ABOUT AUTHOR:
Raj Kishor
Avigna Clinical Research Institute
Bangalore
raryan859@gmail.com
ABSTRACT:
Gastroenteritis is a very common disease. Gastroenteritis is a condition that causes irritation and inflammation of the stomach and intestines. The most common symptoms of gastroenteritis are diarrhea, nausea, crampy abdominal pain and vomiting. Also refer to gastroenteritis as "stomach flu." The term stomach flu presumes a viral infection, even though there may be other causes of infection. It causes significant mortality in developing countries and significant economic burden to developed countries. Viruses are responsible for approximately 70% of episodes of acute gastroenteritis in children and rotavirus is one of the best studied of these viruses. Oral rehydration therapy is as effective as intravenous therapy in treating mild to moderate dehydration in acute gastroenteritis and is strongly recommended as the first line therapy. However, the oral rehydration solution is described as an under used simple solution. Vomiting is one of the main reasons to explain the under use of oral rehydration therapy. Antiemetics are not routinely recommended in treating acute gastroenteritis, though they are still commonly prescribed. Ondansetron is one of the best studied antiemetic and its role in enhancing the compliance of oral rehydration therapy and decreasing the rate of hospitalization has been proved recently.
REFERENCE ID: PHARMATUTOR-ART-1910
INTRODUCTION:
Gastroenteritis is an illness triggered by the infection and inflammation of the digestive system, involving the stomach and the small intestine. Symptoms include watery no bloody diarrhea –bloody diarrhea usually means you have a different, more severe infection, vomiting and abdominal cramps. Some of the causes include Viruses, Bacteria, Parasites, Particular chemicals, and some drugs. The main complication of the gastroenteritis is dehydration, but this can be prevented if fluid lost in vomit and diarrhea is replaced. The diagnosis is based on a person’s history of recent contact with the contaminated people, food or water, antibiotic use and sometimes laboratory tests. Gastroenteritis usually consists of mild to severe diarrhea that may be accompanied by loss of appetite (appetite is the desire to eat food or drink, felt as hunger), nausea (nausea is the sensation of unease and discomfort in the upper stomach and head with an urge to vomit), Vomiting and discomfort in the abdomen. Although gastroenteritis usually is not serious in a healthy adult, causing only discomfort and inconvenience, it can cause life threatening dehydration and electrolyte imbalance in the very ill or week and very old .Gastroenteritis can be prevented by thoroughly washing the hands after the bowel movement or contact with fecal matter is the best way to prevent infection. Antibiotics are used to eliminate only certain kinds of bacterial infection.
SYMPTOMS:
You may have symptoms including: Diarrhea (which may contain blood and mucous or be watery, greasy or frothy), Felling sick or vomiting, Abdominal cramp, bloating, stomach rumbling or pain, Loss of appetite, and low grades fever.
CAUSES: It causes diarrhea, and may also cause vomiting, abdominal pain and other symptoms. In most cases the infection clears over several days, but sometimes takes longer. The main risk is dehydration. The main causes of gastroenteritis are infection with viruses, bacteria or parasites. Viruses – Viruses are main causes of gastroenteritis, particularly in children. These includes: Rota virus, noro virus, adeno virus etc. Bacteria – The common cause of bacterial gastroenteritis is food poisoning .Different bacteria that causes food poisoning includes: E-coli, Salmonella etc. Parasites – Parasites rarely causes gastroenteritis .Giardia is a common parasite that is found in water and food.
RECOVERY TIME:
The time between catching the infection and the start of symptom (the incubation period) depends on the type of infection you have. It can range from one hour to a few week but it is usually between one or three days .Most people recover fully within approximately ten days, although you are likely to start felling better sooner than that.
For children with gastroenteritis, diarrhea usually lasts for five to seven days and stops within two weeks, and vomiting usually lasts for one to two days, stopping within three days.
In adults and older children, the symptom of gastroenteritis may be confused with other condition, such as ulcerative colitis (ulcerative colitis is an inflammation of the large intestine).
DIAGNOSIS:
Gastroenteritis is typically diagnosed clinically, based on a person’s sign and symptoms. Your doctors will ask about your symptom and examine you. He or she will ask how often you have vomited, about the frequency and consistency of your bowel movements, how much urine you are passing, whether you have any blood in your faces and if you have been able to keep down any food or drink. Your doctor’s may also ask about your medical history or if you have been in recent contact with someone who had diarrhea and vomiting. However, stool culture should be performed in those with blood in the stool, those who might have been exposed to food poisoning and those who have recently travelled to the developing world. Diagnostic testing may also be done for surveillance. As hypoglycemia occurs in approximately 10% of infants and young. Electrolytes and kidney function should also be checked when there is a concern about severe dehydration.
