Gastroenteritis
Template:Short description Template:Cs1 config Template:Good article Template:Infobox medical condition (new)
Gastroenteritis, also known as infectious diarrhea, is an inflammation of the gastrointestinal tract including the stomach and intestine.<ref name="Sch2015">Template:Cite book</ref> Symptoms may include diarrhea, vomiting, and abdominal pain.<ref name="EBMED2010">Template:Cite journal</ref> Fever, lack of energy, and dehydration may also occur.<ref name=Ci2013/><ref name="Fer2015">Template:Cite book</ref> This typically lasts less than two weeks.<ref name=Sch2015/> Although it is not related to influenza, in the U.S it is sometimes called the "stomach flu".<ref>Template:Cite book</ref>
Gastroenteritis is usually caused by viruses;<ref name="Helm2006" /> however, gut bacteria, parasites, and fungi can also cause gastroenteritis.<ref name="Ci2013" /><ref name="Helm2006">Template:Cite book</ref> In children, rotavirus is the most common cause of severe disease.<ref name="Rota2012">Template:Cite journal</ref> In adults, norovirus and Campylobacter are common causes.<ref name="pmid21695033">Template:Cite journal</ref><ref name="pmid22025030">Template:Cite journal</ref> Eating improperly prepared food, drinking contaminated water or close contact with a person who is infected can spread the disease.<ref name=Ci2013/> Treatment is generally the same with or without a definitive diagnosis, so testing to confirm is usually not needed.<ref name=Ci2013/>
For young children in impoverished countries, prevention includes hand washing with soap, drinking clean water, breastfeeding babies instead of using formula,<ref name=Ci2013/> and proper disposal of human waste. The rotavirus vaccine is recommended as a prevention for children.<ref name=Ci2013/><ref name=Rota2012/> Treatment involves getting enough fluids.<ref name=Ci2013/> For mild or moderate cases, this can typically be achieved by drinking oral rehydration solution (a combination of water, salts and sugar).<ref name=Ci2013/> In those who are breastfed, continued breastfeeding is recommended.<ref name=Ci2013/> For more severe cases, intravenous fluids may be needed.<ref name=Ci2013/> Fluids may also be given by a nasogastric tube.<ref name="Webb2005">Template:Cite journal</ref> Zinc supplementation is recommended in children.<ref name="Ci2013">Template:Cite journal</ref> Antibiotics are generally not needed.<ref>Template:Cite journal</ref> However, antibiotics are recommended for young children with a fever and bloody diarrhea.<ref name=EBMED2010/>
In 2015, there were two billion cases of gastroenteritis, resulting in 1.3 million deaths globally.<ref name="GBD2015Pre">Template:Cite journal</ref><ref name="GBD2015De">Template:Cite journal</ref> Children and those in the developing world are affected the most.<ref name="Web09">Template:Cite book</ref> In 2011, there were about 1.7 billion cases, resulting in about 700,000 deaths of children under the age of five.<ref name="Walk2013">Template:Cite journal</ref> In the developing world, children less than two years of age frequently get six or more infections a year.<ref name="M93">Template:Cite book</ref> It is less common in adults, partly due to the development of immunity.<ref name="Eck2011">Template:Cite journal</ref>
Signs and symptomsEdit
Gastroenteritis usually involves both diarrhea and vomiting.<ref name=Eck2011/> Sometimes, only one or the other is present.<ref name=EBMED2010/> This may be accompanied by abdominal cramps.<ref name=EBMED2010/> Signs and symptoms usually begin 12–72 hours after contracting the infectious agent.<ref name="Web09" /> If due to a virus, the condition usually resolves within one week.<ref name=Eck2011/> Some viral infections also involve fever, fatigue, headache and muscle pain.<ref name=Eck2011/> If the stool is bloody, the cause is less likely to be viral<ref name=Eck2011/> and more likely to be bacterial.<ref name=Bact2007/> Some bacterial infections cause severe abdominal pain and may persist for several weeks.<ref name=Bact2007/>
Children infected with rotavirus usually make a full recovery within three to eight days.<ref name="Rota2011">Template:Cite journal</ref> However, in poor countries treatment for severe infections is often out of reach and persistent diarrhea is common.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Dehydration is a common complication of diarrhea.<ref name="NICE2009">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Severe dehydration in children may be recognized if the skin color and position returns slowly when pressed.<ref name=Tint10/> This is called "prolonged capillary refill" and "poor skin turgor".<ref name=Tint10/> Abnormal breathing is another sign of severe dehydration.<ref name="Tint10">Template:Cite book</ref> Repeat infections are typically seen in areas with poor sanitation, and malnutrition.<ref name=Web09/> Stunted growth and long-term cognitive delays can result.<ref name=M93/>
