Pathology of Gastro-Enteritis

Gastroenteritis is the inflammation of the gastrointestinal tract the stomach and small intestine is also known as infectious diarrhea. (Schlossberg Pp. 334). Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydration may also occur. This typically lasts less than two weeks it is not related to influenza though it has been called the stomach flu. (Teri Pp. 457) Gastroenteritis is usually caused by viruses. However, bacteria, parasites and fungus can cause Gastroenteritis. In children rotavirus is the most common cause of severe disease. In adults, nor virus is the most common causes. Eating improperly prepared food, drinking contaminated water, or close contact with a person who is infected can spread the disease.  

Effects on the Body

Bacterial gastroenteritis can results from invasion of the gut mucosal surface, attachment to mucosal surfaces and release of toxins, or by toxin production in food prior to ingestion. Invasive bacteria strains. Such as shigella and campylobacter usually lead to mucosal ulceration, abscess formation, and inflammation, this can occur due to invasion of the gut alone, but are exacerbated by toxin production. This process results in severe diarrhea due to secretion of water and electrolytes, sometimes containing mucus and blood in the feces with fever, abdominal pain, and rectal tenesmus (a feeling of incomplete defection) known as dysentery.  

Treatment, prevention and Management       

Mild cases usually do not require treatment and will go away after a few days in healthy people. In cases where symptoms persist or when it is more severe, specific treatments based on initial cause may be required.

 In cases where diarrhea is present, replenishing fluids lost is recommended, and in cases with prolonged or severe diarrhea which persists, intravenous rehydration therapy or antibiotics may be required. As simple oral rehydration therapy can be made by dissolving one teaspoon of salt, eight teaspoons of sugar and juice of an orange into one litre of clean water. Studies have shown the efficacy of antibiotics in reducing the duration of the symptoms of infectious enteritis of bacteria origin, however antibiotic treatments are usually not required due to self-limiting duration of infectious enteritis. (Helms pp. 102).The primary treatment of gastroenteritis in both children and adults is rehydration. This is preferably achieved by drinking rehydration solution, although intravenous delivery may be required if there is a decreased level of consciousness or if dehydration is severe. Drinking replacement therapy products made with complex carbohydrates, maybe superior to those based on simple sugars. Drinks especially high in simple sugars, such as soft drinks and fruit juices, are not recommended in children under 5years of age as they may increase diarrhea. Plain water may be used if more specific ORT preparation is unavailable or the person is willing to drink them. A nasogastric tube can be used in young children to administer fluids if warranted. In those require intravenous fluids, one to four hours’ worth is often sufficient.

A supply of easily accessible uncontaminated water and good sanitation practices are important for reducing rates of infection and clinically significant gastroenteritis (Bennett, et al Pp109).personal measures (Such as hand washing with soap) have been found to reduce of gastroenteritis in both the developing and developed world by as much as 30%,( Judith et al Pp. 830) Alcohol- based gels may also be effective. Food or drink that is thought to be contaminated should be avoided. Breastfeeding is important, especially in places with poor hygiene generally. Breast milk reduces both frequencies of infections.

Gastroenteritis is usually an acute and self-limiting disease that does not require medication. The preferred treatment in those with mild to moderate dehydration is oral rehydration therapy. For children at risk of dehydration from vomiting, taking single dose of the anti-vomiting medication metoclopramide or ondansentron, maybe helpful, and butyl scopolamine is useful in treating abdominal pain (Tygart Pp. 67)

 Diagnosis

Gastroenteritis is typically diagnosed clinically, based on a person’s signs and symptoms (Eckardt, et al, Pp. 54). Determining the exact cause is usually not needed as it does not alter management of the condition. However, stool cultures should be performed in those who might have been exposed to food poisoning, and those who have travelled to the developing world. It may be also being done for surveillance. As hypoglycemia. Electrolytes and kidney function should also be checked when there is a concern about severe dehydration. (Starr, et, al Pp. 34) 

Other potential causes of signs and symptoms that mimic those seen in gastroenteritis that need to be ruled out include appendicitis, volvulus, inflammatory bowel disease, urinary tract infections, and diabetes mellitus. Pancreatic insuffiency, short bowel syndrome, wimple’s disease, coeliac disease and laxative abuse should also be considered. The differential diagnosis can be complicated somewhat if a person exhibits only vomiting or diarrhea. Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases. This is in contrast to the large amount of diarrhea that is typical of gastroenteritis. Infection of the lungs or urinary tract in children may also cause vomiting or diarrhea.

Gastroenteritis is the main reason for 3.7 million visits to physicians a year in the United States and 3million visits in France. In the United States gastroenteritis as whole is believed to results in cost of 23billion per year with that due to rotavirus alone resulting in estimated costs of 1 billion a year 

In conclusion Transmissible gastroenteritis coronavirus occurs in pigs resulting in vomiting, diarrhea, and dehydration. It is believed to be introduced to pigs by wild birds and there is no specific treatment available. It is not transmissible to humans.

                                                         Works cited

Schlossberg, David. Pathology of gastroenteritis. Clinical infectious disease. (2015). Pp. 334

Shors, Teri. Gastroenteritis. Challenge. (2013), Pp. 457

Tintinali, Judith E. A comprehensive study guide.  Emergency Medicine. (2009)  PP.839

Eckardt AJ, Baumgart DC.  Viral gastroenteritis in adults.  Recent patents on anti-virus drug discovery. (2012). Pp. 63 

Webb, A Starr, M.  A cute Gastroenteritis in children. Australian family physician. (2005). Pp. 227.