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READINGS
Gastroenteritis is a general name for a condition that affected by abdominal
cramps, diaarhea and vomiting. It can be caused by a number of different agents with
viruses and bacteria being the common causes. Staphylococcal; food poisoning in which
the irritating factor is the toxin produced by the organism may occur when food such as
cream potato salad are allowed to remain at room temperature for a period of time before
they are eaten. The Staphylococcal organisms multiply and forms a toxin which when
ingested causes a violent gastroenteritis in 2-4 hours. Bacterial and viral food poisoning
usually develop 10-16 hours after ingestion of contaminated food.
Gastroenteritis is the irritation and inflammation of the digestive tract. This
condition may cause abdominal pain, vomiting and diarrhea. Severe cases of
gastroenteritis can result in dehydration. In such cases gastroenteritis fluid replacement is
the primary factor in treatment. All ages and both sexes may be affected yet the more
severe symptoms are experienced by infants and those individuals over sixty years old.
The use of certain drugs such as aspirin, antibiotics or cortisone drugs may increase risk
for this condition.
Food poisoning, stress, excessive alcohol or tobacco use, viral infections, food
allergies, improper diet, certain drugs, food consumed in foreign countries and intestinal
parasites are all possible causes for this condition.
Gastroenteritis caused by viral infection or bacteria is easily passed from one
person to another. Care should always be taken to was often especially when preparing
food and after bowel movements. Hand washing after bowel movements is important
since the organism that causes this condition lives in the digestive tract.
The symptoms of gastroenteritis can include: abdominal cramps. Nausea and
vomiting, diarrhea, loss of appetite, weakness, fever or chills and dehydration.
Many organisms pass through during a year and transitory epidemics of
gastroenteritis are common. This infection is temporarily disabling depending upon the
intensity of the symptoms but they are of short duration and usually are not serious
except in infants the very elderly and weakened debilitated individuals. Fluid and

electrolyte imbalances occur easily in these persons because of the lowered efficiency of
their compensatory mechanism.
Viral gastroenteritis may last from several hours to several days and clear up
without medicines while bacterial infections can last over a week and require medication.
Most cases of gastroenteritis in adults will clear up after a few days. For infants under
two months of age any symptoms of this condition should be seen as serious and a doctor
should be consulted.
In most children, gastroenteritis symptoms are caused by rotavirus. The parents of
a child infected with rotavirus often become ill as well. The rotavirus season is usually
during October through April. The incubation period is about two days, followed by
about three days of active vomiting, after which there are approximately 4-8 days of
diarrhea. As with any client ailment-affecting children, a doctor should be consulted even
when symptoms are mild
The Norwalk virus is another possible cause of infections gastroenteritis. This
maybe transmitted through contaminated water. Eating other foods that have been stored
improperly or prepared in an unclean environment also contracts infections
gastroenteritis.
Bed rest with nothing by mouth until vomiting has stopped is the best treatment.
Fluids such as broth, ginger ale and lemonade which nutrients and electrolytes are given
as soon as possible to replace looses. Sometimes antibiotics are given if the infecting
organism is identified and the condition is persistent.
TYPES OF GASTROENTERITIS ACCORDING TO CAUSE
1. Viral Gastroenteritis- caused by the Norwalk Agents, rotavirus and enterovirus
(coxsakievirus, echoviruses).
2. Bcterial Gastroenteritis- commonly caused by Shigella, Salmonella and
Campylobacter.
3. Toxin-associated Gastroenteritis- usually caused by Staphylococcus Aureus or
Clostridum Perfringers.

