-IBIS-1.5.0-
tx
digestive system
gastroenteritis
diagnoses

definition and etiology

definition:
inflammation of the mucosal lining of the digestive tract; a generic term describing a group of clinical syndromes characterized by upper GI tract symptoms (anorexia, nausea, vomiting), diarrhea and abdominal discomfort

etiology:
• bacterial exotoxins
• diarrhea from mucosal invasion or ulceration (Shigella, Salmonella, E. coli cause microscopic bleeding and secretion of electrolytes and water).
• viral infections
• nonbacterial food poisoning
• food intolerance (e.g. lactose)

signs and symptoms

signs and symptoms: depends upon nature and dose of irritant, duration of its action, susceptibility/resistance of the patient, and extent of GI involvement; often sudden, dramatic onset, and may include any of the following:
• anorexia
• vomiting
• nausea
• borborygmi
• abdominal cramps
• diarrhea
• malaise
• muscular aches
• reduced BP, sometimes
• rapid pulse
• elevated temperature
• eosinophilia (parasitic infection or allergies)

lab findings:
• consider CBC, electrolytes, UA if prolonged to assess electrolyte and water balance, and check for occult bleeding
• rectal swab or stool culture to differentiate if severe

course and prognosis

Loss of electrolytes through diarrhea may cause complications. If diarrhea and vomiting persist, dehydration, shock, vascular collapse, and oliguric renal failure may occur. With vomiting prominent, alkalosis with hypochloremia may occur. With diarrhea prominent, acidosis is more likely.

Although gastroenteritis may have a wide range of causes, treatment of fluid and electrolyte loss from diarrhea and vomiting is the most important factor in management. Fatality is uncommon where hydration and electrolytes have been maintained, as these illnesses are typically self-limiting. Further investigation is essential if gastroenteritis persists for more than a few days.

differential diagnosis

• cholera
• salmonellosis
• shigellosis
• food poisoning
• lactose intolerance
• heavy metal poisoning
• paralytic ileus (absence of bowel sounds)
• ulcerative colitis
• amebic dysentery
• acute (surgical) abdomen
• acute appendicitis
• incomplete small bowel obstruction
• colonic malignancy
• candidiasis


footnotes