[gastro- + entero- + -itis]
Inflammation of the stomach and intestinal tract that causes vomiting, diarrhea, or both.
SEE: diarrhea; SEE: enterocolitis
The most common causes are viruses (such as norovirus) and bacteria (such as Salmonella) in food and water.
SYMPTOMS AND SIGNS
The patient typically suffers episodes of vomiting and diarrhea and may develop symptoms of dehydration (such as thirst and dizziness when standing up), as well as malaise, abdominal cramps, or fever.
Physical Examination: The patient generally appears acutely ill, with dry skin and poor skin turgor. Inspection of the mouth shows that the mucous membranes are usually dry, the tongue furrowed, and salivation decreased. Other signs include flattened neck veins, redness of the perianal area, and a decreased urine volume (< 20 mL/hr or 480 mL in 24 hr) and increased urine concentration (a dark, concentrated color). When auscultation is performed, hyperactive bowel sounds must be checked. The patient may have abdominal distension with diarrheal stools that are liquid, green, foul-smelling, and bloody or mucus filled. Stool samples are collected to determine the presence or the effect of pathogens.
Prevention is emphasized by teaching children and adults correct handwashing techniques, water purification methods, and proper care of food. The basic principles of food handling should be taught to all those in the home, including the following topics: the need to wash hands frequently, particularly after using the toilet; use of a meat thermometer to check that meat and dishes containing eggs are adequately cooked; refrigeration of foods (below 40°F [4.4°C]) until just before cooking and again within 1 hr after cooking, esp. in warm weather; separation of raw and cooked foods; and use of different utensils and dishes for raw and cooked meats. Travelers, esp. to developing countries, should not eat raw seafood, raw vegetables, or salads and should peel all fruit themselves. Campers should determine if they are in a location where streams are known to be contaminated with protozoa, e.g., New Hampshire, upstate New York, and Oregon.
Rehydration, usually with liquids taken by mouth, is the key to avoiding dehydration or electrolyte imbalance. Symptomatic remedies that reduce the frequency or volume of diarrhea (such as kaolin/pectin or loperamide) often are helpful.
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