Bacterial gastroenteritis

Definition

Bacterial gastroenteritis is an inflammation of the stomach and intestines caused by bacteria.

See also:

• Food poisoning
• Shigella gastroenteritis
• Viral gastroenteritis

Alternative Names

Infectious diarrhea - bacterial gastroenteritis; Acute gastroenteritis; Gastroenteritis - bacterial

Causes, incidence, and risk factors

Many different types of bacteria can produce the symptoms associated with bacterial gastroenteritis, including:

• Campylobacter jejuni (see: Campylobacter enteritis)
• Clostridium
• E. coli (see: E. coli enteritis)
• Salmonella (see: Salmonella enteritis)
• Shigella (see: Shigella enteritis)
• Staphylococcus
• Yersinia

Some sources of the infection are:

• Bakery products
• Dairy products
• Improperly prepared food
• Reheated meat dishes
• Seafood

Risk factors are:

• Eating or drinking improperly prepared foods or contaminated water
• Traveling or living in areas of poor sanitation

About 1 in 1,000 people develop bacterial gastroenteritis each year.

Symptoms

Each organism causes slightly different symptoms but all result in diarrhea. Other symptoms include:

• Abdominal cramps
• Abdominal pain
• Bloody stools
• Loss of appetite
• Nausea and vomiting

Signs and tests

• Examination of food for bacteria
• Stool culture positive for the bacteria that causes the infection
• White blood cells in the stool

This disease may also alter the results of the following tests:

• Fecal smear
• Stool gram stain

Treatment

Treatment involves replacing fluids and electrolytes (salt and minerals) that the body loses when you have diarrhea. In rare cases, blood transfusions are required.

Self-care measures to avoid dehydration include:

• Drinking electrolyte solutions to replace fluids lost by diarrhea
• Eating no solid food until the diarrhea has passed

Persons with diarrhea, especially young children, who are unable to drink fluids due to nausea may need medical attention and fluids by IV ( intravenously).

If you take "water pills" (diuretics), you may need to stop taking the medication during an acute episode of diarrhea, as directed by your health care provider.

Ask your doctor before using any antidiarrheal medicines.

Antibiotic or antimicrobial therapy is usually not needed unless the rest of the body is affected.

Expectations (prognosis)

In most cases, symptoms improve with fluid and electrolyte replacement within a week. Rare cases of kidney failure or death related to bacteria gastroenteritis have been reported.

There have been increasing incidents of local outbreaks of severe infection with certain strains of E. coli bacteria. These outbreaks can be dangerous, especially to the elderly or very young children.

Complications

• Arthritis
• Death (rare)
• Dehydration
• Kidney failure (rare)
• Irritable bowel syndrome
• Low blood counts (anemia)
• Systemic (body-wide) infection

Calling your health care provider

Call for an appointment with your health care provider if:

• You have blood or pus in your stools, or your stool is black
• You have abdominal pain that does not go away after a bowel movement
• You have symptoms of dehydration
• You have a fever above 101 °F, or your child has a fever above 100.4 °F, along with diarrhea
• You have recently traveled to a foreign country and develop diarrhea
• You develop diarrhea after eating with other people who also have diarrhea
• You have started on a new medication and develop diarrhea
• Your diarrhea does not get better in 5 days (2 days for an infant or child), or worsens before that
• Your child has been vomiting for more than 12 hours (in a newborn under 3 months you should call as soon as vomiting or diarrhea begins)

Prevention

Proper handling, storage, and preparation of food -- in addition to good sanitation -- are principles of prevention.

References

Zulfiqar AB. Acute Gastroenteritis in Children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007. Chap: 337.