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Gastroenteritis in adultsThis factsheet is for adults with gastroenteritis. If your child has gastroenteritis, please see the separate BUPA factsheet, Gastroenteritis in children. Gastroenteritis is an inflammation or irritation of the stomach and intestines. In the UK, about one in five people are affected by gastroenteritis each year. In most cases, gastroenteritis clears up without the need for specific medical treatment. What is gastroenteritis?The stomach and intestines are known collectively as the gastrointestinal tract - or gut. Gastroenteritis is an infection of the gut. You can get infected from eating or drinking food that is contaminated with bacteria, viruses or parasites, or from other infected people (see "Causes" below). Some of these germs can damage the cells lining the inner surface of the gut and interfere with its normal functions. Certain bacteria or viruses may also produce toxins that irritate the gut and cause it to produce excess amounts of fluid. This can lead to the various symptoms of gastroenteritis such as diarrhoea. Symptoms of gastroenteritisThe time between catching the infection and the start of symptoms - the incubation period - depends on the cause of gastroenteritis. Depending on the type of bacteria, virus or parasite, it can range from a few hours to a couple of weeks. Symptoms also vary depending on the cause. You may have some or all of the following symptoms:
Most people recover within a week. However, with severe infections, which are uncommon in the UK, the illness may persist for many weeks. The symptoms of gastroenteritis may be confused with other bowel conditions, such as irritable bowel syndrome (IBS). It's important to seek medical advice if your symptoms persist for more than a week, or if you have recently travelled abroad. Causes of gastroenteritisVirusesViruses are a major cause of gastroenteritis. These include:
BacteriaThe commonest cause of bacterial gastroenteritis is food poisoning. For more information, please see the separate BUPA factsheet, Food hygiene. ParasitesParasites rarely cause gastroenteritis in the UK, but are a major problem in less developed countries. Common parasites that cause infections include:
These are found in lakes and streams. Other causesSome food allergies, for example an allergy to strawberries, can lead to gastroenteritis. For more information on food allergies, please see the separate BUPA factsheet, Food allergy. Rarely, diarrhoea may be caused by other infections such as pneumonia or urinary tract infection. However, very occasionally it may be a manifestation of a more serious disease such as encephalitis, diabetes, appendicitis or a blockage of the gut. If you have recently travelled to a country where malaria is present, this could also be a potential cause. How is gastroenteritis spread?The infections are transmitted:
TreatmentSelf-treatmentMost cases of gastroenteritis can be treated with self-care. If you have lost lots of fluid through persistent diarrhoea and/or vomiting, you may be dehydrated. The balance of salts in your body may also be disturbed. The most important aspect of treatment is to replace the fluids you have lost, to prevent getting dehydrated.
Take small sips of drinks and bites of salty crackers until you feel well enough to eat again. When your appetite returns, eat mild foods such as soups, pasta, rice and dry toast. MedicinesMedicines to stop diarrhoea such as loperamide (eg Imodium) are best reserved for short-term situations, such as making travel easier, or to get through a social event. These medications slow down the intestines, but have no effect on the excess fluid in the intestines, so it will come out later. They can also have side-effects such as tummy cramps and dizziness. If you are in pain, take the painkiller that you would normally take for a headache. When to contact a doctorYou should contact your doctor if:
Your doctor may prescribe an anti-sickness medicine (anti-emetic). Many anti-emetics are also sedatives, so it's advisable not to drive or use machinery after taking them. Most cases of gastroenteritis are caused by viruses, which are not treatable with antibiotics. In general therefore, doctors in the UK do not prescribe antibiotics for a typical case of gastroenteritis. However, if your doctor suspects that you have a bacterial infection, he or she may ask you for a stool sample to send for laboratory testing. The results will help to determine which antibiotic to treat you with. Hospital treatmentIf you have lost so much fluid that you are very dehydrated, you may need hospital treatment to replace fluids intravenously. PreventionThe best way to prevent gastroenteritis is to always wash your hands after going to the toilet and to disinfect toilets after use. You should also practise good food hygiene. For more information, please see the separate BUPA factsheet, Food hygiene. Should I stay off work?You should stay off work until the symptoms of diarrhoea and vomiting have stopped. Generally, if your job involves handling food or you are a healthcare worker you should be symptom-free for at least 48 hours before you return to work. This should be increased to one week if you handle food and are still suffering from diarrhoea. Check with your manager or occupational health adviser in your company. Further leave may be necessary if you are infected with Salmonella - ask your doctor for advice. Further information
References
Reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP. partner/principal general practitioner at Rowcroft Medical Centre. Published by BUPA's health information team, healthinfo@bupa.com February 2006.
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