Gastroenteritis

Introduction

Gastroenteritis is an inflammation of the mucous membranes of the stomach and small intestine. The inflammation is often accompanied by nausea and diarrhoea. In most cases, viruses are the cause of gastroenteritis - in rare cases, the triggers are bacteria or parasites. Gastroenteritis has nothing to do with the flu (influenza).

Gastroenteritis is usually transmitted through smear infections. The pathogen gets onto objects or surfaces from the stool or vomit of an affected person. As a result, people with poor hygiene can become infected by touching the infected surfaces and the pathogens enter the mouth and subsequently the stomach via the hands. Doctors refer to this as faecal-oral transmission. However, the pathogens can also be transmitted via contaminated drinking water or contaminated food.

The symptoms of gastroenteritis vary depending on the pathogen - they range from mild to severe. Noroviruses are often responsible for the disease in adults and rotaviruses in children. Gastroenteritis is particularly common in infants and children.

Symptoms

The symptoms of gastroenteritis begin acutely: patients suffer from severe diarrhoea and vomiting.Doctors speak of severe diarrhoea when those affected have mushy or liquid stools three times a day or more.

Patients with prolonged diarrhoea lose a considerable amount of fluid.The loss of fluids further weakens patients and can lead to circulatory problems. Infants, small children and the elderly are particularly sensitive.In the case of gastroenteritis, the focus is on compensating for the loss of fluids by drinking more.

Other symptoms of gastroenteritis can include abdominal pain, nausea, headaches and aching limbs.Fever occurs in rare cases.Depending on the pathogen or the patient's condition, gastroenteritis can also be so mild that no symptoms occur at all.

Course

In most cases, gastroenteritis runs its course without complications and those affected usually recover quickly. The vomiting usually subsides within one to two days and the diarrhoea after two to seven days. Bacterial gastroenteritis is generally more severe than viral gastroenteritis.

Nevertheless, severe forms of gastroenteritis can also occur. Particularly in infants, small children and the elderly, the loss of fluids can reach critical proportions that require targeted and rapid treatment. The most important thing here is to compensate for the loss of fluids and electrolytes.

Causes

Viruses are often responsible for gastroenteritis - in rarer cases also bacteria or parasites. Possible viruses include noroviruses, rota viruses, astro viruses, corona viruses and adenoviruses. While adults suffer from noroviruses in half of all cases, infants and young children often contract rotaviruses.

The bacteria that cause gastroenteritis include the following pathogens: Vibrio cholera, Shigella, Campylobacter, Clostridium difficile, Salmonella, Yersinia and pathogenic strains of the intestinal bacterium Escherichia coli.

Gastroenteritis is usually transmitted by smear infection. The pathogens are transferred from the stool or vomit of an affected person to objects or surfaces, where they sometimes survive for days. As a result, people with poor hygiene can become infected by touching the infected surfaces and the pathogens enter the mouth and stomach via the hands. Doctors refer to this as faecal-oral transmission. Some viruses are highly contagious - even a very small amount of virus is enough to infect another person.

Bystanders can also become infected when vomiting: Droplets are transmitted directly to other people via the air. The germs can therefore spread quickly, especially in places where many people come together (for example in nurseries, hospitals or retirement or care homes). The germs also spread via contaminated drinking water or contaminated food, for example fish or seafood.

Diagnosis

Gastroenteritis is usually diagnosed on the basis of typical symptoms. After taking a medical history and making a diagnosis, the doctor should clarify how much fluid the affected person is losing, whether complications have occurred or whether food intolerances such as lactose intolerance may be present. The doctor is also interested in what and how much the patient has eaten in the past few hours. This information is used to assess the patient's fluid and energy balance. The doctor may also want to know if the patient has travelled abroad, has other illnesses or is taking medication.

In many cases, this information can also be collected by a doctor without having to see the patient in person or examine them on site. A doctor can diagnose gastroenteritis very well via telemedicine and in many cases treat it over the phone or video. This is particularly useful as it prevents further infections through contact with other people in a doctor's surgery or on public transport and protects patients. Furthermore, the patient can send a photo of their bowel movements as part of a telemedical consultation - this helps to make an even more accurate diagnosis.

It is only necessary to investigate gastroenteritis in greater depth in certain severe cases. This is the case, for example, if the patient has blood in their faeces, complications such as blood poisoning occur, there is an immune deficiency or an infant under the age of three months is affected. In order to clarify whether the gastroenteritis was caused by viruses or bacteria, a stool sample is analysed in the laboratory. A blood and urine test can also be carried out.

Treatment

In the case of gastroenteritis, treatment to compensate for the loss of fluids and electrolytes is usually sufficient. In otherwise healthy adults, the symptoms disappear on their own and the body can overcome the diarrhoea without medication. It is important to drink plenty of fluids, preferably mineral water or sweetened herbal teas, as sugar and salts have been lost with the diarrhoea. In addition, those affected should take it easy and replenish lost energy. As the body needs potassium as well as sodium, it is advisable to eat bananas as they contain a lot of potassium. In more severe cases, patients can take electrolyte supplements. These contain table salt, potassium chloride, sodium citrate and dextrose and counteract dehydration.

You can also prepare a rehydration solution yourself. A litre of water is enriched with six level teaspoons of sugar, half a level teaspoon of salt and, optionally, a decilitre of orange juice or a mashed banana.

Gastroenteritis should be closely monitored in infants, young children and the elderly: Treatment by a medical professional - whether in a doctor's surgery or telemedically by telephone or video - is advisable in these cases. In severe cases of gastroenteritis, it may be necessary for the affected person to be treated in hospital. In this case, the patient is administered the necessary substances as an infusion or via a nasogastric tube.

If gastroenteritis is caused by bacteria, it can be treated with antibiotics. This applies, for example, to illnesses caused by bacteria such as salmonella, shigella or yersinia. If the gastroenteritis was caused by viruses, antibiotics are not effective. In the case of severe diarrhoea, appropriate medication can alleviate the symptoms.

Prevention

To prevent gastroenteritis, it is important to observe certain hygiene measures. Regular hand washing and special attention when dealing with infants (nappy changes) or sick people help to prevent the spread of germs. As bacterial gastroenteritis is caused by contaminated food, food should be cooked thoroughly. In some cases, a vaccination against rotaviruses provides protection - however, there is still no vaccination against noroviruses.