Gastroenteritis or Stomach Flu, is made of two words- Gastro: Stomach, Enteri: Intestines and Itis: Inflammation. Therefore, Gastroenteritis is inflammation of gastrointestinal tract involving Stomach and Intestines. It is indeed one of the common symptoms in people, but dangerous in children and babies, as it can cause severe complications.
Today we are going to uncover the question-answers approach towards Gastroenteritis and Difference between Bacterial and Viral Gastroenteritis while also dealing with causes, signs and symptoms of gastro-enteritis.
Gastroenteritis can be causes by a number of pathogens, involving the main categories as Viruses (Viral gastroenteritis), Bacteria (Bacterial gastroenteritis), Parasites (Parasitic gastroenteritis) and finally, Fungus (Fungal gastroenteritis). Following table explains the causes of Gastroenteritis in more detailed fashion:
Contents
Causes
- Virus
- Bacteria
- Parasite
- Fungus
Viral Gastroenteritis Causes
These can include the following:
- Rotavirus (common in <5 year olds)
- Norovirus (common at all ages)
- Sapovirus (common in <5 years)
- Astrovirus (common in <5 years)
- Adenovirus (common in <5 years)
Bacterial Gastroenteritis Causes
These can include the following:
- Campylobacter jejuni
- E.coli (Traveller’s diarrhea)
- Salmonella
- Shigella
- Vibrio cholerae
- Stahylococcus Aureus
- Clostridium difficile
Parasitic Gastroenteritits Causes
These can include the following:
- Giardia lamblia
- Entamoeba histolytica
Fungal Gastroenteritis Causes
These can include the following:
- Candida spp (candiasis)
- Histoplasmosis capsulatum (histoplasmosis)
- Mucorales spp (mucormycosis)
- Paracoccidioides brasiliensis (South American blastomycosis)
Difference between Bacterial and Viral Gastroenteritis
| Feature | Viral | Bacterial |
|---|---|---|
| Setting | Developed/Developing country | Poor hygiene and sanitation |
| Season | Winter | Summer |
| Incubation period | 1-3 days usually | 1-7 days commonly, few hours maybe (Staph. Aureus) |
| Fever | Common with Rotavirus and Norovirus | Common with Diarrhea (Salmonella and Shigella) |
| Vomitting | Very common, espeically in children | Uncommon with diarrhea |
| Duration | 1-3 days: Norovirus,Sapovirus 2-8 days: Others |
1-2 days: Toxins producing bacteria 2-8 days: Others |
| Diagnosis | Diagnosis of exclusion Electron microscopy (EM) or Enzyme Immunoassay (EIA) |
Stools: Leucocytes and blood Culture of stools for bacterial growth Total Leucocyte Count (TLC) or Differential Leucocyte Count (DLC) of blood |
| Treatment | Only Supportive treatment Anti-motility drugs and Anti-bacterials are contradicted |
Anti-biotics Suportive treatment |
| Diarrhea | Common Non-bloody in all cases |
Prominent Blood-stained |
Clinical Features
Signs and Symptoms
Gastro-enteritis or Stomach flu presents as following symptoms:
- Vomiting
- Diarrhoea
- Abdominal cramps
- Lasts around 1-7 days at max
- Start around (Gastroenteritis Incubation period) 12-72 hours of ingestion of contaminated food
- Associated symptoms include Headache, Fever, Chills and Myalgia (muscle pain)
Following Bristol Stool Chart can always help in assessing the Diarrhea:
 |
| Bristol Stool Chart |
Clinical approach through Questions
Clinical approach to patient of gastroenteritis is made through sets of questions which are as follows:
QUESTION 1: What are the C/C (Chief complaints) or symptoms of the patients?
QUESTION 2: What is the onset of symptoms?
QUESTION 3: What is the duration of symptoms? (more than 4 weeks is Chronic gastroenteritis; less than 4 weeks is Acute gastroenteritis)
QUESTION 4: Is there any diarrhea? (Follow history of diarrhea)
QUESTION 5: Is there blood or mucus in diarrhea?
QUESTIONS 6: Has the patient traveled anywhere recently? (Traveler’s diarrhea)
QUESTION 7: Is there any Fever? (Follow History taking for Fever)
QUESTION 8: What is the frequency of stool? (Remember there is definition of diarrhea too: three or more loose or liquid stools per day)
QUESTION9: If diarrhoea is bloody, then is there any pain in right lower quadrant? (it can clue towards Crohns disease)
QUESTION 10: Are the signs of dehydration present? (Skin turgor and sunken eyes are common)
QUESTION 11: What is the drug/medicine history? (To rule out immuno-compromised patients)
QUESTION 12: Is there any urge to pass stools (Also known as tenesmus)
BONUS TIPS:
- Old patients with constipation followed by diarrhea are having Spurious Diarrhea.
- Chronic diarrhea (more than 4 weeks), then check tenderness or fever. If it is present, then it is Inflammatory Bowel Disease or IBD, if absent, then it is Mal-absorption.
See the Video!
Following video will help understand things better :
Source: Khan Academy
