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Gastroenteritis: Causes, Symptoms, and Management

Gastroenteritis = inflammation of stomach and intestines causing diarrhea, vomiting, or both.

Etiology

  • Viral (70–80%): Norovirus (adults), Rotavirus (children), Adenovirus, Astrovirus, Sapovirus.
  • Bacterial: Campylobacter, Salmonella, Shigella, E. coli (STEC, ETEC), C. difficile, Vibrio.
  • Parasitic: Giardia, Cryptosporidium, Cyclospora.
  • Non-infectious: Toxins (S. aureus, B. cereus), medications, food intolerance, IBD flare.

Symptoms

  • Watery diarrhea (blood/mucus suggests invasive bacterial/parasitic)
  • Nausea, vomiting
  • Abdominal cramps
  • Low-grade fever
  • Malaise, anorexia

Management

  • Oral rehydration (ORS) is cornerstone; IV if severe dehydration/shock.
  • Continue age-appropriate feeding (breastmilk, formula, complex carbs); avoid BRAT diet.
  • Antiemetics (ondansetron) for persistent vomiting.
  • Antibiotics only for specific bacterial/parasitic causes (dysentery, traveler's diarrhea, confirmed C. diff).
  • Antimotility agents (loperamide) contraindicated in bloody diarrhea/fever/children.
  • Zinc (10–20 mg/day) reduces duration/severity in children.
  • Probiotics (LGG, S. boulardii) modest benefit.

Red Flags → Seek Care

  • Signs of dehydration (dry mucosa, ↓ urine, sunken eyes/fontanelle, poor skin turgor)
  • High fever, bloody stool, severe pain
  • Immunocompromised, very young/old, pregnant
  • Duration >7 days (acute) or >14 days (persistent)

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