Gastroenteritis

Gastroenteritis is inflammation of the mucous membrane of the stomach and intestines. Its features include diarrhoea and vomiting, which cause loss of water and electrolytes, followed by dehydration and electrolyte imbalance. The main causes of gastroenteritis are viruses, bacteria and parasites. Symptoms: diarrhoea, stomach ache, nausea, fever, chills, lethargy and general weakness, severe abdominal pain, and dry lips and mouth.

In some people the symptoms of this condition are obvious, and they need treatment for a few days. Expected outcome: vomiting and diarrhoea usually settle within 2–5 days, but adults may feel weak and tired for up to a week.

Warning

• If you develop a fever or bloody stools, seek medical care.
• If vomiting and diarrhoea last more than 24 hours, see a doctor.
• The serious complication of this illness is dehydration and a shortage of salts in the blood, which must be treated under a doctor's supervision with medicines and an IV drip if needed. How the disease spreads: this illness may be passed on through contaminated water or by sharing personal items. Using feeding bottles for children, and poor hygiene of these bottles, is one of the most important reasons for the spread of this disease worldwide. The disease is also spread by shaking hands, close contact with a sick person, and contaminated food such as fruit and vegetables that have not been washed properly and carefully. Medicines
• If gastroenteritis is severe or long-lasting, anti-nausea and antidiarrhoeal medicines may be prescribed.
• For some bacteria and parasites, specific antibiotic treatment may be needed.
• If dehydration occurs, the loss of water and electrolytes is corrected by the doctor.

Treatment: the first line of treatment for gastroenteritis is giving fluids to treat dehydration. This can be achieved by giving fluids by mouth, although intravenous (IV) fluids may be needed if there is reduced consciousness or severe dehydration with repeated vomiting. Prevention: the most important way to prevent gastroenteritis is good personal and public hygiene.

A source of clean water that is easy to reach is essential. Additional measures such as hand washing are effective both in reducing the rate of infection and in shortening its duration. In the hot season, food should be freshly prepared and should not be kept outside the fridge. Avoid suspicious food sold outside. Eating a lot of ready-made food (sausages, sandwiches, etc.) should be avoided, especially for children.

A lot of ice cream is eaten in this season, so it is very important that ice cream is pasteurised. People travel a lot in summer, and contaminated ice should be avoided, especially factory-made ice when it is not known how it was produced. Use ice only indirectly to cool water and drinks: put the bottle among the ice rather than putting ice into the glass of water. If you suspect that water may be contaminated, boil it for 10 to 15 minutes. Activity and nutrition

• Rest in bed until the nausea, vomiting, diarrhoea and fever have gone.
• Avoid fruit juice, milk and sweet foods, which make diarrhoea worse.
• Gradually start eating light foods such as rice, bananas and potatoes.
• After contact with a sick person, wash your hands properly with soap and water for 30 seconds.
• Even in the worst diarrhoea, 60 to 70 per cent of food is still absorbed.
• If you can tolerate fluids, drink plenty of them.

• Even if eating makes the diarrhoea worse, it is important for preventing malnutrition, so eat more often and have smaller portions at each meal.
• If vomiting prevents eating, the patient should be given fluids in small amounts and often, which in itself helps to prevent vomiting.
• To prevent dehydration, give plenty of clear, thin fluids such as tea, runny jelly and commercial electrolyte solutions such as ORS (oral rehydration salts, available from pharmacies). Advice for mothers caring for children with gastroenteritis
• Mothers are advised to breastfeed their children.
• Give children fresh food and do not give them food left over from the night before.
• Keep children's meals in the fridge.
• Do not give children foods such as sausages and processed cold meats.
• If you are planning to travel, make sure you will have clean water.
• Buy snacks and ice cream from a safe place, and do not give children too many snacks.

Prepared and compiled by: Pooneh Nemati Pourkermani – Education Unit
Source: Brunner and Suddarth, Gastrointestinal Disorders, 2012; Marlow, Paediatric Diseases
Document code: NO-BR-11