Gastroenteritis

• Gastroenteritis is inflammation all the way from the stomach to the intestines and presents with pain, nausea, vomiting and diarrhoea.
• The most common cause of GE is viral:

  • Easily spread, often have affected family member or contact
  • Isolate the patient
  • Rotavirus
  • Norovirus
  • Adenovirus
• E.Coli:

  • Only certain strains cause GE - E. coli 0157
  • Spread through infected faeces, unwashed salads and contaminated water
  • E. coli 0157 produces Shiga toxin - abdominal cramps, blood diarrhoea and vomiting, haemolytic uraemic syndrome
  • Avoid antibiotics - increased risk of HUS
• Campylobacter Jejuni

  • Most common cause of GE
  • Spread by raw poultry, untreated water and unpasteurised milk
  • Abdominal cramps, bloody diarrhoea, vomiting and fever
  • Antibiotics can be considered after isolating the organism and the patient has severe symptoms or other risk factors
  • Clarithromycin
• Shigella:

  • Spread via faeces
  • Bloody diarrhoea, abdominal cramps and fever
  • Can produce Shiga toxin which can cause haemolytic uraemic syndrome
  • Severe cases - azithromycin
• Salmonella:

  • Raw eggs or poultry or food contaminated with the infected faeces of small animals
  • Watery diarrhoea - may be associated with mucus or blood
  • Abdominal pain and vomiting
  • Antibiotics only necessary in severe cases and are guided by culture results
• Bacillus Cereus:

  • Contaminated cooked food - grows on food not immediately refrigerated after cooking
  • Fried rice or pasta left at room temperature
  • Produces a toxin called cereulide - reheating does not destroy this toxin
  • Vomiting within 5 hours, diarrhoea after 8 hours and resolution within 24 hours
• Post-gastroenteritis complications:

  • Lactose intolerance
  • IBS
  • Reactive arthritis
  • GBS
  • Haemolytic uraemic syndrome