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Gastroenteritis refers to several disorders produ-
ced by the inflammation of the gastric and intes-
tinal mucus, the main symptom of which is diarr-
hea. Diarrhea is considered acute when it does
not last for more than two weeks; persistent when
it last from two to four weeks; and chronic if it lasts
for more than four weeks.
It is very frequent and it can be anticipated that
nearly 100% of the population will suffer from
some form of gastroenteritis during their lives.
Causes of acute gastroenteritis
Acute gastroenteritis (AGE) can be due to several
factors, although in more than 90% of cases, it is
due to infection (bacterial or viral).
•
AGE can be caused by bacteria in water or
in other contaminated food. The infection is
passed on from one person to another or by
an animal, usually orally (touching your mouth
with your hands after being in contact with a
possible source of infection).
•
Viruses could also provoke watery diarrhea. In
fact, in temperate climate regions, viruses are
mainly responsible in the winter months for the
spread of diarrhea sufficiently serious on some
occasions, requiring the hospitalisation of chil-
dren under 4 and the elderly, in particular, be-
cause of dehydration. This could be the case
in all types of AGE.
Other less frequent causes:
•
Parasites, usually because of drinking conta-
minated water.
•
Acute diarrhea that is not caused by infections
is usually due to the ingestion of toxic subs-
tances, lactose intolerance, ingestion of hea-
vy metals, or due to the side effects of some
drugs (antibiotics).
Symptoms
The symptoms of diarrhea appear from the start
or, generally, a few hours after vomiting has subsi-
ded and, in many cases, both coincide. It should
be watery or gooey, yellowish or light brown, but
it should not contain blood, clots, or pus, or thick
mucus. If this is the case, consult your physician
urgently, particularly if there you have more than
38º C fever and/or, if you have travelled to a tro-
pical country. Colic pain is normal, provided it is
not too intense or lasting, and the abdomen does
not become hard (in table). If the stool is as black
as petroleum, it is necessary to go to the hospital
urgently since this indicates bleeding at some point
in the digestive system and this could be extremely
serious. Other possible symptoms are pain in the
muscles and joints, generally associated with a vi-
rus infection, and drowsiness, consternation, and
tiredness when the signs of dehydration appear.
Treatment
In principle, it is always recommended that you
check with your physician who will make the pre-
cise diagnosis on the type of gastroenteritis affec-
ting you and, based on this, your physician will be
responsible for the specific treatment (antibiotics,
etc.).
¿Qué medidas generales podemos aplicar?
•
The first one would be the right diet. It is
always recommended that if possible, you
should abstain from eating solid food during
the first 24 hours. The contrary is true with re-
gards to liquids, which should be drunk abun-
dantly (water, isotonic beverages...) and are
essential to prevent dehydration. Afterwards,
a soft diet consisting of vegetable broths, fish,
rice, boiled ham, is recommended. Then, bit
by bit, introduce other foods, starting with the
most digestible (broiled fish and meat, ome-
lettes, etc.) until we can eat the ones that are
more indigestible (legumes, cold meats, fat,
etc.). Dairy products should be the last to be
introduced in the diet when the patient no lon-
ger has any symptoms, and always depending
on clinical evolution.
•
You should not self-medicate with drugs such
as Loperamide (Fortasec) without first chec-
king with your doctor. You must bear in mind
that these drugs are contraindicated in bacte-
rial gastroenteritis since they inhibit the peris-
taltic movements of the intestines and the eva-
cuation of infected faeces. It should be also
be noted that in these cases, diarrhea helps
evacuate the infected gastric juices, preventing
that they accumulate in the intestine and make
the infection last longer or cause other types of
complications (spread of the infection).
•
Diet is important. Besides gradually incorpo-
rating different types of food, avoiding dairy
products for a few days is recommended the
irritation of the intestinal mucous provokes a
temporary intolerance to lactose. This applies
mostly to milk and, to a lesser extent, yoghourt
and cheeses since these, in their fermentation
stage, contain 30% less lactose, especially in
the case of yoghourt. In the case of cheese,
those that are the most cured contain less lac-
tose.
By: Doctor Román Rodríguez Barrigüete,
Medical Department, Madrid