderly residents in aged care with gastroenteritis must be tested as soon as possible to minimise the effects of outbreaks in aged care facilities (ACFs), Australian scientists reported.

How can gastroenteritis be prevented?

To stop infections from spreading, it is recommended that you wash your hands, eat properly washed, cooked, or prepared foods, bleach soiled laundry, and acquire the necessary vaccinations for Salmonella typhi, Vibrio cholera, and rotavirus if traveling to a high risk area. A study showed that pentavalent an oral rotavirus vaccine reduced hospitalisations and accident and emergency (A&E) department visits related to rotavirus gastroenteritis (RVGE) by up to 100%.

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