Gastrointestinal infection (gastroenteritis)

Definition and causes

Gastrointestinal infections caused by bacteria, viruses or parasites. The disease mechanism, symptoms, infectious manner, location and duration of infection can be very different depending on which organism is causing the infection as well as the individual's resilience.

In the developing countries are gastrointestinal infections extremely frequent, and this is expected to be killed each year up to 5-10 million people as a result of such infections. Particularly children are vulnerable.

In the Western world viruses are the most common cause of gastrointestinal infections, and the average has each person diarrhea annually because of gastrointestinal infections.

The transmission mode of gastrointestinal infections is dependent on the micro-organism that causes the infection. By some gastrointestinal infections, infection occurs through direct contact with infected people. Other microorganisms transmitted through ingestion of contaminated food or water (or food washed in contaminated water).

The mechanisms that lead to disease, are also different and dependent on the micro-organism. Some forms of bacteria to grow in, for example. Food so-called pre-toxins (a kind of poisonous), the subsequent intake gives acute diarrhea and / or vomiting (within a few hours), which also disappears quickly again. This is the mechanism by classical food poisoning.

Other bacteria, for example.Vibrio cholerae, Which gives cholera (see nednfor) orE. coli(see below), which is a frequent cause of the ordinary "tourist diarrhea", is also the toxin that causes disease, but these are formed only in the intestine.

Finally, there are some micro-organisms that directly attacks the mucous membranes of the intestine, thus causing diarrhea. This mechanism seen by the frequentSalmonella poisoning, As well as by infection withSalmonella typhi, Which gives typhoid, or withShigella bacteria, Which gives dysentery.

Below, some of the micro-organisms (viruses, bacteria and parasites), which can give gastrointestinal infections be described:

Viruses:
Various viruses may infect from person to person or through food, and in Denmark are viral infections, the most common cause of gastrointestinal infections. One of the most common isNoro virus(previously known as Norwalk), which leads to the often quoted Roskilde disease. These will give diarrhea and vomiting for a few days but usually require no treatment. Noro virus is highly contagious and can in addition to infection through food spread by airborne particles, the infection can spread to, for example. a hospital.

Bacteria:
Numerous bacteria may infect through food and raises a number of infections by very different character.Salmonella typhiandShigella bacteriagives rise to serious infections, typhoid and dysentery, as described in separate articles.

Different species ofSalmonella bacteria, And bacteriaCampylobacterandYersiniaoften spill over food. The spill over meat, eggs and poultry and usually led to short-term diarrhea and vomiting (they are discussed in greater detail in the article Salmonella infections).

Some typesE. colican infection through food, and E.coli bacteria are the most common cause of tourism or travel diarrhea. The type of E. coli, called VTEC, and held, inter alia, in not enough heat-treated beef, in the unfortunate event could lead to kidney failure in children (who have in recent years been several examples of this in Norway).

Listeria monocytogenesis a bacterium that does not occur as frequently as before. It can multiply in food and can grow at low temperatures, so storing food in the fridge does not protect against this bacterium. It can sometimes lead to brain membrane inflammation (meningitis), but infection with Listeria is rare and seen mostly in already debilitated people.

Infection with the bacteriumVibrio choleraegives cholera. This bacterium has been eradicated in Denmark, but few cases seen after traveling. The spill through drinking water or food contaminated with water containing bacteria. The symptoms are to start with vomiting and diarrhea with stools, but quickly replaced by large quantities of water thin diaréer.

Some types of staphylococci form as mentioned toxins in food, which can give classical food poisoning. BacteriumClostridium botulinumalso produces toxins in food, and can causeBotulismorpølseforgiftningThat can provide temporary paralysis. The toxin-borne diseases are described in the article food poisoning.

Parasites:
Parasitic infections are less frequent in Denmark. ParasitesGiardia lambliaandCryptosporidium parvumcan infection through contaminated water. The latter usually only signs in immunocompromised individuals, such as. people with AIDS. Water that contains Giardia lamblia, can see quite clearly. The symptoms can vary greatly from person to person. For some, there was no symptoms, while others may develop prolonged diarrhea, malabsorption and weight loss. Infection with Giardia lamblia may be more common after traveling.

Finally, you can getamøbedysenteriHaving taken amøbe-contaminated water or food washed in contaminated water. In Denmark this can be seen only by people coming home from traveling. For the symptoms and treatment see the article Amøbedysenteri.

Symptoms of gastroenteritis

As mentioned are the symptoms and severity of these entirely dependent on the micro-organisms which cause infection, and who will be infected. Particularly children in developing countries are severely affected because they often live under poor hygienic conditions, and thus easily infected and have weakened resistance due to malnutrition and / or recurrent infections.

The most common symptom is the first:

Diarrhea.
Nausea and possible. vomiting.
Fever.
Abdominal pain.

Also visible:

Bloody stools.
Ledsymptomer.

After prolonged diarrhea is often dehydration. This is seen in an extreme degree by cholera, where you can lose 20-25 liters per. days.

Precautions and diagnosis

Close contact with infected persons should be avoided if possible. In addition to general good håndhygiejne reduce the number of infections. It is also important to ensure adequate heating of meat, and to avoid intake of example. raw eggs and seafood. Read more about proper food handling in the article food poisoning during Precautions.

Most gastrointestinal infections will go away by itself within a few days (see below) and does not require that you go to the doctor. But during prolonged diarrhea (more than two weeks), weight loss, blood in stool, as well as pronounced effects and / or dehydration, should contact a doctor. We should disclose that it has become ill after traveling abroad, as this could mean infection with exotic (and possibly. More serious) infections. Moreover, we must disclose whether family members or people you have eaten

In many cases, your doctor will not do much, but in severe cases can be performed microscopy and culture of a stool sample to detect any. bacteria. Hosp. performed a skopi (kikkertundersøgelse) of the gastrointestinal tract.

Treatment of gastroenteritis

The treatment of gastrointestinal infection depends on the micro-organism in question. Treatment is mostly symptomatic, ie. that it treating only the symptoms. The most important thing is to replace salt and water loss. In more severe cases, it is necessary to treat with antibiotics.

Most viral infections will soo