Bacterial gastroenteritis

Answer 1

Definition

Bacterial gastroenteritis is inflammation of the stomach and intestines caused by bacteria.

Alternative Names

Infectious diarrhea - bacterial gastroenteritis; Acute gastroenteritis; Gastroenteritis - bacterial

Causes, incidence, and risk factors

Bacterial gastroenteritis can affect one person or a group of people who all ate the same contaminated food. It more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants.

The germs may get into the food you eat (called contamination) in different ways:

• Meat or poultry may come into contact with the normal bacteria from the intestines of an animal being processed.
• Water that is used during growing or shipping may contain manure or human waste.
• Food handling or preparation in grocery stores, restaurants, or homes.

Food poisoning often occurs from eating or drinking:

• Any food prepared by someone who does not use proper hand washing techniques
• Any food prepared using cooking utensils, cutting boards, or other tools that are not fully cleaned
• Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have sat out of the refrigerator too long
• Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly
• Raw fish or oysters
• Raw fruits or vegetables that have not been washed well
• Raw vegetable or fruit juices and dairy (look for the word "pasteurized")
• Undercooked meats or eggs
• Water from a well or stream, or city or town water that has not been treated

Many different types of bacteria can cause bacterial gastroenteritis, including:

• Campylobacter jejuni (see: Campylobacter enteritis)
• Clostridium
• E. coli (see: E. coli enteritis)
• Salmonella (see: Salmonella enteritis)
• Shigella (see: Shigella enteritis)
• Staphylococcus
• Yersinia

Symptoms

Each organism causes slightly different symptoms but all result in diarrhea. Other symptoms include:

• Abdominal cramps
• Abdominal pain
• Bloody stools
• Loss of appetite
• Nausea and vomiting

Signs and tests

• Examination of food for bacteria
• Stool culturepositive for the bacteria that causes the infection
• White blood cells in the stool

This disease may also alter the results of the following tests:

• Fecal smear
• Stool gram stain

Treatment

You will usually recover from the most common types of bacterial gastroenteritis within a couple of days. The goal is to make you feel better and avoid dehydration.

• Don't eat solid foods until the diarrhea has passed, and avoid dairy products, which can make diarrhea worse (due to a temporary state of lactose intolerance).
• Drink any fluid (except milk or caffeinated beverages) to replace fluids lost by diarrhea and vomiting.
• Give children an electrolyte solution sold in drugstores. See also: Diarrhea in children

If you have diarrhea and are unable to drink fluids (for example, due to nausea or vomiting), you may need medical attention and intravenousfluids (fluids into your veins). This is especially true for young children.

If you take diuretics, you need to manage diarrhea carefully. Talk to your health care provider -- you may need to stop taking the diuretic while you have the diarrhea. NEVER stop or change medications without talking to your health care provider and getting specific instructions.

For the most common causes of bacterial gastroenteritis, your doctor would NOT prescribe antibiotics, unless the diarrhea is unusually severe.

You can buy medicines at the drugstore that can help stop or slow diarrhea. Do not use these medicines without talking to your health care provider if you have bloody diarrhea or a fever. Do not give these medicines to children.

Expectations (prognosis)

In most cases, symptoms improve with fluid and electrolyte replacement within a week. Rare cases of kidney failure or death related to bacterial gastroenteritis have been reported.

There have been increasing incidents of local outbreaks of severe infection with certain strains of E. coli bacteria. These outbreaks can be dangerous, especially to the elderly or very young children.

Complications

• Dehydration
• Kidney failure (rare)
• Low blood counts (anemia)
• Systemic(body-wide) infection

Calling your health care provider

Call for an appointment with your health care provider if:

• You have blood or pus in your stools, or your stool is black
• You have abdominal pain that does not go away after a bowel movement
• You have symptoms of dehydration (thirst, dizziness, light-headedness)
• You have a fever above 101F, or your child has a fever above 100.4F, along with diarrhea
• You have recently traveled to a foreign country and developed diarrhea
• Your diarrhea does not get better in 5 days (2 days for an infant or child), or gets worse
• Your child has been vomiting for more than 12 hours (in a newborn under 3 months you should call as soon as vomiting or diarrhea begins)

Prevention

Proper handling, storage, and preparation of food -- in addition to good sanitation -- are principles of prevention.

See also: Preventing food poisoning

References

Sodha SV, Griffin PM, Hughes JM. Foodborne disease. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 99.