Reactive arthritis occurs in 1% of people following infections with Campylobacter species.<ref name=Bact2007/> Guillain–Barré syndrome occurs in 0.1%.<ref name=Bact2007/> Hemolytic uremic syndrome (HUS) may occur due to infection with Shiga toxin-producing Escherichia coli or Shigella species.<ref name=BMJ2007/> HUS causes low platelet counts, poor kidney function, and low red blood cell count (due to their breakdown).<ref name="BMJ2007">Template:Cite journal</ref> Children are more predisposed to getting HUS than adults.<ref name=M93/> Some viral infections may produce benign infantile seizures.<ref name=EBMED2010/>
CauseEdit
Viruses (particularly rotavirus (in children) and norovirus (in adults)) and the bacteria Escherichia coli and Campylobacter species are the primary causes of gastroenteritis.<ref name=Web09/><ref name=Sz2010/> There are, however, many other infectious agents that can cause this syndrome including parasites and fungi.<ref name=M93/><ref name=Helm2006/> Non-infectious causes are seen on occasion, but they are less likely than a viral or bacterial cause.<ref name=EBMED2010/> Risk of infection is higher in children due to their lack of immunity.<ref name=EBMED2010/> Children are also at higher risk because they are less likely to practice good hygiene habits.<ref name=EBMED2010/> Children living in areas without easy access to water and soap are especially vulnerable.<ref name=EBMED2010/>
ViralEdit
Rotaviruses, noroviruses, adenoviruses, and astroviruses are known to cause viral gastroenteritis.<ref name=Kumar2020>Template:Cite book</ref> Rotavirus is the most common cause of gastroenteritis in children,<ref name=Sz2010/> and produces similar rates in both the developed and developing world.<ref name=Rota2011/> Viruses cause about 70% of episodes of infectious diarrhea in the pediatric age group.<ref name=Webb2005/> Rotavirus is a less common cause in adults due to acquired immunity.<ref name="ID2011">Template:Cite journal</ref> Norovirus is the cause in about 18% of all cases.<ref>Template:Cite journal</ref> Generally speaking, viral gastroenteritis accounts for 21–40% of the cases of infectious diarrhea in developed countries.<ref>Template:Cite journal</ref>
Norovirus is the leading cause of gastroenteritis among adults in America accounting for about 90% of viral gastroenteritis outbreaks.<ref name=Eck2011/> These localized epidemics typically occur when groups of people spend time proximate to each other, such as on cruise ships,<ref name=Eck2011/> in hospitals, or in restaurants.<ref name=EBMED2010/> People may remain infectious even after their diarrhea has ended.<ref name=Eck2011/> Norovirus is the cause of about 10% of cases in children.<ref name=EBMED2010/>
BacterialEdit
In some countries, Campylobacter jejuni is the primary cause of bacterial gastroenteritis, with half of these cases associated with exposure to poultry.<ref name="Bact2007">Template:Cite journal</ref> In children, bacteria are the cause in about 15% of cases, with the most common types being Escherichia coli, Salmonella, Shigella, and Campylobacter species.<ref name=Webb2005/> If food becomes contaminated with bacteria and remains at room temperature for several hours, the bacteria multiply and increase the risk of infection in those who consume the food.<ref name=M93/> Some foods commonly associated with illness include raw or undercooked meat, poultry, seafood, and eggs; raw sprouts; unpasteurized milk and soft cheeses; and fruit and vegetable juices.<ref>Template:Cite journal</ref> In the developing world, especially sub-Saharan Africa and Asia, cholera is a common cause of gastroenteritis. This infection is usually transmitted by contaminated water or food.<ref name="Cholera11">Template:Cite journal</ref>
Toxigenic Clostridioides difficile is an important cause of diarrhea that occurs more often in the elderly.<ref name=M93/> Infants can carry these bacteria without developing symptoms.<ref name=M93/> It is a common cause of diarrhea in those who are hospitalized and is frequently associated with antibiotic use.<ref>Template:Cite journal</ref> Staphylococcus aureus infectious diarrhea may also occur in those who have used antibiotics.<ref>Template:Cite journal</ref> Acute "traveler's diarrhea" is usually a type of bacterial gastroenteritis, while the persistent form is usually parasitic.<ref name="CDC Travelers'">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Acid-suppressing medication appears to increase the risk of significant infection after exposure to several organisms, including Clostridioides difficile, Salmonella, and Campylobacter species.<ref name="PPI2007">Template:Cite journal</ref> The risk is greater in those taking proton pump inhibitors than with H2 antagonists.<ref name=PPI2007/>
