Infective gastroenteritis

Question 1

What is the definition of infective gastroenteritis?

Answer 1

Sudden onset of diarrhoea/vomiting due to infection/inflammation of the GI tract

Question 2

What is the epidemiology of infective gastroenteritis?

Answer 2

20% of the UK population suffer every year

Question 3

What is the pathology of infective gastroenteritis?

Answer 3

• Ingestion of pathogen (bacteria, virus etc.) via faecal transmission or water/food contamination
• Can attach to villi to cause structural changes such as villus shortening
• Bacteria can release enterotoxins = illness e.g. salmonella
• Bacteria can undergo mucosal adherence e.g. E.coli
• Bacteria can undergo mucosal invasion e.g. shigella

Question 4

What are the risk factors/aetiology of infective gastroenteritis?

Answer 4

• Contaminated food/water intake via poor cooking/poor hygiene
• Unsanitary/cramped living conditions – including if other people are affected
• Swimming/cannoning
• Traveling abroad
• Homosexual

Question 5

What are the signs/symptoms of infective gastroenteritis?

Answer 5

• Diarrhoea – watery or dysentery (with blood)
• Vomiting
• Abdominal cramping

Question 6

What other conditions present similarly to infective gastroenteritis?

Answer 6

• Irritable Bowel syndrome
• Inflammatory bowel disease
• Malaria
• UTI/chest infection in elderly

Question 7

What is the policy with attending work if suffering from gastroenteritis?

Answer 7

• Must stay at home until 48 hours after symptoms have improved – especially if working with food or people

Question 8

What investigations are carried out for suspected gastroenteritis?

Answer 8

• Stool culture and microscopy
• Bloods –U&Es, antibodies
• Blood culture

Question 9

What are the surgical treatment for infective gastroenteritis?

Answer 9

None

Question 10

What are the pharmacological treatment for infective gastroenteritis?

Answer 10

• Fluid replacement sachets
• Prochlorperazine – antiemetic
• Loperimide – antidiarrheal
• Hyoscine - antispasmodic
• Antibiotics – only if systemically unwell or immunosuppressed
• Immunisation (prevention)

Question 11

What are the non- pharmacological treatment for infective gastroenteritis?

Answer 11

• Hydration!!
• Reduce intake of dairy products initially then slowly add back into diet – bread, bananas, rice are good
• Inform public health if appropriate