Gastroenteritis
Basics
Description
Description
Inflammation of stomach and intestines associated with diarrhea and vomiting; often the result of infectious or toxin exposure
Etiology
InfectiousEtiology
- Viruses:
- 50–70% of all cases with Norovirus cases on the rise in travelers returning from Mexico and India
- Invasive bacteria:
- Campylobacter: Contaminated food or water, wilderness water, birds, and animals:
- Most common cause
- Gross or occult blood is found in 60–90%
- Salmonella: Contaminated water, eggs, poultry, or dairy products:
- Typhoid fever (Salmonella typhi) characterized by unremitting fever, abdominal pain, rose spots, splenomegaly, and bradycardia
- Immunocompromised susceptible
- Shigella: Fecal–oral route
- Vibrio parahaemolyticus: Raw and undercooked seafood
- Yersinia: Contaminated food (pork), water, and milk:
- May present as mesenteric adenitis or mimic appendicitis
- Specific food-borne disease (food poisoning):
- Staphylococcus aureus:
- Most common toxin-related disease
- Symptoms within 1–6 hr after ingesting food
- Bacillus cereus:
- Classic source is fried rice left on steam tables
- Symptoms within 1–36 hr
- Staphylococcus aureus:
- Cholera: Profuse watery stools with mucous (rice-water stools)
- Ciguatera:
- Fish intoxication
- Onset 5 min–30 hr (average 6 hr) after ingestion
- Paresthesias, hypotension, peripheral muscle weakness
- Scombroid:
- Caused by blood fish: Tuna, albacore, mackerel, and mahi-mahi
- Flushing, headache, erythema, dizziness, blurred vision, and generalized burning sensation
- Symptoms last <6 hr
- Treatment includes antihistamines
- Campylobacter: Contaminated food or water, wilderness water, birds, and animals:
- Protozoa:
- Giardia lamblia:
- High-risk groups: Travelers, day care children, homosexual men, and campers who drink untreated mountain water
- Giardia lamblia:
Noninfectious Causes
- Toxins:
- Zinc, copper, cadmium
- Organic chemicals: Polyvinyl chlorides
- Pesticides: Organophosphates
- Radioactive substances
- Alkyl mercury
- Altered host response to food substance (tyramine, monosodium glutamate, tryptamine)
Pediatric Considerations
- Focus evaluation on state of hydration
- Most of viral origin and self-limited
- Rotavirus accounts for up to 50%
- Shigella infections associated with seizures
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Schaider, Jeffrey J., et al., editors. "Gastroenteritis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307544/all/Gastroenteritis.
Gastroenteritis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307544/all/Gastroenteritis. Accessed November 13, 2024.
Gastroenteritis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307544/all/Gastroenteritis
Gastroenteritis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 13]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307544/all/Gastroenteritis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Gastroenteritis
ID - 307544
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307544/all/Gastroenteritis
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
ER -