Viruses by far are the most common pathogens, but they are difficult to culture.
Of the aforementioned pathogens, only Salmonella and Shigella isolates are reportable to
the Center for disease Control. Most cases of Acute Gastroentertis however occur in the
warm summer months. The warm temperature during these months is favorable for
growth of bacteria.
Bacterial and viral GI illnesses are spread by the fecal-oral route. Most cases are
acquired by person-to-person contact, although the potential for food-and water- borne
outbreaks is ever present. Many factors such as numbers of organisms ingested, source of
exposure, and host-defense mechanisms, determine whether a person will become ill.
The number of GI pathogens is very large. Some organisms are carried by the
human host only. Other pathogens have animal hosts as well. Poultry, beef and dairy
products are often become contaminated with Salmonella during processing. If meats are
not cooked to the proper temperature, or are mishandled somewhere along the cooking
process, the organisms can multiply to numbers sufficient to cause GI illness.
The enterotoxin- producing organisms produce toxins that cause GI
illness. The most common is the Staphylococcus Aureus. When food is contaminated
with the organisms and held or cooked to improper temperatures, toxins are produced.
Once these bacterial toxins are ingested, the resulting GI illness is usually mild and selflimited, but dehydration can occur. Patients who ingest the performed bacterial toxins and
subsequently become ill are not infectious.
For most bacterial and viral enteric illnesses, persons can be considered infectious
while the organisms are incubating and when the person is having overt symptoms or
convalescing from a disease. The patient is most infectious while having diarrhea (when
large number of microorganisms are excreted). If hands are not washed with soap and
water, particularly after defecating, the organisms can be spread directly to others hands,
by uncooked foods touched by the person, or indirectly through contaminated fomites.
Water supplies especially in places with inadequate sanitation can become
polluted with sewage. Inadvertent cross-connections between sewage and water lines
have also occurred. In both instances, widespread bacterial and viral enteritis occur in
persons who consume the contaminated water.

The body has a number of natural barriers to pathogens. Initially, the gastric acid
is effective in killing many bacteria. Conditions in which gastric acidity is reduced
(antacid used, achlorhydria, gastrectomy0 make a person more susceptible to certain
bacterial pathogens. Surviving microorganisms then move into the intestines, where
normal microbial flora has some antimicrobial activity against these foreign
microorganisms. If the patient is taking antibiotics such as tetracyclines or ampicillin at
the time of exposure, the normal microbial flora may have be reduced and predispose the
patient to infection. The immunosuppressed patient is also at risk. Persons at either end of
the age spectrum are at risk for more serious disease and complication.
Organisms can produce diarrhea by a number of mechanisms. They can provoke
the small and large intestines to secrete large quantities of fluids (often by rising levels of
cyclic AMP), cause malabsorption (by deconjugating bile salts), and invade and damage
intestinal cells directly (as Shigella invades the colonic mucosa to produce dysentery).
Vomiting caused by S. Aureus enterotoxins is probably due to toxin interaction
with abdominal viscera. The vagus and sympathetic nerves then carry this sensory
stimulus to the vomiting center of the brain.
Incubation period of the pathogens that cause gastroenteritis varies from a few
hours to a week. Although symptoms also vary according to the etiologic agent, several
symptoms of gastroenteritis are common to all of them. The patient with gastroenteritis
will probably experience an acute onset of nausea, vomiting or diarrhea. If the pathogen
is bacterial, these symptoms are often accompanied by fever, headache and blood in the
stools. Myalgias and abdominal cramps are frequently present. Illness caused by toxins
usually occurs within 2 to 12 hours of eating the contaminated food and rarely includes
fever and bloody diarrhea.
No matter what the cause of the diarrhea or vomiting, dehydration is always a
possibility. Therefore the patient will need to be assessed carefully for symptoms of
dehydration. Young children and elderly persons are especially susceptible to rapid
dehydration.
Individuals at risk of developing complications of bacterial infections tend to have
some type of underlying condition either of the hemetopoietic system or the GI tract.
Patients with deficiencies in cellular immunity are also at increased risk of complications.

The use of antibiotics in the treatment of gastroenteritis depends upon the

etiologic agent, but most of the illnesses are self-limiting. Antibiotic use is avoided with
mild infections caused by some bacteria (Salmonella), as the antibiotics may prolong the
carrier state or lead to resistant organism. Antibiotics are used in the cases of enteric
fever, bacteremia, localized infections and in cases of severe or prolonged diarrhea.
Antibiotics are no effective against viral or toxin-induced illnesses. Dehydration is also
necessary especially if the patient demonstrates severe loss of fluid in the body.