Gastroenteritis

Health information about Gastoenteritis

Expats.cz Staff

Written by Expats.cz Staff Published on 13.05.2004 10:59:00 (updated on 13.05.2004) Reading time: 6 minutes

Gastoenteritis commonly known as FOOD POISONING is an acute illness related to food ingestion. Most of them are infective and caused by bateria and viruses.

It is in almost all cases charaterised by diarrhoea,vomiting and abdominal pain after the ingestion of contaminated food .

Gastroentertis is of two major types:

· Viral
· Bacterial

VIRAL CAUSES: ROTA VIRUS is responsible worldwide for both sporadic and epidemics of diarrhoea.It is currently one of the most important causes of CHILDHOOD DIARRHOEA.The prevalence is higher during the winter months

Adults may become infected with rotavirus but symptoms are usually mild or absent.

CLINICAL FEATURES:

* Vomiting
* Fever
* Diarrhoea
* The metabolic consequences of water and electrolyte loss

TREATMENT: Adequate oral rehydration therapy to overcome the water and electrolyte imbalance.ORS is most commonly given to children. If the oral rehydration therapy does not improve the condition then intravenous fluids are given .Antibiotics should not be prescribed.

BACTERIAL CAUSES: The most common bacteria causing food poisoning are the following:

1. SALMONELLA : They are a gram negative generally motile bacillus . They are of various types. S. enteritidis and S.typhimurium cause acute gastroenteritis.They have a worldwide distribution and they withstand freezing and dry conditions for prolonged periods.

TRANSMISSION occurs by ingestion of contaminated foods particularly eggs and poultry products or water. The organism is found in the alimentary tract and the oviducts of poultry and within the egg itself.

SYPMTOMS: Abrupt diarrhoea ,fever´vomiting and malaise

DIAGNOSI: stool culture

TREATMENT is asymptomatic.Antiiotic therapy is required only for severe disease.

FEATURED EMPLOYERS

PREVENTION involves improved animal husbandry and care with slaughtering and processing of animals for human consumption.

2. SHIGELLA: Shigellosis is an acute self limiting intestinal infection caused by gram negative non- spore forming bacilli. All of them are enteroinvasive and some strains elaborate atoxin that is enterotoxic and neurotoxic.

PREVALENCE: It is found worldwide and is more prevalent in areas with poor hygiene and overcrowding .

TRANSMISSION: is by the faecal-oral route and a very low dose is sufficient to produce the disease.

Children usually under 5 years are predominantly affected .

SYMPTOMS: The onset is acute with fever , malaise ,abdominal pain and watery diarrhoea. As it increases in intensity bloody diarrhoea with mucus ,tenesmus faecal urgency and severe cramping ,abdominal pain becomes predominant .

DAIGNOSIS: Stool culture

TREATMENT: Symptomatic with oral fluid replacement In severe case Ciprofloxacin 500mg twice daily can be given.

PREVENTION: Public health measures ,particularly the disposal of excreta and the provision of potable ,prevent infetion.

3. ESCHERICHIA COLI : They produce a diarrhoeal illness that is mediated through a heat labile toxin or heat stable toxin. (enterotoxigenic E.coli ETEC).

TRANSMISSION: It is usually found in undercooked beef and raw cow´s milk.

SYMPTOMS: Watery diarrhoea with or without haemorrhagic colitis

DAIGNOSIS: Stool culture

TREATMENT: Oral administration of fluids and electrolytes is the mainstay of therapy as many are self limiting and require no specific antimicrobial theray. For severe infections ciprofloxacin 500mg twice daily is often used .

4. CLOSTRIDIUM BOTULINUM : This organism is found in the soil and food is easily contaminated with the spores ,which can survive heating to 100 degrees.They proliferate in preserved canned foods and produce toxins.

TRANSMISSION: Spores survive cooking ,and germinate in anaerobic conditions ,e.g canned or bottled food.

SYMPTOMS: Brief diarrhoea and paralysis due to neuromuscular blockade.

DIAGNOSIS: Demonstrate toxin in food or faeces.

TREATMENT: It is supportive and should be directed at maintaining adequate respiration ,with assisted ventilation if necessary.I.V administration of antitoxin is given .Recovery in 10-14 days.

