Foot Reflexology - Gastroenteritis
Gastroenteritis
Gastroenteritis is inflammation of the lining of the stomach, small intestine, and large intestine. It is usually caused by infection with microorganisms but can also be caused by ingestion of chemical toxins or drugs.
-Gastroenteritis is usually caused by infection.
-Common clinical manifestations include diarrhea, nausea, vomiting, and abdominal pain
-Diagnosis is based on a few laboratory tests; recent contact with contaminated food, water, and people with certain microbial infections; and recent use of antibiotics.
-Antibiotics are used only to treat gastroenteritis caused by parasites or certain bacteria.
-The most effective way to prevent infection is to wash your hands after using the toilet or coming into contact with fecal matter and to avoid uncooked food.
Gastroenteritis
La gastroenteritis es una inflamación del revestimiento del estómago, el intestino delgado y el intestino grueso. Generalmente es causada por una infección con microorganismos, pero también puede ser causada por la ingestión de toxinas químicas o medicamentos.
-La gastroenteritis generalmente es causada por una infección.
-Las manifestaciones clínicas comunes incluyen diarrea, náuseas, vómitos y dolor abdominal.
-El diagnóstico se basa en algunas pruebas de laboratorio; contacto reciente con alimentos y agua contaminados y personas con ciertas infecciones microbianas; y uso reciente de antibióticos.
-Los antibióticos se utilizan solo para tratar la gastroenteritis causada por parásitos o ciertas bacterias.
-La forma más eficaz de prevenir la infección es lavarse las manos después de usar el baño o entrar en contacto con materia fecal y evitar los alimentos crudos.
Gastroenteritis usually includes mild to severe diarrhea with loss of appetite, nausea, vomiting, abdominal cramps, and discomfort. Although gastroenteritis is not serious and causes little more than discomfort and inconvenience in healthy adults, it can cause life-threatening dehydration and electrolyte imbalances in the seriously ill, debilitated, very young, and very old.
In the United States, approximately 48 million people develop gastroenteritis each year from eating contaminated food, and approximately 3,000 die from it. Globally, approximately 1.6 million people die each year from infectious gastroenteritis.
Most Common Causes of Gastroenteritis
-Viruses (most common)
-Bacteria
-Parasitics
Other causes include
-Chemical toxins
-Drugs
Infections that cause gastroenteritis can spread from person to person, especially if a person with diarrhea does not wash their hands thoroughly after having a bowel movement. People can also become infected if they touch an item (such as a toy or diaper) that has infected stool on it and then touch their mouth. All such transmissions involving infected stool are called fecal-oral transmission.
One person, or sometimes a large number of people, can become infected by eating food or drinking water that has been contaminated with germy stool (an outbreak of disease among a large number of people is called an epidemic). If foods are not properly cooked or pasteurized, they can easily become contaminated with bacteria that cause gastroenteritis. Contaminated water is sometimes drunk accidentally, such as when swimming in a pool that has been contaminated by animal or human feces.
Sometimes gastroenteritis is acquired through direct contact with animals that carry infectious microorganisms.
Microorganisms that cause gastroenteritis
-Viruses
In the United States, viruses are the most common cause of gastroenteritis. Some viruses infect the cells lining the small intestine and cause watery diarrhea, vomiting, and fever.
Gastroenteritis is caused by four types of viruses
-Norovirus, rotavirus, astrovirus, and enteric adenovirus.
-Most viral gastroenteritis infections are caused by the following viruses
-Norovirus
-Rotavirus
Astroviruses can infect people of all ages, but they usually infect infants and young children. In temperate climates, infection is most common in the winter. In tropical climates, infection is more common in the summer. The infection is spread by the fecal-oral route. Symptoms begin 3 to 4 days after infection.
Adenovirus is the fourth most common cause of viral gastroenteritis in children. It most often affects children under 2 years of age. It can occur at any time of the year, but is more common in the summer. The infection is spread by the fecal-oral route and respiratory droplets (such as those produced when coughing). Anyone nearby can be infected by breathing in the droplets. Symptoms begin 3 to 10 days after infection.
Other viruses, such as cytomegalovirus and enterovirus, can cause gastroenteritis in people with weakened immune systems.
Did you know? Worldwide, about 1.6 million people die each year from gastroenteritis caused by infection.
