Fluids and electrolytes are lost during TD, and replenishment is important, especially in young children or adults with chronic medical illness. In adult travelers who are otherwise healthy, severe dehydration resulting from TD is unusual unless vomiting is prolonged. Nonetheless, replacement of fluid losses remains an adjunct to other therapy and helps the traveler feel better more quickly. Travelers should remember to use only beverages that are sealed, treated with chlorine, boiled, or are otherwise known to be purified.
Children who accompany their parents on trips to high-risk destinations can contract TD as well, with elevated risk if they are visiting friends and family. Causative organisms include bacteria responsible for TD in adults, as well as viruses including norovirus and rotavirus. The main treatment for TD in children is ORS. Infants and younger children with TD are at higher risk for dehydration, which is best prevented by the early initiation of oral rehydration. Empiric antibiotic therapy should be considered if there is bloody or severe watery diarrhea or evidence of systemic infection. In older children and teenagers, treatment recommendations for TD follow those for adults, with possible adjustments in the dose of medication. Among younger children, macrolides such as azithromycin are considered first-line antibiotic therapy, although some experts now use short-course fluoroquinolone therapy (despite its not being FDA-approved for this indication in children) for travelers aged
Gastroenteritis In Adults Pdf Free
However, there is a more severe form of gastroenteritis that sticks around for several days. Apart from the watery poo and throwing up, you get blood in the poo and tummy pains for no extra charge. Sometimes a high temperature (fever), aching limbs and headache are added extras.
Gastroenteritis is an infection of the gut (intestines). The severity can range from a mild tummy (abdominal) upset for a day or two with mild diarrhoea, to severe diarrhoea and being sick (vomiting) for several days or longer. Many germs (viruses, bacteria and other microbes) can cause gastroenteritis.
Viruses are easily spread from one person to another by close contact. This is often because of the virus being present on people's hands after they have been to the toilet. Surfaces or objects touched by the infected person can also allow transmission of the virus. The virus can also be passed on if the infected person prepares food. Outbreaks of a virus causing gastroenteritis in many people can occur - for example, in schools, hospitals or nursing homes.
Food poisoning from eating contaminated food causes some cases of gastroenteritis. Many different types of microbes can cause food poisoning. Common examples of bacterial infection are called campylobacter, salmonella and Escherichia coli (usually shortened to E. coli). Poisons (toxins) produced by bacteria can also cause food poisoning. Another group of microbes called parasites can also be a cause. Food and Water contaminated by bacteria or other microbes is another common cause, particularly in countries with poor sanitation. See the separate leaflet called Food Poisoning for more details.
Diarrhoea and being sick (vomiting) are the two main symptoms of gastroenteritis. This may cause lack of fluid in the body (dehydration), so consult a doctor quickly if you suspect you are becoming dehydrated. Mild dehydration is a common gastroenteritis symptom and is usually easily reversed by drinking lots of fluids. Severe dehydration can be fatal unless quickly treated because the organs of your body need a certain amount of fluid to function.
Most people with gastroenteritis recognise this from their typical symptoms and they do not usually need to see a doctor or to seek medical advice. Symptoms are often quite mild and commonly get better within a few days without any specific treatment.However, in some circumstances, you may need to see a doctor when you have gastroenteritis. The doctor may ask you questions about recent travel abroad, if you have been in contact with someone with similar symptoms, or if you have recently taken antibiotic medication or been admitted to hospital. This is to look for possible causes of your gastroenteritis. The doctor will also usually check you for signs of lack of fluid in the body (dehydration). They may check your temperature, pulse and blood pressure. They may also examine your tummy (abdomen) to look for any tenderness
It used to be advised not to eat for a while if you had gastroenteritis. However, now it is advised to eat small, light meals if you can. Be guided by your appetite. You may not feel like food and most adults can do without food for a few days. Eat food as soon as you are able - but don't stop drinking. If you do feel like eating, avoid fatty, spicy or heavy food at first. Plain foods such as wholemeal bread and rice are good foods to try eating first.