FOOD AND NUTRITION:
The goal of a gastroenteritis diet is to prevent dehydration. It is also important to maintain a proper balance of electrolytes
Electrolytes, like sodium and potassium, are minerals your body needs to work properly.
Vomiting and diarrhea can take too many electrolytes out of your body. Choose foods that will help you to rehydrate, regulate the balance of electrolytes in your body, and maintain nutrition.
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Recommended Foods |
Foods to Avoid (Adults) |
Foods to Avoid (Infants and Children) |
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For young infants. Breast milk or normal infant formula Normal food is usually best. This could include:
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Some adults and older children find milk products difficult to tolerate during or immediately after an episode of gastroenteritis. |
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Note: If you suspect gastroenteritis in yourself
- Stop eating for a few hours to let your stomach settle.
- Drink plenty of water.
- Ease back in to eating.
- Get plenty of rest.
EXERCISE AND YOGA:
Gastroenteritis and the associated dehydration can make you very tired. Give yourself several days to recover before trying to return to exercise. You should be eating a normal or close to normal diet and keeping down all food and liquids before working out again. Keep in mind that germs and viruses spread easily in fitness centers, so if you usually exercise at a gym, you shouldn't go there until you're no longer contagious. Older adults and people with weakened immune systems should check with a doctor before returning to normal activity gastroenteritis can cause extra complications in these populations.
These disorders are easily curable through yogic system of treatment. In most cases, the trouble controlled within two weeks and it is fully cured in about two months. Let us explain how people suffering from these troubles can cure themselves by following the yoga system of practice. The yoga system of treatment requires: (i) proper diet, and (ii) daily practice of a few asana.
Proper diet: Eat as balanced diet which should include salad, green vegetables and fresh fruits along with other dishes of the day. Eat at least two hours before going to bed at night. Eat not more than about eighty-five percent of your capacity. Do not drink water during the meals, but only about after half an hour of finishing your meals. Take ten to twelve glasses of water every day.
Yoga practice: The important pranayama and asana for correcting these disorders are: Pranayama with Rechaka, asana. Varun mudra (it balances the water content and prevents all diseases which comes due to lack of water.)Benefits of this yoga are it retains clarity in blood by balancing water content in the body. Prevents the pain of gastroenteritis and muscle shrinkage.
WATCH OUT:
Watch out for blood in vomit: When a person vomits blood, he regurgitates blood from his gastrointestinal tract. Sometimes the vomiting of blood, also called hematemesis, may occur in relation to a minor medical condition, or it may be an indication of a serious illness or disease. Among the most common causes of vomiting blood are bleeding ulcers, swallowed blood, or gastrointestinal tract tumors. Sometimes, however, a person may see blood in vomit because he has vomited so forcefully or for such an extended time that blood vessels in his esophagus or throat have torn and bled. Additionally, some people may expel blood through their mouths as a result of coughing and assume they have vomited blood.
Bleeding ulcers are among the most common conditions that cause blood in vomit. For example, a person may develop a hole, referred to as an ulcer, in part of his digestive system. If the hole eventually grows larger and begins to damage blood vessels, it may be called ableeding ulcer. Likewise, an ulcer may grow so that it causes a hole to form in a person’s intestine or in both his intestine and an organ. Both of these conditions may cause a person to vomit blood.
Tumors of the digestive system may sometimes cause a person to vomit blood. For example, an individual may develop a tumor in the lining of his esophagus, which may cause blood to be present in his vomit. These tumors can be benign, which means not cancerous, or malignant, which means cancerous. Regardless of whether or not a tumor is cancerous, however, it may sometimes cause a patient to see blood in vomit. Likewise, a person who has a benign or malignant tumor in his stomach may also vomit blood.
Watch out for possible sign/symptom of dehydration: Depending on how much of your body weight is lost through fluids, dehydration can be described as mild, moderate or severe.
Mild to moderate dehydration—The first sign of dehydration is thirst. Other symptoms may include: dizziness or light-headache, tiredness , dry mouth and lips, Passing only low amount of urine infrequently.
