Gastroenteritis

• Gastroenteritis is inflammation all the way from the stomach to the intestines and presents with nausea, vomiting and diarrhoea
• Viral gastroenteritis is common. It is highly contagious. Common causes are:

  • Rotavirus
  • Norovirus
• Only certain strains of Escherichia Coli cause gastroenteritis. It is spread through contact with infected faeces, unwashed salads or contaminated water.

  E. Coli 0157 produces Shiga toxin:

  • Abdominal cramps
  • Bloody diarrhoea
  • Vomiting
  • Antibiotics should be avoided if E. Coli gastroenteritis is suspected due to the increased risk of haemolytic uraemic syndrome
• Campylobacter is a common cause of travellers diarrhoea spread by improperly cooked poultry, untreated water and unpasteurised milk
• Symptoms of Campylobacter Jejuni:

  • Abdominal cramps
  • Diarrhoea often with blood
  • Vomiting
  • Fever
• High risk countries for gastroenteritis:

  • South America
  • Mexico
  • Africa
  • South and southeast Asia
  • Middle east
• Shigella, salmonella, E. Coli 0157 and campylobacter cause bloody diarrhoea
• If a patient who has recently travelled presents with diarrhoea, take a stool sample for microscopy and culture and ask microbiology about treatment
• For patients with evidence of systemic illness- admit to hospital and sent direct faecal smear and culture
• For patients with no travel (and other special circumstances) or systemic illness- no stool culture needed and treat symptoms e.g. Imodium
• Antidiarrhoeal medications are particularly avoided in e. coli 0157 and shigella infections, and where there is bloody diarrhoea or high fever
• Prophylactic antibiotic treatment may be appropriate for high risk travellers