Most common bacteria causing gastroenteritis
-Campylobacter
-Clostridium difficile (C. difficile)
-Escherichia coli (E. coli), especially the O157:H7 strain
-Salmonella
-Shigella dysenteriae
-Staphylococcus, which causes staphylococcal food poisoning
Bacterial gastroenteritis is less common than viral gastroenteritis. Bacteria cause gastroenteritis in a variety of ways.
Some species (such as Vibrio cholerae, enterotoxigenic strains of E. coli) attach to the intestinal mucosa without invading it but produce enterotoxins. These toxins cause the intestine to secrete water and electrolytes, producing watery diarrhea.
Other bacteria (such as Staphylococcus aureus [see also Staphylococcal Food Poisoning], Bacillus cereus, and Clostridium perfringens) produce an exotoxin in contaminated food. This toxin can cause gastroenteritis without causing a bacterial infection. These toxins usually cause severe nausea and vomiting as well as diarrhea. Symptoms usually develop within 12 hours of ingesting the infected food and resolve within 36 hours.
Some bacteria (such as some strains of E. coli, Campylobacter, Shigella, Salmonella, and Clostridium difficile) can invade the lining of the small or large intestine (colon). There, they destroy cells, forming bleeding sores (ulcers) that leak large amounts of fluid containing proteins, electrolytes, and water. The diarrhea contains white and red blood cells that can be seen under a microscope and sometimes visible bleeding.
Salmonella and Campylobacter are common bacterial causes of diarrhea in the United States. Infection usually comes from uncooked poultry. It can also come from unpasteurized milk. Campylobacter can occasionally be transmitted from dogs or cats with diarrhea. Salmonella can be transmitted by eating undercooked eggs or by contact with reptiles (such as turtles or lizards), birds, or amphibians (such as frogs and salamanders).
Shigella species are also a common bacterial cause of diarrhea in the United States, usually spread directly from person to person (especially in day care centers), but foodborne epidemics can also occur.
E. coli gastroenteritis is caused by several different subtypes of E. coli.
Clostridium difficile (C. difficile) is probably the most common bacterial cause of diarrhea in the United States today and the most common cause of diarrhea after antibiotic treatment (see Drug-Related Gastroenteritis). However, it sometimes occurs in people who have not been treated with antibiotics. Antibiotics kill the good bacteria that normally live in the intestines, which allows C. difficile to thrive. C. difficile produces a toxin that causes watery diarrhea that can range from mild to severe, bloody diarrhea (see also Clostridium difficile Diarrhea).
Several other bacteria can cause gastroenteritis, but they are less common in the United States. Yersinia enterocolitica can cause gastroenteritis or a syndrome that resembles appendicitis. People can become infected by eating uncooked pork, unpasteurized milk, or contaminated water. Several species of Vibrio (such as Vibrio parahaemolyticus) can cause diarrhea after eating uncooked seafood. Vibrio cholerae causes cholera, which causes watery diarrhea and, in resource-poor countries, can sometimes lead to severe dehydration. Epidemics may occur after natural disasters in refugee camps. Listeria monocytogenes rarely causes foodborne gastroenteritis but more often causes bloodstream infections or meningitis in pregnant women, newborns, or the elderly. Aeromonas may be acquired by swimming or drinking contaminated fresh or salty seawater. Plesiomonas shigelloides may cause diarrhea after eating raw shellfish or traveling to tropical areas in resource-poor countries.
Most Common Parasites
-Giardia
-Cryptosporidium
Certain intestinal parasites, especially Giardia lamblia, can attach to the intestinal wall and cause nausea, vomiting, diarrhea, and a general feeling of being unwell. The resulting infection, called giardiasis, occurs in all parts of the United States and around the world. If the infection persists (is chronic), it can prevent the body from absorbing nutrients (called a malabsorption syndrome). The infection is usually spread by drinking contaminated water (sometimes from wells or unconventional water sources encountered while hiking or camping), eating contaminated food, or by person-to-person contact (such as at day care centers).
Another intestinal parasite, Cryptosporidium, causes watery diarrhea, sometimes with abdominal cramps, nausea, and vomiting. The resulting infection, called cryptosporidiosis, is usually mild in otherwise healthy people but can be severe or even fatal in people with weakened immune systems. Cryptosporidium is most commonly acquired by drinking contaminated water. The parasite is resistant to conventional concentrations of chlorine, making it the most common cause of recreational water-related illness in the United States.
