Gastroenteritis is an inflammation of the stomach and intestines, usually caused by viruses, bacteria, or parasites. It leads to diarrhea, vomiting, abdominal cramps, and dehydration. Most cases are self-limiting, but proper hydration and supportive care are essential, especially in children and elderly patients.
Causes of Gastroenteritis
Viral Causes (Most Common)
- Rotavirus (common in children)
- Norovirus (outbreaks in adults)
- Adenovirus
Bacterial Causes
- E. coli
- Salmonella
- Shigella
- Vibrio cholerae
- Campylobacter
Parasitic Causes
- Giardia lamblia
- Entamoeba histolytica
Symptoms
- Acute watery diarrhea
- Nausea and vomiting
- Abdominal cramps
- Fever
- Weakness
- Signs of dehydration (dry mouth, reduced urination, dizziness)
Diagnosis
Most cases are diagnosed clinically based on symptoms. Tests may be required in severe or persistent cases.
- Stool examination
- Culture for bacterial pathogens
- Electrolyte analysis in dehydration
Management
1. Rehydration Therapy (Most Important Step)
The primary treatment for gastroenteritis is preventing and correcting dehydration.
- Oral Rehydration Solution (ORS) – first choice
- IV fluids – if dehydration is severe or patient cannot drink
ORS Guidelines
- Give small sips frequently
- Continue even if vomiting occurs
- Avoid sugary drinks and soft drinks
2. Dietary Management
- Continue feeding; avoid starvation
- Use soft, easily digestible foods (rice, banana, curd)
- Avoid fatty, spicy, and oily foods
3. Symptomatic Treatment
- Paracetamol – for fever or pain
- Ondansetron – for vomiting
- Zinc supplements – useful in children
4. Antibiotics
Antibiotics are NOT required in most viral gastroenteritis cases. They are used only when bacterial infection is suspected or confirmed.
When to Use Antibiotics?
- Bloody diarrhea
- High fever
- Severe traveler’s diarrhea
- Suspected cholera
- Amoebiasis or giardiasis
Common Antibiotics
- Fluoroquinolones (ciprofloxacin, ofloxacin)
- Azithromycin
- Metronidazole (for amoebiasis/giardiasis)
Use antibiotics strictly as per guidelines to prevent antimicrobial resistance.
Severe Dehydration — When to Hospitalize
- Very dry mouth and tongue
- No urination for more than 6 hours
- Persistent vomiting
- Sunken eyes
- Lethargy or unconsciousness
- Blood in stools
Prevention
- Hand washing before meals
- Drink clean and safe water
- Rotavirus vaccination in children
- Proper food hygiene
Patient Counseling
- Use ORS frequently to stay hydrated
- Do not self-medicate with antibiotics
- Continue feeding small, soft meals
- Seek medical help if symptoms worsen or dehydration appears
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