Gastroenteritis

Question 1

What is the differential diagnosis for gastroenteritis?

Answer 1

Infective:
Gastroenteritis

Non-infective:
Inflammatory causes (inflammatory bowel disease, diverticular disease)
Loos of absorptive area e.g. coeliac
Pancreatic disease
Drugs (antibiotics, magnesium, digoxin)
Colon cancer
Systemic disease (thyrotoxicosis, uraemia, carcinoid)
IBS
gastrectomy
HIV - diarrhoea >2 weeks with absense of cause should prompt testing.

Question 2

What are some of the potential causative organisms?

Answer 2

Non-typhoidal salmonella
Campylobacter
Vibro parahaemolyticus
Norovirus/Rotavirus
Staphylococcus aureus
Bacillus cereus
Clostridium
E.coli 
Cryptosporiduum

Question 3

What is the most common cause of gastroenteritis?

Answer 3

Campylobacter jejuni

Question 4

What are the investigations?

Answer 4

Stool sample for: 
Culture or PCR for bacteria
Toxin testing for c. diff
Antigen testing or PCR for viruses
Microscopy for ova, cysts and parasites
(All patients should have a minimum of 3 stool samples sent)

C-reactive protein
Blood cultures
Urea and electrolytes
Full blood count

Question 5

What is the typical treatment for acute gastroenteritis?

Answer 5

Supportive with adequate hydration and electrolyte replacement.

Question 6

What are the reporting requirements for gastroenteritis?

Answer 6

Most bacterial causes e.g. Campylobacter, shigella, salmonella and e.coli should be reported to PHE.

Question 7

What are the infection control requirements for gastroenteritis?

Answer 7

Isolated in a side room with separate toileting facilities.
Appropriate PPE and hand washing
Remain isolated until diarrhoea and vomiting has resolved for 48 hours.