Other parasites that can cause symptoms similar to those of cryptosporidiosis include Cyclospora, Isospora belli, and a group of microorganisms called microsporidia that can infect people with weakened immune systems. Entamoeba histolytica causes amebiasis, which infects the large intestine and sometimes the liver and other organs. Amebiasis is a common cause of bloody diarrhea in countries with poor sanitation but is rare in the United States.
Symptoms of Gastroenteritis
The type and severity of symptoms depend on the type and amount of microorganisms or toxins ingested. Symptoms vary depending on the person's resistance.
Symptoms often begin suddenly (sometimes acutely) with loss of appetite, nausea or vomiting, and gurgling and cramping pains in the abdomen. Audible bowel and abdominal cramping may occur. Diarrhea is the most common symptom and may be accompanied by visible blood and mucus in the stool. The patient's abdomen (and intestinal loops) may swell (distend), cause pain, and be filled with gas.
The patient may have a fever and feel generally unwell, with muscle aches and extreme fatigue.
Gastroenteritis caused by viruses
-The virus causes watery diarrhea. The stool rarely contains mucus or blood. For specific symptoms caused by norovirus and rotavirus, see Norovirus Gastroenteritis and Rotavirus Gastroenteritis.
-Adenovirus causes mild vomiting 1 to 2 days after the diarrhea starts. The diarrhea can last 1 to 2 weeks. Infants and children may have mild vomiting, usually starting 1 to 2 days after the diarrhea starts. About 50% of people have a low-grade fever. Some people may have a stuffy, runny nose, itchy throat, and cough. Symptoms are usually mild but may last longer than other viral gastroenteritis.
-Astrovirus symptoms are similar to those of a mild rotavirus infection.
Gastroenteritis caused by parasites
Parasitism often causes diarrhea that may last a long time and may come and go. It is usually not bloody. If a person has diarrhea for a long time due to a parasitic infection, they may be very tired and lose weight.
Complications of gastroenteritis
Severe vomiting and diarrhea can lead to significant fluid loss (dehydration). Symptoms include fatigue, less urine, dry mouth, and, in infants, crying without tears. Excessive vomiting or diarrhea can lead to electrolyte problems (such as low potassium levels in the blood [hypokalemia] and dehydration), which can cause low blood pressure and a fast heart rate. Hyponatremia (low sodium levels in the blood) may also develop, especially if the person loses a lot of fluid and is replaced with fluids that contain little or no salt (such as water and tea). Fluid and electrolyte imbalances can be dangerous, especially for the very young, the elderly, and those with chronic medical conditions. Severe cases can cause low blood volume (hypovolemic shock) and kidney failure.
Diagnosis of Gastroenteritis
- Doctor's evaluation
- History of contact with sick people, certain animals, contaminated food or water, or recent travel, or use of antibiotics
Sometimes stool tests
Gastroenteritis is usually diagnosed based on symptoms alone, but doctors may consider other gastrointestinal disorders that cause similar symptoms (such as ulcerative colitis).
The cause of gastroenteritis is often not obvious and needs to be sought. Sometimes other family members or coworkers have recently become ill with similar symptoms, or someone has been exposed to certain animals. Other times, gastroenteritis can be caused by eating undercooked, spoiled, or contaminated food (such as raw seafood or mayonnaise that has been in the refrigerator too long). Recent travel, especially to certain countries, or recent use of antibiotics can provide clues to the cause.
If symptoms are severe or last for more than 48 hours, stool samples may be sent to a laboratory to be checked for white blood cells, bacteria, viruses, or parasites.
Severely ill people may need blood tests to determine if there is an imbalance in water and electrolytes, or tests to determine if kidney function is normal.
If symptoms persist longer than expected, doctors may need to use a sigmoidoscopy (a flexible viewing tube used to view the lower digestive tract) to check for disorders such as ulcerative colitis.
Treatment of gastroenteritis
-Fluids and rehydration
-Sometimes medications
-Acupuncture
-Foot reflexology
-Acupuncture
-Foot reflexology
Rehydration
Usually, the only treatment needed for gastroenteritis is bed rest and drinking plenty of fluids. Even people who are vomiting should drink as many small, frequent drinks as they can tolerate.