5. CLOSTRIDIUM PERFRINGENS
:Spores are found in food and survive boiling

SYMPTOMS: Watery diarrhoea and cramping pain

DIAGNOSIS: Culture organism in faeces and food.

TREATMENT: Fluid and electrolyte replacement-oral or i.v

6. BACILLUS CEREUS :Spores found in food often in rice which survive boiling .

SYPMTOMS: diarrhoea ,vomiting and dehydration.

DIAGNOSIS: culture organism in faeces and food.

Recovery is rapid

TRAVELLER´S DIARRHOEA

The most causes of traveller´s diarrhoea are

· Enterotoxigenic E.coli (ETEC) 40 -75%
· Shigella spp 0- 15%
· Salmonella spp 0-10%
· Rota virus 0-10%
· Giardia Lamblia,Entamoeba histolytica 0-3%
· Unknown 22-25%

PROTOZOAL INFECTIONS

Human intestinal protozoal infections are found worldwide ,particularly in the developing countries.

AMOEBIASIS

The most important human disease due to amoeba is amoebiasis ,which is caused by ENTAMOEBA HISTOLYTICA.It occurs worldwide ,but higher incidence rates are found in the tropics and subtropics.

LIFE- CYCLE AND MODE OF TRANSMISSION: The organism exists both as a motile trophozoite and as a cyst that can suvive outside the body.Cysts are transmitted chiefly by ingestion of contaminated food or water or spread directly by person to person contact.Trophozoites emerge from the cyst in the small intestine and then pass on to the colon,where they multiply.These then invade the colonic epithilium and finally ulceration of the mucosa occurs. Some of these trophozoites enter the portal vein and reach the liver and cause hepatitis and intrahepatic abscecces.

SYMPTOMS: Many individuals can carry the pathogen without any clinical disease (asymptomatic cyst passers)

The incubation period is highly variable and may be as short as a few days or as long as several months or even a year. The presenting features may be gradual or acute The gradual onset colitis presents with mild intermittent diarrhoea and abdominal discomfort progressing to bloody diarrhoea

with mucus.Headache ,nausea and anorexia are often present.Acute colitis is characterized by severe watery ,bloody diarrhoea.

POSSIBLE COMPLICATIONS;

* Toxic dilatation of the colon with perforation and peritonitis.
* Severe haemorrhage
* Amoeboma in the caecum or rectosigmoid region.
* Amoebic liver abscess.

DIAGNOSIS:

* Direct examination of freshly passed stool
* Liver function tests and ultrasound to check the liver abscess.

TREATMENT

Metronidazole 800 mg thrice daily for five days is given for colitis .For liver abscess prolonged course for 10-15 days is given.

PREVENTION

drinking water must be boiled for 10 minutes as the cysts are usually destroyed.One must improve the standard of personal hygiene and hands must be washed thoroughly before eating .

GIARDIASIS: GIARDIA INTESTINALIS is a flagellate found worldwide .Prevalence is high throughout the Tropics.It is an important cause of traveller´s diarrhoea worldwide ,usually occurring on return from travel.

TRANSMISSION: Person -to person spread is common in day nurseries and residential institutions and between male homosexuals.It has caused water bourne epidemics.

SYMPTOMS: Diarrhoea,often watery ,nausea,anorexia,abdominal discomfort and distension.If the illness is prolonged ,weight loss ensues.Chronic giardiasis can result in growth retardation in children.

DIAGNOSIS: Both cysts and trophozoites can be found in the stool.

TREATMENT: Metronidazole 2g as a single dose for 3 days.

With the weather changing and hot weather coming ,we should take all precautions to protect ourselves and our family from gastroenteritis. Most of the the infections are water bourne ,so we should preferably drink mineral water.Tap water should be avoided .Or it should be boiled for 10 minutes at boiling temp before drinking.

Fish and poultry must be bought from reliable supermarkets.Raw eggs must be avoided. Personal hygiene is very crucial and children must be encouraged to wash their hands before eating and after using the lavatory.

Canadian medical center offers both acute and chronic management of gastroenteritis.Our specialized team of doctors are capable of diagnosing and treating the patients at the center .We also have 24 hrs emergency ambulance service which attend to patients at home .The pharmacy is well stocked with all the essential medication .

This Article was provided by Canadian Medical Care
For more information about their Prague clinic
Visit : http://www.cmcpraha.cz/

Would you like us to write about your business? Find out more