ParasiticEdit
A number of parasites can cause gastroenteritis.<ref name=Webb2005/> Giardia lamblia is most common, but Entamoeba histolytica, Cryptosporidium spp., and other species have also been implicated.<ref name=Webb2005/><ref name="CDC Travelers'" /> As a group, these agents comprise about 10% of cases in children.<ref name=BMJ2007 /><ref name="CDC Travelers'" /> Giardia occurs more commonly in the developing world, but this type of illness can occur nearly everywhere.<ref name="Giar2010">Template:Cite journal</ref> It occurs more commonly in persons who have traveled to areas with high prevalence, children who attend day care, men who have sex with men, and following disasters.<ref name=Giar2010/>
TransmissionEdit
Transmission may occur from drinking contaminated water or when people share personal objects.<ref name=Web09/> Water quality typically worsens during the rainy season and outbreaks are more common at this time.<ref name=Web09/> In areas with four seasons, infections are more common in the winter.<ref name=M93/> Worldwide, bottle-feeding of babies with improperly sanitized bottles is a significant cause.<ref name=Web09/> Transmission rates are also related to poor hygiene, (especially among children),<ref name=Eck2011/> in crowded households,<ref>Template:Cite journal</ref> and in those with poor nutritional status.<ref name=M93/> Adults who have developed immunities might still carry certain organisms without exhibiting symptoms.<ref name=M93/> Thus, adults can become natural reservoirs of certain diseases.<ref name=M93/> While some agents (such as Shigella) only occur in primates, others (such as Giardia) may occur in a wide variety of animals.<ref name=M93/>
Non-infectiousEdit
There are a number of non-infectious causes of inflammation of the gastrointestinal tract.<ref name=EBMED2010/> Some of the more common include medications (like NSAIDs), certain foods such as lactose (in those who are intolerant), and gluten (in those with celiac disease). Crohn's disease is also a non-infectious cause of (often severe) gastroenteritis.<ref name=EBMED2010/> Disease secondary to toxins may also occur. Some food-related conditions associated with nausea, vomiting, and diarrhea include: ciguatera poisoning due to consumption of contaminated predatory fish, scombroid associated with the consumption of certain types of spoiled fish, tetrodotoxin poisoning from the consumption of puffer fish among others, and botulism typically due to improperly preserved food.<ref>Template:Cite journal</ref>
In the United States, rates of emergency department use for noninfectious gastroenteritis dropped 30% from 2006 until 2011. Of the twenty most common conditions seen in the emergency department, rates of noninfectious gastroenteritis had the largest decrease in visits in that time period.<ref>Template:Cite journal</ref>
PathophysiologyEdit
Gastroenteritis is defined as vomiting or diarrhea due to inflammation of the small or large bowel, often due to infection.<ref name=M93/> The changes in the small bowel are typically noninflammatory, while the ones in the large bowel are inflammatory.<ref name=M93/> The number of pathogens required to cause an infection varies from as few as one (for Cryptosporidium) to as many as 108 (for Vibrio cholerae).<ref name=M93/>
DiagnosisEdit
Gastroenteritis is typically diagnosed clinically, based on a person's signs and symptoms.<ref name=Eck2011/> Determining the exact cause is usually not needed as it does not alter the management of the condition.<ref name=Web09/>
However, stool cultures should be performed in those with blood in the stool, those who might have been exposed to food poisoning, and those who have recently traveled to the developing world.<ref name=Webb2005/> It may also be appropriate in children younger than 5, old people, and those with poor immune function.<ref name="IDSA2017">Template:Cite journal</ref> Diagnostic testing may also be done for surveillance.<ref name=Eck2011/> As hypoglycemia occurs in approximately 10% of infants and young children, measuring serum glucose in this population is recommended.<ref name=Tint10/> Electrolytes and kidney function should also be checked when there is a concern about severe dehydration.<ref name=Webb2005/>
