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Gastroenteritis

Gastroenteritis
Other namesGastro, stomach bug, stomach virus, stomach flu, gastric flu, gastrointestinitis
Gastroenteritis viruses: A = rotavirus, B = adenovirus, C = norovirus and D = astrovirus. The virus particles are shown at the same magnification to allow size comparison.
SpecialtyInfectious disease, gastroenterology
SymptomsDiarrhea, vomiting, abdominal pain, fever[1][2]
ComplicationsDehydration[2][3]
CausesViruses, bacteria, parasites, fungus[2][4]
Diagnostic methodBased on symptoms, occasionally stool culture[2]
Differential diagnosisInflammatory bowel disease, malabsorption syndrome, lactose intolerance[5]
PreventionHand washing, drinking clean water, proper disposal of human waste, breastfeeding[2]
TreatmentOral rehydration solution (combination of water, salts, and sugar), intravenous fluids[2]
Frequency2.4 billion (2015)[6]
Deaths1.3 million (2015)[7]

Gastroenteritis, also known as infectious diarrhea or simply as gastro, is an inflammation of the gastrointestinal tract including the stomach and intestine.[8] Symptoms may include diarrhea, vomiting, and abdominal pain.[1] Fever, lack of energy, and dehydration may also occur.[2][3] This typically lasts less than two weeks.[8] Although it is not related to influenza, in the U.S. and U.K., it is sometimes called the "stomach flu".[9]

Gastroenteritis is usually caused by viruses;[4] however, gut bacteria, parasites, and fungi can also cause gastroenteritis.[2][4] In children, rotavirus is the most common cause of severe disease.[10] In adults, norovirus and Campylobacter are common causes.[11][12] Eating improperly prepared food, drinking contaminated water or close contact with a person who is infected can spread the disease.[2] Treatment is generally the same with or without a definitive diagnosis, so testing to confirm is usually not needed.[2]

For young children in impoverished countries, prevention includes hand washing with soap, drinking clean water, breastfeeding babies instead of using formula,[2] and proper disposal of human waste. The rotavirus vaccine is recommended as a prevention for children.[2][10] Treatment involves getting enough fluids.[2] For mild or moderate cases, this can typically be achieved by drinking oral rehydration solution (a combination of water, salts and sugar).[2] In those who are breastfed, continued breastfeeding is recommended.[2] For more severe cases, intravenous fluids may be needed.[2] Fluids may also be given by a nasogastric tube.[13] Zinc supplementation is recommended in children.[2] Antibiotics are generally not needed.[14] However, antibiotics are recommended for young children with a fever and bloody diarrhea.[1]

In 2015, there were two billion cases of gastroenteritis, resulting in 1.3 million deaths globally.[6][7] Children and those in the developing world are affected the most.[15] In 2011, there were about 1.7 billion cases, resulting in about 700,000 deaths of children under the age of five.[16] In the developing world, children less than two years of age frequently get six or more infections a year.[17] It is less common in adults, partly due to the development of immunity.[18]

  1. ^ a b c Singh A (July 2010). "Pediatric Emergency Medicine Practice Acute Gastroenteritis — An Update". Pediatric Emergency Medicine Practice. 7 (7).
  2. ^ a b c d e f g h i j k l m n o p q Ciccarelli S, Stolfi I, Caramia G (29 October 2013). "Management strategies in the treatment of neonatal and pediatric gastroenteritis". Infection and Drug Resistance. 6: 133–61. doi:10.2147/IDR.S12718. PMC 3815002. PMID 24194646.
  3. ^ a b Ferri's Clinical Advisor 2015: 5 Books in 1. Elsevier Health Sciences. 2014. p. 479. ISBN 978-0-323-08430-7. Archived from the original on 2017-09-08.
  4. ^ a b c A Helms R (2006). Textbook of therapeutics: drug and disease management (8 ed.). Philadelphia [u.a.]: Lippincott Williams & Wilkins. p. 2003. ISBN 978-0-7817-5734-8. Archived from the original on 2017-09-08.
  5. ^ Caterino JM, Kahan S (2003). In a Page: Emergency medicine. Lippincott Williams & Wilkins. p. 293. ISBN 978-1-4051-0357-2. Archived from the original on 2017-09-08.
  6. ^ a b GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  7. ^ a b GBD 2015 Mortality and Causes of Death Collaborators (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  8. ^ a b Schlossberg D (2015). Clinical infectious disease (Second ed.). Cambridge University Press. p. 334. ISBN 978-1-107-03891-2. Archived from the original on 2017-09-08.
  9. ^ Shors T (2013). The microbial challenge: a public health perspective (3rd ed.). Burlington, MA: Jones & Bartlett Learning. p. 457. ISBN 978-1-4496-7333-8. Archived from the original on 2017-09-08.
  10. ^ a b Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD (February 2012). "2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis". The Lancet Infectious Diseases. 12 (2): 136–41. doi:10.1016/S1473-3099(11)70253-5. PMID 22030330.
  11. ^ Marshall JA, Bruggink LD (April 2011). "The dynamics of norovirus outbreak epidemics: recent insights". International Journal of Environmental Research and Public Health. 8 (4): 1141–9. doi:10.3390/ijerph8041141. PMC 3118882. PMID 21695033.
  12. ^ Man SM (December 2011). "The clinical importance of emerging Campylobacter species". Nature Reviews Gastroenterology & Hepatology. 8 (12): 669–85. doi:10.1038/nrgastro.2011.191. PMID 22025030. S2CID 24103030.
  13. ^ Webb A, Starr, M (April 2005). "Acute gastroenteritis in children". Australian Family Physician. 34 (4): 227–31. PMID 15861741.
  14. ^ Zollner-Schwetz I, Krause R (August 2015). "Therapy of acute gastroenteritis: role of antibiotics". Clinical Microbiology and Infection. 21 (8): 744–9. doi:10.1016/j.cmi.2015.03.002. PMID 25769427.
  15. ^ Webber R (2009). Communicable disease epidemiology and control : a global perspective (3rd ed.). Wallingford, Oxfordshire: Cabi. p. 79. ISBN 978-1-84593-504-7. Archived from the original on 2015-10-26.
  16. ^ Walker CL, Rudan, I, Liu, L, Nair, H, Theodoratou, E, Bhutta, ZA, O'Brien, KL, Campbell, H, Black, RE (Apr 20, 2013). "Global burden of childhood pneumonia and diarrhoea". Lancet. 381 (9875): 1405–16. doi:10.1016/S0140-6736(13)60222-6. PMC 7159282. PMID 23582727.
  17. ^ Dolin R, Mandell GL, Bennett JE, eds. (2010). "Chapter 93". Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia: Churchill Livingstone/Elsevier. ISBN 978-0-443-06839-3.
  18. ^ Eckardt AJ, Baumgart DC (January 2011). "Viral gastroenteritis in adults". Recent Patents on Anti-Infective Drug Discovery. 6 (1): 54–63. doi:10.2174/157489111794407877. PMID 21210762.

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