Gastroenteritis

GASTROENTRITIS

Gastroenteritis is an acute disease in which there is inflammation of the stomach and the intestines. Food poisoning is a self-limiting form of gastroenteritis. Many types of microorganism can cause gastroenteritis. In more than half the cases, the causative organism cannot be identified. Salmonella and Campylobacter species are the most frequent causes, but in children it is usually the rotavirus.

Gastroenteritis is an infection, which occurs, in all parts of the world. Gastroenteritis can occur sporadically, that is during certain seasons and in certain age groups. For example, rotavirus among children occurs more frequently in temperate countries during the winter seasons. In tropical countries there is little seasonal variation. Gastroenteritis can also occur in epidemic proportions. This means that many people are affected over a definite period of time and usually there is a common source of infection e.g. food or drink. The infection passes from person to person usually by the handling of food or drink by a by a son whose hands are contaminated wit the faeces of an infected person.

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Common Causes of Gastroenteritis
Signs and Symptoms
Signs of dehydration
What You Can Do
In small children and babies
Good Habits To Observe For babies and young children
General Precautions

Common Causes of Gastroenteritis

1.Tissue damaging Bacteria
v Salmonella enteritidis
v Campylobacter jejuni
v Shigella species
v E. coli
2.Toxin-producing bacteria
v E.coli (enterogenic)
v Vibrio cholerae
v Clostridium
v Staphylococcus
v Bacillus cereus
3.Tissue Damaging Virus
v Rotavirus
v Norwalk virus.
v Adenovirus
v Enterovirus
4.Protozoa
v Cryptosporidium
v Entamoeba histolytica
v Gardia lamblia

Signs and Symptoms

The signs and symptoms vary depending on the cause of the disease and the severity. In most cases of gastroenteritis the symptoms are mild and self-limiting. The onset of symptoms vary from a few hours e.g. Staphylococcus infections, to about 5 days as in Campylobacter infections, or even after up to three weeks in Salmonella typhi. The patient experiences one or more of these symptoms when there is gastroenteritis namely: -

v Cramping pain in the abdomen
v Diarrhoea
v Vomiting
v Large volume stools as in small diarrhoea
v Watery stools, without blood or pus, as in toxin-medicated causes.
v Blood and mucus in stools as in cases of mucosal damage e.g. Salmonella, Shigella and
    Campylobacter infections.
v Fever e.g. Salmonella typhi
v Headache and meningitis e.g. Salmonella typhimurium and some Shigella produce     neurotoxins.
v Dehydration or water depletion. This can occur rapidly in small children, when there is
    diarrhoea and vomiting. In small children, if gastroenteritis is not identified quickly, it can
    lead to collapse and death. In dehydration there is loss of the water reserves and depletion
    of minerals and salt.

Signs of dehydration

v Decreased elasticity of the skin. When pinched the skin stays up for a short while.
v Drowsiness.
v Lethargic and ‘floppy’ child.
v Sunken fontanelle (soft spot on the top of a baby’s head) in small babies.
v Very dry mouth and tongue.
v Sunken eyes.

What You Can Do

v Give fluids frequently if the person can retain the fluid. Preferably give oral rehydration fluid
    (consult your pharmacist) or if it is not available, cooked rice water.
v Avoid coffee, tea, milk and milk products.
v Avoid solids food when there is vomiting and till diarrhoea lessens.
v If there is vomiting several times over a few hours – see your doctor especially in small
    children and elderly people.
v If dehydration is suspected, immediately consult your doctor.
v If diarrhoea persists for more than 3 days, depending on the state of the person, you should     consult your doctor.
v If vomiting settles – keep giving clear fluids and give light food such as plain biscuits, rice
     porridge, grated cooked apple, and jelly.
v Gradually return to normal food.

In small children and babies

v Continue breast-feeding.
v If formula feeds are used – reduce concentration of formula and give oral rehydration fluids
in between feeds. Make fresh feeds each time.
v Consult a doctor, if symptoms persist, as soon as possible.

Good Habits To Observe For babies and young children

v All food utensils for babies must be sterilized.
v All water used for making milk formula should be boiled and kept covered.
v Cool hot milk formula quickly by putting the covered bottle in the refrigerator. Avoid giving
warm and reheated formula that has been kept for a long time, as milk is a good medium for bacteria to grow in.
v Throw away baby’s left over milk.
v Avoid giving any food that have been exposed or fallen on the floor to babies.
v Do not blow on the baby’s food to cool it.
v Do not taste each spoonful of babies’ and children’s food before putting it into their mouth.
v Adults who have diarrhoea or vomiting or any contagious illness or infections on their hands should not prepare babies’ and children’s food.

General Precautions

v Wash hands after going to the toilet.
v Wash hands before preparing food.
v Food handlers including those who prepare food should not have any contagious illness.
v Do not cough or sneeze over cooked food.
v All food should be prepared above ground level.
v Separate cutting boards should be used for meat and vegetables.
v Cooked and uncooked food should be kept in separate compartments in the
freezer. Cooked food should be kept at a higher level.
v All cooked food should be covered.
v Cooking areas should be kept clean to avoid invasion by flies and other vermin.
v Avoid giving antidiarhoel medicines to children under 2 years of age unless prescribed by a doctor.

Take all the necessary preventive steps and do not hesitate to consult your nearest health clinic, family doctor or pharmacist for advice.