Gastroenteritis: A-to-Z Guide from Diagnosis to Treatment to Prevention

Child with GastroenteritisIntroduction to gastroenteritis:

Tummy aches are an unpleasant part of childhood. They can be even less pleasant if accompanied by fever, diarrhea or vomiting. Nevertheless, gastroenteritis is a part of everyone’s childhood. I still remember my parents’ tender care when I was sick. You may not be able to make it go away, but perhaps you can comfort your child in a way that they will remember for a lifetime.

What is it?

Gastroenteritis is an inflammation of the gastrointestinal tract. Most often this is caused by an infection. Other causes include allergies, autoimmune problems, poisons, or toxins.

Organisms that cause it include viruses, bacteria, and parasites. Rotavirus, adenovirus, Norwalk virus, and CMV are among the significant viral causes. Campylobacter, Clostridium, E. coli,

Salmonella, and Staph are among the significant bacterial causes. Plague is a rare but serious cause of gastroenteritis. Giardia is a common parasite in the US that often causes chronic gastroenteritis in children.

Who gets it?

Infections of the GI tract are among the most common childhood illnesses. There are at least 1 billion episodes of gastroenteritis in children around the world every year.

Anyone can get gastroenteritis. It is most common in children under age 5, in day cares, among travelers, among the immune suppressed, and in places lacking clean food or water.

What are the symptoms?

The symptoms vary depending on the cause, but abdominal cramps, diarrhea and/or vomiting are typical features. The abdominal pain is sometimes mild, but is sometimes severe enough to be confused with appendicitis. In appendicitis the pain often comes before the vomiting; in gastroenteritis the nausea or vomiting often begins before the pain.

In gastroenteritis, the diarrhea may be watery or bloody – or not.

Some children with gastroenteritis will have no noticeable symptoms. Others will be quite ill, with symptoms outside the GI tract.

Is it contagious?

Most forms are quite contagious, and may be spread via the fecal-oral route, by direct contact, by fomites, and through food poisoning.

How long does it last?

Most types of acute gastroenteritis are over within a week or so. Giardia infections are one example that typically lasts much longer.

How is git diagnosed?

Gastroenteritis is suspected based on the history and physical examination. If the illness is not subsiding in a timely manner, or if the child is quite ill, stool studies may be performed to identify the specific cause.

How is it treated?

Prevention or treatment of dehydration is a common feature in the many types. Some forms require the use of antibiotics; most types, however, are made worse by antibiotics.

Active culture yogurt (or beneficial bacteria capsules) will help reduce symptoms and speed recovery for most types of gastroenteritis.

Anti-diarrhea and anti-vomiting medicines should be used only with caution in children, to avoid trapping the infectious organisms in the body.

How can it be prevented?

Gastroenteritis is so common that it cannot be completely prevented. Good hand washing, however, can reduce the number of times that a child gets gastroenteritis. Breast feeding and active culture yogurt have both been shown to help prevent gastroenteritis.

Special care is needed in day cares, during food preparation, and after toileting or diapering to avoid spreading the organisms.

Gastroenteritis caused by rotavirus can be prevented with an oral rotavirus vaccine.

Related concepts:

Acute gastroenteritis, AGE, Chronic gastroenteritis, Intestinal infection.

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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