Craig SA, Zich DK. Gastroenteritis. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 92.

Answer 2

Definition

Bacterial gastroenteritis is inflammation of the stomach and intestines caused by bacteria.

Alternative Names

Infectious diarrhea - bacterial gastroenteritis; Acute gastroenteritis; Gastroenteritis - bacterial

Causes, incidence, and risk factors

Many different types of bacteria can cause bacterial gastroenteritis, including:

• Campylobacter jejuni (see: Campylobacter enteritis)
• E. coli (see: E. coli enteritis)
• Salmonella (see: Salmonella enteritis)
• Shigella (see: Shigella enteritis)
• Staphylococcus
• Yersinia

Bacterial gastroenteritis can affect one person or a group of people who all ate the same food containing the bacteria. The condition more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants.

Bacteria may get into your food in different ways:

• Meat or poultry may come into contact with intestinal bacteria when being processed
• Water that is used during growing or shipping may contain animal or human waste
• Improper food handling or preparation

Food poisoning often occurs from eating or drinking:

• Any food prepared by someone who did not wash their hands properly
• Any food prepared using unclean cooking utensils, cutting boards, or other tools
• Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long
• Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly
• Raw fish or oysters
• Raw fruits or vegetables that have not been washed well
• Raw vegetable or fruit juices and dairy
• Undercooked meats or eggs
• Water from a well or stream, or city or town water that has not been treated

Symptoms

Symptoms depend on the type of bacteria that caused the sickness. All types of food poisoning cause diarrhea. Other symptoms include:

• Abdominal cramps
• Abdominal pain
• Bloody stools
• Loss of appetite
• Nausea and vomiting

Signs and tests

Your health care provider will examine you for signs of food poisoning, such as pain in the stomach and signs your body does not have as much water and fluids as it should. This is called dehydration.

Laboratory tests may be done on the food or a stool sample to determine what bacteria is causing your symptoms.

Treatment

You will usually recover from the most common types of bacterial gastroenteritis within a couple of days. The goal is to make you feel better and avoid dehydration.

These things may help you feel better if you have diarrhea:

• Drink 8 to 10 glasses of clear fluids every day. Water is best.
• Drink at least 1 cup of liquid every time you have a loose bowel movement.
• Eat small meals throughout the day, instead of 3 big meals.
• Eat some salty foods, such as pretzels, soup, and sports drinks.
• Eat some high potassium foods, such as bananas, potatoes without the skin, and watered-down fruit juices.

Give your child fluids for the first 4 to 6 hours. At first, try 1 ounce (2 tablespoons) of fluid every 30 to 60 minutes.

Try an over-the-counter drink, such as Pedialyte or Infalyte. Do not water down these drinks. Pedialyte is also available as a popsicle.

Watered-down fruit juice, or broth, may also help.

See also: Diarrhea in children

If you have diarrhea and are unable to drink fluids because of nausea or vomiting, you may need to go to the hospital to receive fluids through a vein (IV). This is especially true for young children.

If you take diuretics, talk to your health care provider. You may need to stop taking the diuretic while you are sick. Never stop or change medications without talking to your health care provider and getting specific instructions.

Antibiotics are usually not prescribed for most common types of bacterial gastroenteritis, unless the diarrhea is extremely severe.

Do not use over-the-counter medicines to treat diarrhea without talking to your doctor first. They should not be given to children.

Expectations (prognosis)

Most of the time, you get better within a week if you drink enough fluids.

Rarely, kidney failure or death have occured in people with bacterial gastroenteritis.

Complications

Complications may include:

• Anemia
• Body-wide (systemic) infection
• Not enough water in your body (dehydration)
• Kidney failure (rare)

Calling your health care provider

Call for an appointment with your health care provider if you have:

• Blood or pus in your stools
• Black stools
• Stomach pain that does not go away after a bowel movement
• Symptoms of dehydration (thirst, dizziness, light-headedness)
• Diarrhea with a fever above 101°F (100.4°F in children)
• Recently traveled to a foreign country and developed diarrhea

Also call your doctor if:

• The diarrhea gets worse or does not get better in 2 days for an infant or child, or 5 days for adults
• A child over 3 months old has been vomiting for more than 12 hours; in younger babies, call as soon as vomiting or diarrhea begins

Prevention

See: Preventing food poisoning

References

Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 15.

Reviewed By

Review Date: 01/10/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.