Gastroenteritis is the irritation and inflammation of the inner lining of the stomach and small intestine. It could be due to a viral, bacterial or parasitic infection and can lead to severe vomiting and diarrhoea. The most common cause of gastroenteritis in children is Rotavirus. Gastroenteritis is most commonly transmitted through contaminated food or water. It can also transmit from close contact with an infected individual. An overflow of sewage lines on the roads during the monsoons can cause further spread of the causative organism. Open defecation is another common reason that causes the spread of the condition through flies and other pests.
Once infected, the condition can manifest in about 24 to 48 hours. Some of the most common symptoms include – severe diarrhoea, vomiting, abdominal pain, cramps and dehydration. These symptoms help diagnose the condition. A stool test confirms the diagnosis. The infection usually gets resolved with time. Rehydrating liquids like electoral are advised. Severe cases may need intravenous fluids. Medication that controls fever and painkillers may be prescribed for symptomatic relief. Adequate rest and staying away from foods that are difficult to digest can help quick recovery.
Severe dehydration, one of the most common complications of gastroenteritis, can be life threatening in the elderly, young children and people with suppressed immune systems. It can lead to organ failure and death.
Depending on the causative agent, gastroenteritis can be of 4 main types:
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.
- 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.
Stomach flu is the general term used for what doctors call ‘gastroenteritis. Dr Mehul Choksi, Consultant Gastroenterologist and Endoscopist, S.L. Raheja, Fortis, Mahim says, '‘It is a contagious infection of the stomach and the small intestine caused by bacteria, viruses or protozoa.’
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.
Dr Choksi highlights diarrhea, abdominal pain, cramping and vomiting as the classic symptoms of the disease. Apart from these, you may also suffer from:
Dehydration symptoms include:
- Loss of appetite
- Poor feeding in children
Here is detailed information on 6 symptoms of gastroenteritis or stomach flu
- Muscle cramps
- Rapid heartbeat
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
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
Other precautions that you should take:
- 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
Here is some additional information on how to protect yourself from gastroenteritis during monsoons
- 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
The content has been verified by
Dr Mehul Choksi
, Consultant Gastroenterologist and Endoscopist, S.L. Raheja, Fortis, Mahim.