Gastroenteritis or stomach flu -- causes, types, symptoms, diagnosis, treatment and prevention

Are suffering from bouts of diarrhea, stomach pain and cramps? You could have caught stomach flu.

Gastroenteritis    causes, types, symptoms, diagnosis, treatment and preventionSo, you go out with your friends and have yummy panipuri from the nearby roadside stall. It's quite possible that the following day your bowel movements force you to visit the loo too often and the stomach pain coupled with weird cramps keep irritating you throughout the day. Well, if you continue having food from unhygienic places, stomach flu or gastroenteritis could be a regular event in your life.

Dr Mehul Choksi PicWhat is stomach flu or gastroenteritis? What causes it?

Stomach flu is the general term used for what doctors call 'gastroenteritis.' 'It is a contagious infection of the stomach and the small intestine caused by bacteria, viruses or protozoa,' says Dr Mehul Choksi, Consultant Gastroenterologist and Endoscopist, S.L. Raheja, Fortis, Mahim.

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Although some of the symptoms of gastroenteritis may be similar to that of gastritis, they are different from each other. 'Gastritis is not the same as gastroenteritis. Gastritis is the inflammation of the stomach mucosal lining and is caused by H. pylori infection, non-steroidal anti-inflammatory drugs, alcohol use and other rare conditions,' explains Dr Choksi.

Types of gastroenteritis

Depending on the causative agent, gastroenteritis can be of 4 main types:

  • Viral gastroenteritis: Viruses like rotavirus and norovirus are a common cause of viral gastroenteritis in children. Norovirus also commonly affects adults.
  • Bacterial gastroenteritis: Bacteria including Escherichia coli, Salmonella and Shigella are widely present in raw, uncooked and contaminated food and water. Traveler's diarrhea caused by E.Coli is a common type of bacterial gastroenteritis.
  • Parasitic gastroenteritis: It mainly affects people who travel to places with high prevalence of protozoan contamination and resultant outbreaks.
  • Non-infectious gastroenteritis: Sometimes, the disease can be caused due to other agents like toxins released by bacteria or some environmental pollutants and toxins. It is cured as soon as the toxin is eliminated from the gut.

Gastroenteritis can be acute or chronic depending on the severity of the infection

Acute gastroenteritis: It is a sudden onset or attack of stomach flu that can even be life-threatening. It is usually caused by infectious bacteria or parasites like Giardia.

Chronic gastroenteritis: Sometimes the infection can become chronic if the patient also suffers from a nutritional related disorder or a malabsorption symdrome. It is more likely to affect people with a comprised immune system or weak immunity. People with poorly managed diabetes can also develop a chronic condition.

Transmission of gastroenteritis:

The disease is acquired mainly through contaminated food and water. But the rate of transmission and risk of suffering from the disease is also dependent on factors like level of hygiene, immunity of an individual and nutritional status of the person.

What are the symptoms of gastroenteritis?

Dr Choksi highlights diarrhea, abdominal pain, cramping and vomiting as the classic symptoms of the disease. Apart from these, you may also suffer from:

  • Nausea
  • Headache
  • Fever
  • Loss of appetite
  • Poor feeding in children

Dehydration symptoms include:

  • Muscle cramps
  • Dizziness
  • Rapid heartbeat

Diagnosis of gastroenteritis

Once your doctor suspects gastroenteritis, diagnosis of the disease involves clinical evaluation and stool examination. But unless there is an outbreak of the disease, identification of the causative agent is not required. If your symptoms persist even after a few days of treatment, you might need to undergo a clinical evaluation.

  • Blood test: A complete blood count is done to check eosinophil (type of blood cell) count that might go high in case of parasitic infection
  • Stool test: In case there is presence of blood in stool, or if diarrhea persists for more than 48 hours, stool examination is required. Some enzyme immunoassays are used to detect viral and bacterial antigen in stool sample.
  • Endoscopic tests: Examination of the colon may be indicated in some cases with the help of a sigmoidoscope or colonoscope, where a tube is inserted through the anus to visualise the colon
  • Nutritional assessment: Children with gastroenteritis who do not respond to treatment well may be required to undergo a nutritional assessment test

Treatment and prevention

Viral gastroenteritis cannot be cured with medicines. The only treatment option is prevention of dehydration by intake of sufficient fluids.

Bacterial gastroenteritis is treated with antibiotics like metronidazole and vancomycin. 'Antibiotics are commonly to be taken for 3 to 5 days. Oral rehydration solution is used to maintain adequate hydration. In case of severe dehydration you may need hospitalisation for intravenous hydration therapy and intravenous antibiotics,' says Dr Choksi.

Here are some preventative measures Dr Choksi suggests to keep the disease at bay

  • Avoid eating from the roadside or unhygienic commercial establishment as there are high chances of contamination. Foods which are served steaming hot are the best foods to be taken.
  • Prefer drinking bottled/boiled water
  • Carry oral rehydration solution whenever you're travelling with children
  • It's better to carry an antibiotic like ciprofloxacin in your medical kit

Other precautions that you should take:

  • Washing hands before having meal
  • Following hygienic procedures while handling food
  • Avoiding swimming to prevent spread of the disease
  • Infants should be vaccinated against rotavirus
  • People with lowered immunity should be extra careful about eating outside

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