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. This bacterium is the most common cause of traveler’s diarrhea. This condition is marked by loose stools, abdominal cramping, nausea, and bloating.

There are many strains of E. coli, some of which are harmless. In fact, hundreds of strains live in your digestive tract as “good” bacteria. However, certain toxic strains may lead to serious illness. If you’re 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’re exposed to new strains of E. coli.

Some strains are more dangerous than others. They produce a toxin called Shiga, or verocytotoxin. This toxin 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 United States.

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

  • fever
  • sweats
  • intestinal gas
  • severe cramps
  • loss of appetite
  • nausea
  • vomiting
  • fatigue
  • lethargy

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

If you have any of the following symptoms, contact your doctor immediately:

  • high fever, over 101˚F in adults and over 100.4˚F in children
  • blood in your stool or urine
  • dehydration
  • fatigue
  • vomiting
  • inability to keep fluids down
  • diarrhea for more than five days, or two days for children
  • pain that doesn’t go away after a bowel movement

You can be exposed to disease-causing strains of E. coli by eating or drinking something contaminated with the bacterium. This often occurs because of unsafe food handling. Many infections result from eating meat that has come in contact with bacteria and waste from animal intestines during processing. Infections are also caused by 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 can also lead to food poisoning.

E. coli is rarely spread without food or drink, but it can happen. If someone neglects to wash their hands after a bowel movement and then touches something that others will use, it can lead to exposure and illness.

Your doctor will perform a physical examination and ask you 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.

The main complication of enteritis is dehydration due to diarrhea. Drinking fluids and keeping up with your hydration is extremely important. If you can’t keep liquids down due to intense vomiting or diarrhea, you may need to go to the hospital for intravenous fluid therapy.

Anti-diarrheal medications are sold over-the-counter at drugstores. However, if you have bloody diarrhea or a fever—a very important symptom—you should talk to your doctor before using these.

Though antibiotics are often prescribed to treat bacterial infections, there’s 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.

Most people recover without medication within two days. The most important treatment is to drink lots of fluids and get plenty of rest.

If you take diuretics, such as water pills, you may need to stop taking them while you have enteritis. Talk to your doctor for more information.

The CDC offers the following guidelines to help prevent STEC infections:

  • Wash your hands frequently, especially after using the bathroom or changing soiled diapers, and before preparing or eating food.
  • Cook all meats thoroughly, using 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.
  • Wash fruits and vegetables 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.

The outlook often depends on the severity of your infection and timely treatment. Most people recover from enteritis 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 even death.