E. coli Enteritis

Written by Christine Case-Lo | Published on September 10, 2012
Medically Reviewed by George Krucik, MD

What Is E. coli Enteritis?

Enteritis is inflammation or swelling of the intestines. One of the most common causes of enteritis is the bacterium Escherichia coli or E. coli. According to the National Library of Medicine (NLM), this bacterium is the most common cause of traveler’s diarrhea, a condition that is marked by loose stools, abdominal cramping, nausea, and bloating. (NLM, 2011)

There are many strains of E. coli, some of which are harmless. In fact, hundreds of strains live in the digestive tract as “good” bacteria. However, certain toxic strains may lead to serious illness. If you are exposed to a toxic strain, you can develop food poisoning and enteritis. This infection is sometimes called traveler’s diarrhea because when you travel you are exposed to new strains of E. coli that you may react negatively to.

Some strains are more dangerous than others. They produce a toxin called Shiga, or verocytotoxin, which causes severe illness and bleeding that can be fatal, especially in children. Shiga-producing toxic E. coli (often called “STEC” for short) may also be referred to as E.coli 0157. According to the Centers for Disease Control and Prevention (CDC), an estimated 265,000 STEC infections occur each year in the U.S. (CDC, 2011)

What Causes E. coli Enteritis?

You can be exposed to disease-causing strains of E. coli by eating or drinking something contaminated with the bacterium. Contamination often occurs due to unsafe food handling. Many infections are due to eating meat that has come in contact with bacteria and waste from animal intestines during processing, or food that has been washed in water polluted with human or animal waste.

Raw or undercooked meats and eggs can also be hazardous. Drinking untreated water from a stream or well can likewise cause exposure. Leaving dairy products or mayonnaise out of the refrigerator too long can promote bacterial growth and lead to food poisoning.

E. coli is rarely spread without food or drink being involved, but it can happen. If someone neglects to wash his or her hands after a bowel movement and then touches objects that other people touch, it can lead to exposure and illness.

What Are the Symptoms of E. coli Enteritis?

You will typically develop symptoms of enteritis 24 to 72 hours after being exposed. The main symptom is severe, sudden diarrhea. The diarrhea is often bloody. Other symptoms include:

  • fever
  • intestinal gas
  • severe cramps
  • loss of appetite
  • nausea
  • vomiting

Certain strains of E. coli release a toxin that can trigger the destruction of red blood cells in children. This is called hemolytic uremic syndrome. It is a very severe infection, but it is rare. Symptoms include pale skin, easy bruising, bloody urine, and a reduced amount of urine due to kidney damage.

If you have a high fever (over 101 F in adults and over 100.4 F in a child), have blood in your stool, feel dehydrated, can’t keep fluids down, have had diarrhea for more than five days (two for children), or have pain that does not go away after a bowel movement, contact a doctor immediately.

How Is E. coli Enteritis Diagnosed?

Your doctor will perform a physical examination and ask questions about your symptoms. To confirm a diagnosis, your doctor will order a stool culture to test for the presence of disease-causing E. coli.

What Treatments Are Available for E. coli Enteritis?

The main complication of enteritis is dehydration due to diarrhea. Drinking fluids is important. If you cannot keep liquids down due to intense vomiting or diarrhea, you may need to go to the hospital for intravenous fluid therapy.

Antidiarrheal medications are sold over the counter at drugstores, but if you have bloody diarrhea or a fever, you should talk to your healthcare provider before using these.

Though antibiotics are often prescribed to treat bacterial infections, according to the National Institute of Allergy and Infectious Diseases (NIAID), there is no evidence that antibiotics are effective in treating E. coli. In fact, antibiotics can increase the risk of hemolytic uremia in the case of certain bacterial strains. (NIAID, 2011)

Most people recover without medication within two days. Fluids and plenty of rest are the most important treatment.

If you take diuretics (water pills)regularly, you may need to stop taking them while you have enteritis. Talk with your doctor.

What Can I Expect in the Long-Term?

The outlook often depends on the severity of the infection and timely treatment. Most cases of enteritis clear up within a few days. Some rare, toxic strains of E. coli are very serious and require hospitalization.

What Are the Potential Complications of E. coli Enteritis?

Most patients recover within a few days with no long-term effects. In rare cases, a severe infection can cause hemolytic uremia, which can lead to anemia, kidney failure, and death.

Can I Prevent E.coli Enteritis?

The CDC offers the following guideline to help prevent STEC infections (CDC, 2011):

  • Wash your hands frequently, especially after using the bathroom or changing soiled diapers, and before preparing or eating food.
  • Cook all meats thoroughly; use a meat thermometer to determine when food has reached a safe temperature.
  • Wash any cooking utensils, knives, and cutting boards that frequently come into contact with raw food.
  • Fruits and vegetables must be washed well, especially if eaten raw.
  • Avoid raw fish and oysters, as well as raw juices and unpasteurized dairy products.
  • Avoid drinking water while playing or swimming in lakes, streams, ponds, and swimming pools.
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