Moderate dehydration causes you to lose strength and stamina. It is primary cause of heat exhaustion. You should be able to reserve mild to moderate dehydration by drinking more fluids, without medical attention .If dehydration is ongoing , it can affect your kidney function and cause kidney stones to develop.
Severe dehydration - untreated mild or moderate dehydration can lead to severe dehydration. Severe dehydration is a medical emergency and requires immediate medical attention. You should seek medical attention if you or your child has any of the following symptoms:
- Dry ,wrinkled skin
- An inability to urinate or not passing urine for eight hours.
- Irritability and sunken eyes
- Low B.P and rapid heartbeat, seizures.
- Blood in your stool or vomit.
If not treated immediately, severe dehydration can lead to complications. You can even die from severe dehydration because the blood stops circulating. If you experience this level of dehydration, you may need to be admitted to hospital and be put on a drip to restore the substantial loss of fluids.
PREVENTION:
Gastroenteritis occurs when a person has a combination of symptoms including nausea, diarrhea and stomach cramping. This is why you will also hear it called “stomach flu.”You cannot really do much to prevent viral gastroenteritis, outside of avoiding the virus when other people have it. There is, however, quit a bit of information to follow when insuring prevention of bacterial gastroenteritis. The chief culprit is food poisoning. To prevent it, you mainly need to use good sense in the care and handling of foods.
You can prevent patient’s disease from spreading to other by following these instructions:
- Keep your distance (as much as possible) from people who have gastroenteritis. You have no way of knowing if their stomach ailment is a viral orbacterial illness. Thus, you do not know the amount of contagion that surrounds the ill person.
- Wash your hands often with anti-bacterial soap. This is particularly important after using the restroom, changing diapers or when you have come in contact with a sick person or animal.
- Note the sanitation and hygiene practices around food handling anywhere you eat. Poor habits in these areas may cause a nasty bout of gastroenteritis due to food poisoning.
- Clean all surfaces on cabinets and counter tops with hot water and bleach in order to kill germs.This action goes a long way toward preventing an upset stomach of any kind.
This disease can be avoided or prevented next time by following these instructions:
- Make sure everyone in the family washes their hands regularly, especially after the use the toilet and before they eat.
- Wash your child’s hands with warm water and soap after they use the toilet and before they eat.
- Wash your hands before you feed and after you change your child’s nappies.
- Keep your child away from other children as much as possible the diarrhea has stopped.
- See your doctor if symptoms continue.
Information on self care and medication in treating gastroenteritis:
Self care: If you have gastroenteritis, it is very important to replace any fluid that your body loses through vomiting and diarrhea. Drink at least two liters of water a day. Oral rehydration salts are recommended for people who are vulnerable to the effect of dehydration.
Medication: Unless your symptoms are severe, medication to treat gastroenteritis is not usually needed. The medications that are used to treat the symptoms of gastroenteritis are: Loperamide, Panadol, ORS, Dextrose intra venous.
CONCLUSION:
Gastroenteritis literally means inflammation of the gastrointestinal tract. Viral gastroenteritis is also called "stomach flu." It is extremely common, especially in children and is highly contagious. Bacterial gastroenteritis is also known as "food poisoning" and is caused by food that has been prepared or stored improperly. It causes diarrhea, and may also cause vomiting, abdominal pain and other symptoms. In most cases the infection clears over several days, but sometimes takes longer. The main risk is dehydration. The main treatment is to have lots to drink which aims to avoid dehydration. You should also eat as normally as possible. There's no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defense.
REFERENCES:
- emedicinehealth.com/gastroenteritis/article_em.htm
- nhs.uk/Conditions/gastroenteritis/Pages/Introduction.aspx
- en.wikipedia.org/wiki/Gastroenteritis
- onhealth.com/gastroenteritis/article.htm
- chealth.canoe.ca/condition_info_details.asp?disease_id=61
- onhealth.com/gastroenteritis/page9.htm#what_is_the_prognosis_of_gastroenteritis
- edition.cnn.com/2013/03/03/health/gastroenteritis-five-things
- mayoclinic.com/health/viral-gastroenteritis/DS00085
- gastrojournal.org/article/S0016-5085(08)00957-8/abstract
- jech.bmj.com/content/58/4/273.abstract
- amec.glp.net/c/document_library/get_file?p_l_id=850754&folderId=754745&name=DLFE-19871.pdf
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