-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