As explained, if symptoms are severe, or continue for more than several days, your doctor may ask for a sample of the diarrhoea. This is sent to the laboratory to look for infecting microbes (bacteria, parasites, etc). Sometimes an antibiotic or other treatments are needed if certain bacteria or other infections are found to be the cause. Antibiotics are not needed for gastroenteritis caused by viruses and may even make things worse.
Rarely, other parts of the body may react to an infection that occurs in the gut (intestines). This can cause symptoms such as joint inflammation (arthritis), skin inflammation and eye inflammation (either conjunctivitis or uveitis). Reactive complications are uncommon when a virus causes gastroenteritis.
The infection can spread to other parts of your body such as your bones, joints, or the meninges that surround your brain and spinal cord. This is rare. If it does occur, it is more likely if gastroenteritis is caused by salmonella infection.
A lactose intolerance can sometimes occur for a while after gastroenteritis. This is known as secondary or acquired lactose intolerance. Your gut lining can be damaged by the episode of gastroenteritis. This leads to lack of a chemical (enzyme) called lactase that is needed to help your body digest a sugar called lactose that is in milk. Lactose intolerance leads to bloating, tummy (abdominal) pain, wind and watery stools after drinking milk. The condition gets better when the infection is over and the gut lining heals. It is more common in children.
This is another potential complication. It is rare and is usually associated with gastroenteritis caused by a certain type of E. coli infection. It is a serious condition where there is anaemia, a low platelet count in the blood and kidney failure. It is more common in children. If recognised and treated, most people recover well.
During an episode of gastroenteritis, certain medicines that you may be taking for other conditions or reasons may not be as effective. This is because the diarrhoea and/or vomiting means that reduced amounts of the medicines are taken up (absorbed) into your body. Examples of such medicines are medicines for epilepsy, diabetes and contraception. Speak to your doctor or practice nurse if you are unsure of what to do if you are taking other medicines and have gastroenteritis.
Skyum F, Pedersen C, Andersen V, et al; Risk factors for contagious gastroenteritis in adult patients with diarrhoea in the emergency department - a prospective observational multicentre study. BMC Infect Dis. 2019 Feb 1119(1):133. doi: 10.1186/s12879-019-3754-4.
During gastroenteritis, it is important to eat as normally as possible. In fact, eating helps the lining of the intestine to heal quickly and allows the body to regain strength. On the contrary, not eating prolongs diarrhea.
Make sure you rehydrate well by drinking water or a rehydration solution preferably, especially if you cannot eat. If your child is breast or bottle-fed, he or she can continue drinking his or her regular milk, without diluting it. Offer it more often, in small quantities. To find out more about rehydration, read the page Hydrating and rehydrating when you have gastroenteritis.
It is not recommended that you stop eating. It will not reduce the symptoms of gastroenteritis, does not provide enough calories and can delay healing. You can eat small portions of the recommended foods for gastroenteritis that you can tolerate.
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.
The following evidence-based guidelines for management of infants, children, adolescents, and adults in the United States with acute or persistent infectious diarrhea were prepared by an expert panel assembled by the Infectious Diseases Society of America (IDSA) and replace guidelines published in 2001 [1]. Public health aspects of diarrhea associated with foodborne and waterborne diarrhea, international travel, antimicrobial agents, immunocompromised hosts, animal exposure, certain sexual practices, healthcare-associated diarrheal infections, and infections acquired in childcare and long-term care facilities will be referred to in these guidelines, but are not covered extensively due to availability of detailed discussions of this information in other publications. For recommendations pertaining to Clostridium difficile, refer to the existing IDSA/Society for Healthcare Epidemiology of America (SHEA) guidelines on C. difficile infections, which are in the process of being updated.
A panel of multidisciplinary experts in management of infectious diarrhea in children and adults was convened in 2012. The panel consisted of pediatricians and internists with expertise in clinical medicine, infectious disease, epidemiology, gastroenterology, preventive medicine, nutrition, microbiology, and enteric disease. Panel participants included representatives from the Society for Healthcare Epidemiology of America (SHEA), CDC, and the IDSA Standards and Practice Guidelines Committee (SPGC). The guideline was reviewed and endorsed by SHEA and the Pediatric Infectious Diseases Society. The guideline was also reviewed and approved by the IDSA SPGC and the Board of Directors. 2ff7e9595c
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