Also called intestinal flu, traveler’s diarrhea, viral enteritis, and food poisoning, gastroenteritis is a self-limiting disorder characterized by diarrhea, nausea, vomiting, and abdominal cramping. It occurs in all age-groups and is a major cause of morbidity and mortality in underdeveloped nations.
It can also be life-threatening in elderly and debilitated people.
Gastroenteritis has many possible causes, including the following:
❑ bacteria (responsible for acute food poisoning) — Staphylococcus aureus, Salmonella, Shigella, Clostridium botulinum, Escherichia coli, Clostridium perfringens
❑ amoebae — especially Entamoeba histolytica
❑ parasites — Ascaris, Enterobius, Trichinella spiralis
❑ viruses (may be responsible for traveler’s diarrhea) — adenovirus, echovirus, or coxsackievirus
❑ ingestion of toxins — plants or toadstools (mushrooms)
❑ drug reactions — antibiotics
❑ enzyme deficiencies
❑ food allergens.
The bowel reacts to any of these enterotoxins with hypermotility, producing severe diarrhea and secondary depletion of intracellular fluid.
Clinical manifestations vary, depending on the pathologic organism and the level of GI tract involved. Gastroenteritis produces symptoms such as diarrhea, abdominal discomfort (ranging from cramping to pain), nausea, and vomiting. Other possible symptoms include fever, malaise, and borborygmi.
In children and elderly and debilitated people, gastroenteritis produces the same symptoms, but the inability of these patients to tolerate electrolyte and fluid losses leads to a higher mortality.
Patient history can aid diagnosis of gastroenteritis. A stool culture should be obtained. Blood cultures are indicated in febrile patients.
Usually supportive, treatment consists of nutritional support and increased fluid intake.
An episode of acute gastroenteritis is self-limiting. When an episode is severe and produces symptoms for more than 3 or 4 days and the patient is a young child or an elderly or debilitated person, hospitalization may be necessary. Treatment may include fluid and electrolyte replacement, antibiotic therapy, and antiemetics.
❑ Administer medications; correlate dosages, routes, and times appropriately with the patient’s meals and activities — for example, give antiemetics 30 to 60 minutes before meals.
❑ If the patient can’t tolerate food, replace lost fluids and electrolytes with clear liquids and sports-type drinks. Vary his diet to make it more enjoyable, and allow some choice of foods. Instruct the patient to avoid milk and milk products, which may exacerbate the condition.
❑ Record strict intake and output. Watch for signs of dehydration, such as dry skin and mucous membranes, fever, and sunken eyes.
❑ Wash your hands thoroughly after giving care to avoid spread of infection.
❑ Instruct the patient to take warm sitz baths three times per day to relieve anal irritation.
Clinical tip If food poisoning is probable, contact public health authorities to interview patients and food handlers, and take samples of the suspected contaminated food.
❑ Educate regarding good hygiene to prevent recurrence. Instruct patients to thoroughly cook foods, especially pork; to refrigerate perishable foods, such as milk, mayonnaise, potato salad, and cream-filled pastry; and to always wash their hands with warm water and soap before handling food, especially after using the bathroom.
❑ Teach patients to clean utensils thoroughly, to avoid drinking water or eating raw fruit or vegetables when visiting a foreign country, and to eliminate flies and roaches in their homes.
Review other book chapters online related to Salmonella enteritidis:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Handbook of Diseases Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 1-58255-266-5 
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