GI tract

• Plaque

  • Plaque is an association of various bacteria and other microbes bound together by slime which has harden onto the teeth
  • The slime is produced by S.mutans and within a day hardens into yellowish plaque which is difficult to remove
• Dental Caries (Tooth decay, cavity)

  • Damages to the teeth are caused by acids produced by plaque microbes.
• Gingivitis

  • Inflammation of the gums as a result of plaque
• Trench mouth

  • Severe gingivitis which causes painful and bleeding gums
• Mumps

  • Highly contagious viral infection of the salivary glands, primarily the parotid gland.
  • Causes painful swelling in the gland, but is not usually serious.
  • Symptoms/signs: flu-like and in vary rare cases, can cause swelling of testicles resulting in reduce fertility.
• Thrush

  • infection by Candida (yeast)
  • Generally affects newborns and those with poor immunity.
  • Signs/Symptoms: creamy white lesion with a “cottage cheese appearance and painful swallowing.
• Staphylococcal Enterotoxicosis

  • Common food poisoning caused by Staph toxin in the intestine
  • Symptoms/ signs: abdominal pain, vomiting, and diarrhea.
  • No specific treatments, but prevention is key (hand-washing)
• Clostridium Perfringens

  • Common food poisoning is due to eating undercooked meat or food kept at an improper temperature.
  • Diarrhea and cramps, but usually no vomiting or fever, and typically last about one day.
  • Cl.perfrigens is a normal microflora of the gut of poultry and other animals.
• Clostridium botulinum

  • Causes botulism, a potentially fatal food poisoning.
  • The botulin toxin prevents muscle contraction by inhibiting the release of acetylcholine, a neurotransmitter.
  • Symptoms/signs: blurred vision, double vision, drooping eyelids, slurred speech, difficulty swallowing and muscle weakness.
  • Fatal if untreated due to respiratory failure
  • Botulin is used for cosmetic reasons (i.e. botox and has been studied as a treatment for depression)

  FYI, Nitrite and nitrate are preservatives used in turkey, ham, and other meats to prevent botulism….
• Salmonellosis

  • caused by gut microflora Salmonella sps.,
  • Transmitted by the oral-fecal route via contaminated food, improper hygiene, and sometimes the handling of animals that carry the bacteria (i.e. lizards and chicken)
  • Symptoms are diarrhea, fever, and abdominal cramps that usually self- resolve within a week.
  • Most people do not need treatment/medication except hydration with electrolytes.
• Shigellosis

  • Infection by Shigella sps. via an oral-fecal route that can cause severe bloody diarrhea (dysentery).
  • Other signs/symptoms include fever and abdominal and rectal pain.
  • Typically self-resolved within a week, but hydration with electrolytes is important.
• Typhoid fever

  • Infection with Salmonella typhi via the fecal/oral route.
  • Symptoms/signs: prolonged headache, high fever (103-104 F), abdominal pain, rash on stomach and chest, weakness, and appetite loss.
  • Unlike most foodborne illnesses which require mostly hydration and ion replacement, antibiotic treatment is needed for typhoid fever.
  • FYI… rare in industrialized countries but common in developing countries with an annual death toll of 200,000+. Vaccines are available for travelers but have limited protection so food safety should be followed.
• Cholera

  • Caused by Vibrio cholera via the fecal-oral route including contaminated water and food
  • About 10% of infected will exhibit severe signs/symptoms of profuse (continuous) watery diarrhea (a.k.a, rice water diarrhea, vomiting, leg cramps, leading to rapid dehydration and loss of electrolytes.)
  • This can result in hypotension, blood acidosis, shock, and death within hours.
  • Patients must replenish lost fluid and electrolytes.
• Traveler’s diarrhea (Montezuma’s revenge)

  • Symptoms/signs: diarrhea, cramping, bloating, low fever, but is self-resolving within 3 days.
  • Typically is due to E.coli. transmitted via poor hygiene. Commonly occurs in people traveling to developing countries and consuming “street” food.
• Peptic (stomach) ulcer and chronic gastritis

  • Bleeding/open wound of the stomach is caused usually by Helicobacter pylori (this is the bacteria that can convert from urea into ammonia and help neutralize the acidity of the stomach.)
  • Most people are asymptomatic, but if untreated, can lead to stomach cancer.
  • Symptoms/signs include stomach pains, nausea, bloating, fatty food intolerance, and bad breath. Once diagnosed, is treated with antibiotics
• Pseudomembranous colitis

  • Caused by Clostridium difficile (aka. C.dif) which causes chronic watery diarrhea, abdominal pain, and colon inflammation (colitis).- most people have this bacteria. if it’s absent, it’s problematic.
  • In some, infection can cause bowel perforation, kidney failure, and death.
  • Mostly affects older people in long-term care who are on antibiotics and people who had abdominal surgery. In these people, antibiotics are unable to remove the pathogen due to multidrug resistance.
  • Treatments include antibiotics, surgery, probiotics, and fecal, microbiota transplant (FMT)
• Brucellosis

  • Caused by Brucella sps. which can be transmitted by ingestion of infected food (usually unpasteurized dairy), direct contact, and inhalation of aerosols.
  • Symptoms/signs: general malaise, joint and muscle pain, organ inflammation (heart, liver, spleen), fatigue, anorexia(거식증), and neurologic problems.
  • FYI, another reason why dairy is pasteurized and why pregnant women are to avoid eating cheese.
• Viral Enteritis

  • Inflammation of the stomach or intestine is caused typically by a rotavirus(a group of viruses that mostly causes diarrhea in children) and mostly affects infants and children.
  • Sometimes referred to as stomach flu
  • Symptoms/signs: similar to other gastrointestinal infections (i.e. cramps, diarrhea, vomiting)
  • No treatment other than hydration with electrolytes (Pedialyte) and prevention of viral transmission.
• Hepatitis

  • Inflammation of the liver
  • Can be caused by microbes, toxins, alcohol, etc.
  • Symptoms/signs: fever, fatigue, loss of appetite, abdominal pain, jaundice, nausea.
• Hepatitis A (HAV)

  • Acute inflammation of the liver due to infection with Hep A virus via oral/fecal route.
  • Most cases are self-resolving and not chronic.
  • Vaccines are available, but no specific treatment. Prevention via sanitary practices is key.
• Hepatitis B (HBV)

  • Transmitted usually via blood (placental and sexual contact) and less commonly via needle drug use.
  • Infants and sexually active individuals most at risk.
  • Chronic infection that can lead to cirrhosis and liver cancer and in some cases death.
  • Vaccine available.
• Hepatitis C (HCV)

  • Transmitted mainly via blood exchange and less so via placental or sexual contact.
  • Drug uses and blood recipients (before 1992) are most at risk.
  • Infection is usually chronic and it is the leading cause of cirrhosis and liver cancer (1-5% of those infected).
  • Though no vaccine yet, it is now considered curable, but pricey.