If a person is severely dehydrated from prolonged vomiting or diarrhea, fluids and electrolytes should be given intravenously. Children are more likely to become dehydrated quickly and should be given an appropriate ratio of sugar to salt water intravenously. Any commercial solution designed to replace lost fluids and electrolytes (called an oral rehydration solution) works well. Carbonated beverages, teas, sports drinks, caffeinated beverages, and juices are not appropriate. If a baby is still breastfeeding, breastfeeding should continue.
As symptoms subside, foods can be gradually added to the person's diet. Although a bland diet is often recommended, it is not necessary to consume only bland foods such as cereals, gelatin, bananas, rice, applesauce, and toast. However, some people cannot tolerate milk products for several days after diarrhea.
Drugs
Doctors may give adults antinausea drugs such as ondansetron, prochlorperazine, or promethazine, which are taken by mouth, by injection, or as suppositories. Children who are still vomiting after 24 hours need to be seen again.
If diarrhea does not decrease after 24 to 48 hours and there is no blood in the stool that could indicate a more serious bacterial infection, they may be given drugs (such as diphenoxylate) to control the diarrhea, or they may be given over-the-counter drugs (such as loperamide). These drugs (called antidiarrheals) are not given to children younger than 18 years with acute diarrhea. Antidiarrheals are also not given to people who have recently taken antibiotics, have bloody diarrhea, have too little blood in their stool to be visible, or have diarrhea and a fever.
Antidiarrhea drugs can cause diarrhea themselves and can make bacteria resistant, so they are usually best avoided, even when a certain bacteria is known to be the cause of gastroenteritis. However, antibiotics may be used if the cause is certain bacteria, such as Campylobacter, Shigella dysenteriae, or Vibrio cholerae, or if the person has traveler's diarrhea. Antibiotics can also be used to treat diarrhea caused by Clostridium difficile. The antibiotics used to treat this infection are different from those used to treat C. difficile infection. (See also table Microorganisms That Cause Gastroenteritis.)
People with parasitic infections may be treated with antiparasitic drugs, such as metronidazole, tinidazole, and nitrazol.
Did you know that antibiotics don't always work for diarrhea caused by bacteria?
-Probiotics
Some bacteria are naturally present in the body and promote the growth of good bacteria. Using probiotics, such as Lactobacillus, which is commonly found in yogurt, can slightly shorten the duration of diarrhea (perhaps by less than a day). However, there is not enough evidence to show that probiotics prevent the more serious consequences of gastroenteritis (such as the need for intravenous fluids or hospitalization), so there is not enough evidence to support the routine use of probiotics to treat or prevent infectious diarrhea.
Prevention of gastroenteritis
-Vaccinations
-Handwashing
-Breastfeeding
Two oral rotavirus vaccines are available that are safe and effective against most strains of rotavirus. Rotavirus vaccines are included in the recommended infant vaccination schedule.
A simple and effective way to prevent gastroenteritis in infants is to breastfeed.
Before preparing a bottle for an artificially fed baby, the caregiver should wash their hands thoroughly with soap and water. If soap and water are not available, use an antibacterial hand sanitizer.
Caregivers should also wash their hands after changing a diaper. The affected area should be cleaned with bleach (¼ cup bleach diluted in 1 gallon of water).
Children with diarrhea should not stay in day care while their symptoms persist. Children with E. coli, which can cause bloody diarrhea, or Shigella should also have two stool tests and return to day care only if both results are negative.
Did you know that washing hands with plain soap and water for 20 seconds is the best way to get them clean?
Infants and other immunocompromised people should not be exposed to reptiles, birds, or amphibians because these animals often carry Salmonella, and infections are more severe in these people.
Because most infections that cause gastroenteritis are spread from person to person, especially through direct or indirect contact with infected stool, washing hands thoroughly with soap and water after defecation is the most effective way to prevent them.
To avoid foodborne infections, wash hands thoroughly before handling food, cook meat and eggs thoroughly, wash knives and cutting boards used for cutting meat before cutting other foods, and refrigerate leftover food quickly. Only pasteurized dairy products and apple juice are safe to drink.
Avoid contact with contaminated food and drinks when traveling.
To prevent recreational water illness, people with diarrhea should not swim. Children and toddlers should have their diapers checked frequently and changed in bathrooms away from water. Swimmers should avoid swallowing pool water while swimming.
Most antibiotics increase the risk of diarrhea from C. difficile infection while they are taken, so antibiotics should be used only when necessary and not for situations where they would not work (for example, when a viral infection occurs).
