Acute Gastroenteritis - Medical Malpractice Lawyers

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Acute Gastroenteritis - Medical Malpractice

Acute gastroenteritis can be caused by bacteria, viruses and parasites. It is a major cause of morbidity and mortality throughout the world. Diarrhoea is in fact among the top five causes of death worldwide. Most deaths occur in babies and young children who live in developing countries. Toxins and drugs can cause gastroenteritis as well. The disease can be self limiting or can require antibiotics or antiparasitics to get better. If the disease is self limited, it tends to last less than a week in duration. It can be mild or severe enough to result in hospitalization.

The three main scenarios for gastroenteritis are sporadic cases like those seen in infants from a rotavirus infection. The second scenario is epidemic gastroenteritis, in which the infection occurs in institutions, among families, on ships and at tourist locations or as a result of a classic water-borne or food borne illness. Most of these are virus-related gastroenteritis. The third scenario is sporadic acute gastroenteritis of adults, cause also by viral illnesses.

Most people get gastroenteritis via the fecal-oral route, meaning that food is contaminated by an infected person who has not washed their hands after using the restroom. You can also get it from drinking contaminated well water or even contaminated city water.

About 3.5 million infants develop acute gastroenteritis, resulting in thirty deaths per year in the US. The rate of gastroenteritis is even higher in developing countries, in which water is contaminated and hand washing is not encouraged. The rate can actually be higher than reported because many people do not seek medical attention for their condition. Noroviruses cause about 23 million cases of gastroenteritis per year throughout the world. They are the leading cause of viral outbreaks of gastroenteritis worldwide and are responsible for up to 80 percent of outbreaks of gastroenteritis in industrialized nations. Norovirus used to be called Norwalk-like virus but has now been identified as a species in the family of viruses known as Caiciviridae. Immunocompromised patients and the elderly are particularly vulnerable.

Some cases of acute gastroenteritis are seasonal. The season for rotavirus infection is between November and April. Cruise ship viral outbreaks of noroviruses are usually more common in summertime. There is a new vaccine for rotavirus that has reduced its incidence in babies and adults. Rotaviral infections are the most common cause of infections in healthcare settings.

The more severe cases of acute gastroenteritis occur in the immunosuppressed, the elderly and the infant populations. It is an important cause of mortality in infants in the developing world. Those who have the highest rate of death in developed countries are the elderly. Noroviruses commonly infect nursing homes, causing a great deal of morbidity and mortality. In babies, the more common infections are due to rotavirus. In the elderly, the most common cause of acute gastroenteritis in the elderly is the Norovirus infection.

The symptoms of acute gastroenteritis include nausea, vomiting, diarrhoea, cramping abdominal pain, steady abdominal pain and sometimes fever. There is usually a prodrome in viral infections with fever and vomiting, followed by one to four days of nonbloody watery diarrhoea. In bacterial infections, the fever can be higher and the diarrhoea can be bloody, due to damage to the lining of the gastrointestinal tract from the bacterium. Dehydration can be prevalent if the person is unable to hydrate themselves properly during the illness. Bacterial infections have a high fever, bloody diarrhoea, severe abdominal pain, multiple stools and malaise.

Doctors diagnose acute gastroenteritis through a thorough history and physical examination. There is usually a history of exposure to tainted food or other known infected individuals. There are the symptoms of nausea, vomiting, diarrhoea and fever that are not due to a chronic illness. The pulse is checked and may be rapid and thready. This is especially true of those who are dehydrated. The skin may "tent" when lifted up and stretched. A stool sample can be evaluated for parasites and bacteria. Cultures of the stool can be done for bacteria and some viruses.

Treatment of acute gastroenteritis includes keeping the person hydrated and giving them anti-fever medications to support them until the diarrhoea passes. Some types of bacterial gastroenteritis can be treated with antibiotics but it is unnecessary in other cases. Parasitic causes of gastroenteritis can be treated with anti-parasitic medications.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here