Gastroenteritis (Stomach Flu) (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- Definition of gastroenteritis
- What causes gastroenteritis?
- What are the most common causes of gastroenteritis?
- What are the symptoms of gastroenteritis?
- Is gastroenteritis contagious?
- Who is at risk for gastroenteritis?
- How is gastroenteritis transmitted?
- How does food become contaminated with gastroenteritis-causing bacteria or viruses?
- How is gastroenteritis diagnosed?
- How is gastroenteritis treated?
- When should I call my doctor for gastroenteritis?
- What are complications of gastroenteritis?
- Can gastroenteritis be prevented?
- What is the prognosis for gastroenteritis?
- Find a local Gastroenterologist in your town
How does food become contaminated with gastroenteritis-causing bacteria or viruses?
In most instances, food and drinks come into contact with feces contaminated with the infecting agent. This can happen in the fields, or in transport, storage, and processing of food and drinks. In processed foods and drinks, this contamination is relatively rare, but when it occurs, an outbreak of the disease is often traced back to faulty equipment, human errors in the processing and/or a breakdown of quality-control procedures.
How is gastroenteritis diagnosed?
Gastroenteritis is most often presumptively diagnosed by the symptom(s) it produces (mainly diarrhea). Because gastroenteritis is usually a self-limited disease, the large majority of people are never seen or diagnosed by a doctor. There are no specific tests for gastroenteritis. However, during outbreaks like those seen on cruise ships, viral and bacterial cultures or PCR and other immunologically-based tests can eventually identify the causative pathogen. By the time this identification occurs, most of the patients with gastroenteritis have begun to recover. When gastroenteritis symptoms become severe, most public health officials and health care professionals run such tests to identify the causative agent of a specific disease, based on all of the patient's history, physical exam, and symptoms. In addition, patients with similar histories of recent food or drink they had in common with others often helps to discover the source of the disease (for example, people who got diarrhea had salads from the same food provider).
How is gastroenteritis treated?
Most people with gastroenteritis require no formal treatment. The key to a rapid and safe recovery at home (home remedy) is proper hydration. Home treatment consists of adequate fluid intake so dehydration is prevented. Clear fluids are recommended (Pedialyte especially for young children, Gatorade, PowerAde and other sports drinks), but not fruit juices or milk as they may prolong the symptoms. If dehydration occurs, the patient should be evaluated by a doctor. Many health care professionals choose to begin IV fluids, the treatment of choice for rapid rehydration.
Other medications may be prescribed to reduce the symptoms of gastroenteritis. To reduce vomiting, promethazine (Phenergan), prochlorperazine (Compazine), or ondansetron (Zofran) are often used. Some physicians suggest using these agents only as a suppository or rapidly disintegrating tablet on the tongue since patients may vomit the pills up. Others may prescribe diphenoxylate and atropineomotil (Lomotil) or lopermadine (Imodium) to slow diarrhea while others do not as the drugs may prolong the disease in some individuals. Many doctors recommend no medical treatment for gastroenteritis symptoms as all of the drugs have side effects and if the patient stays well hydrated, the symptoms usually stop soon anyway.
As the gastroenteritis symptoms abate, especially vomiting, doctors may recommend a BRAT diet (bananas, rice, apples and toast) for a day or two before returning to the patient's regular diet. Potatoes, lean meat like chicken and whole grains can help replace nutrients and electrolytes lost with diarrhea.
Patients who have more serious symptoms or other symptoms in addition to gastroenteritis need to be evaluated, diagnosed, and treated by a physician because the patient will likely have a specific disease that will need treatment. The treatment will depend on the cause of the illness (for example, salmonellosis or Clostridium difficile toxin). Antibiotics and other treatments may not be recommended for some of these diseases so an accurate diagnosis of the disease is important. For Clostridium difficile infected patients, antibiotic sensitivity testing may need to be done to determine the most effective antibiotics to use.
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