The gastro-enteritis

Gastroenteritis, which is colloquially called gastroenteritis or diarrhea, is an inflammatory disease of the gastrointestinal tract and also literally means gastroenteritis. The typical symptoms of gastroenteritis are vomiting and diarrhea. They should not be confused with the “real flu” (influenza).

Gastroenteritis is the most common cause of vomiting and diarrhoea in children and adults. In the past, it was often fatal in children because too much fluid was lost through the vomiting and diarrhoea. Today, the number of deaths is limited from 2.5 million per year to about 2000.

Gastroenteritis can be caused by pathogenic (disease-causing) agents, which include various viruses (see below), bacteria and protozoa. The most common bacterial pathogens are Salmonella, Yersinia, Shigella, Campylobacter, Vibrio cholerae and Clostridium difficile. The protozoa (unicellular organisms) that can cause gastroenteritis are e.g. amoebae.

Although the mechanism underlying the various pathogens differs, damage to the stomach mucosa is usually the result. As a result, the food can no longer be digested well and liquid diarrhea and vomiting occur. Some bacteria also produce toxins, which lead to an increased loss of water and salt.

Toxins can also accumulate in spoiled food, which can lead to classic food poisoning when consumed. Furthermore, the cause of a gastro-enteritis can be of physical nature. For example, ionizing radiation, e.g. during cancer therapy, can damage the stomach lining.

In most cases, gastro-enteritis is transmitted by means of a faecal-oral smear infection. This means that if hands are not cleaned sufficiently, infectious patients can transmit the pathogens to food or people. Ultimately, the contaminated food is then consumed.

Other pathogens such as salmonella accumulate in insufficiently heated food, such as meat products. Only the Noro viruses are so infectious that a droplet infection is possible. When vomiting, very fine infectious droplets are released into the air and can infect relatives or hospital staff.

It can take up to 2 days from the beginning of the infection until the first symptoms appear. Then the gastro-intestinal flu manifests itself through loss of appetite, nausea, vomiting and diarrhoea. The diarrhoea can be bloody.

Stomach problems and pain may occur. In addition, there is general exhaustion and dizziness. If the fluid intake is insufficient, symptoms of dehydration occur, as a lot of fluid is lost through vomiting and diarrhoea.

As a rule, no further microbiological diagnosis is necessary beyond the clinical history. In the case of severe or special disease progression, stool and blood samples can provide information about the type of pathogen in order to clarify further therapeutic measures. The therapy is symptom-oriented.

At first it is important to protect the affected persons from dehydration. For this purpose, they are offered a solution with a glucose/salt mixture (WHO rehydration solution). This can be extended by so-called probiotics.

These are strains of bacteria that belong to the natural intestinal flora and can thus support the natural intestinal activity. In children and people who are not so successful in rehydration, the solution can also be administered as an infusion. Medication that stops vomiting (antiemetics) or lowers the fever can also help.

Antibiotics are not usually prescribed. At the beginning of the disease, only easily digestible carbohydrates should be eaten (e.g. bananas, rusks and white bread) to protect the stomach and intestines. In Germany there is an obligation to report some pathogens of the gastrointestinal infections.

These include Salmonella typhi, Vibrio cholerae, Norovirus, Rotavirus and EHEC. There is not the gastrointestinal virus par excellence. Rather, there are several different viruses that can cause gastroenteritis (gastroenteritis).Below you will find an overview and short description of the respective viruses.

The rota virus is a so-called RNA virus, which is the most common pathogen of childhood gastroenteritis. It is also an important nosocomial (hospital infection) pathogen on pediatric wards in hospitals. The rota virus is transmitted via smear infections (fecal-oral) and can be detected in stool.

There is an oral vaccination with an attenuated (attenuated) live vaccine, which is recommended from the 6th week of life. The last dose should be given before the 26th week of life. Without the vaccination, almost every child falls ill with rotavirus by the age of five.

There is currently no therapy available. However, a sufficient water supply should be ensured during the illness. The usual duration of the disease is 6-8 days.

For Rota viruses there is a legally prescribed obligation to report the disease. Adenoviruses are uncapped DNA viruses, of which there are 51 serotypes (subgroups) that cause disease in humans. They are transmitted by droplet infection or smear infection (fecal-oral).

They mainly cause respiratory tract infections. However, there are also serotypes that cause gastroenteritis (inflammation of the gastrointestinal tract) or diarrhea, especially in children. The viruses can be detected in the swab material of throat swabs or in stool samples.

There is no therapy for adenoviruses. Treatment is therefore symptomatic. However, this is only necessary in cases of severe disease progression.

A mild infection heals by itself. Noro viruses are very environmentally resistant RNA viruses. They are ingested with food and transmitted by smear infection (faecal-oral).

They are highly infectious and can also be transmitted by droplet infection. In the case of torrential vomiting, fine droplets are released into the air, which are then inhaled by healthy people. Classically, they lead to food poisoning when contaminated food is consumed.

Noroviruses very often cause gastroenteritis (inflammation of the gastrointestinal tract) with diarrhea and vomiting, especially in young people. The severe gastroenteritis usually lasts 1-3 days and stops by itself. Since there is no causal therapy, only the symptomatic one is treated.

Above all it is important to compensate for the loss of fluid. With very old patients or small children, a short stay in hospital can sometimes be necessary to control the fluid balance well. This also applies to patients with other pre-existing conditions and general weakness.

There is a legal obligation to report infections with Noro viruses. Sapoviruses are also very environmentally resistant germs. They are mainly transmitted by smear infection.

They cause gastroenteritis in children and are detected in stool. Here, too, only a purely symptomatic therapy is carried out. These viruses appear star-shaped under the electron microscope, which is why they are also called astroviruses.

They are also very resistant to environmental influences. In children they cause acute gastroenteritis with fever, nausea, vomiting, abdominal pain and diarrhea. They are the second most common cause of gastroenteritis in children after the rota viruses. They can be detected in the stool. They are treated symptomatically, with the gastroenteritis stopping of its own accord after a few days.