DehydrationEdit
A determination of whether or not the person has dehydration is an important part of the assessment, with dehydration typically divided into mild (3–5%), moderate (6–9%), and severe (≥10%) cases.<ref name=EBMED2010/> In children, the most accurate signs of moderate or severe dehydration are a prolonged capillary refill, poor skin turgor, and abnormal breathing.<ref name=Tint10/><ref>Template:Cite journal</ref> Other useful findings (when used in combination) include sunken eyes, decreased activity, a lack of tears, and a dry mouth.<ref name=EBMED2010/> A normal urinary output and oral fluid intake is reassuring.<ref name=Tint10/> Laboratory testing is of little clinical benefit in determining the degree of dehydration.<ref name=EBMED2010/> Thus the use of urine testing or ultrasounds is generally not needed.<ref>Template:Cite journal</ref>
Differential diagnosisEdit
Other potential causes of signs and symptoms that mimic those seen in gastroenteritis that need to be ruled out include appendicitis, volvulus, inflammatory bowel disease, urinary tract infections, and diabetes mellitus.<ref name=Webb2005/> Pancreatic insufficiency, short bowel syndrome, Whipple's disease, coeliac disease, and laxative abuse should also be considered.<ref name="Oxford">Template:Cite book</ref> The differential diagnosis can be complicated somewhat if the person exhibits only vomiting or diarrhea (rather than both).<ref name=EBMED2010/>
Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases.<ref name=EBMED2010/> This is in contrast to the large amount of diarrhea that is typical of gastroenteritis.<ref name=EBMED2010/> Infections of the lungs or urinary tract in children may also cause vomiting or diarrhea.<ref name=EBMED2010/> Classical diabetic ketoacidosis (DKA) presents with abdominal pain, nausea, and vomiting, but without diarrhea.<ref name=EBMED2010/> One study found that 17% of children with DKA were initially diagnosed as having gastroenteritis.<ref name=EBMED2010/>
PreventionEdit
Water, sanitation, hygieneEdit
Template:Further A supply of easily accessible uncontaminated water and good sanitation practices are important for reducing rates of infection and clinically significant gastroenteritis.<ref name=M93/> Personal hygiene measures (such as hand washing with soap) have been found to decrease rates of gastroenteritis in both the developing and developed world by as much as 30%.<ref name=Tint10/> Alcohol-based gels may also be effective.<ref name=Tint10/> Food or drink that is thought to be contaminated should be avoided.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Breastfeeding is important, especially in places with poor hygiene, as is improvement of hygiene generally.<ref name=Web09/> Breast milk reduces both the frequency of infections and their duration.<ref name=EBMED2010/>
VaccinationEdit
Due to both its effectiveness and safety, in 2009 the World Health Organization recommended that the rotavirus vaccine be offered to all children globally.<ref name="Sz2010">Template:Cite journal</ref><ref name="WHORota2009">Template:Cite journal</ref> Two commercial rotavirus vaccines exist and several more are in development.<ref name=WHORota2009/> In Africa and Asia these vaccines reduced severe disease among infants<ref name=WHORota2009/> and countries that have put in place national immunization programs have seen a decline in the rates and severity of disease.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> This vaccine may also prevent illness in non-vaccinated children by reducing the number of circulating infections.<ref>Template:Cite journal</ref> Since 2000, the implementation of a rotavirus vaccination program in the United States has substantially decreased the number of cases of diarrhea by as much as 80 percent.<ref name="CDC Rota">Template:Cite journal</ref><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> The first dose of vaccine should be given to infants between 6 and 15 weeks of age.<ref name=Sz2010/> The oral cholera vaccine has been found to be 50–60% effective over two years.<ref>Template:Cite journal</ref>
There are a number of vaccines against gastroenteritis in development. For example, vaccines against Shigella and enterotoxigenic Escherichia coli (ETEC), which are two of the leading bacterial causes of gastroenteritis worldwide.<ref name="WHO ETEC">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="WHO Shig">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
ManagementEdit
Gastroenteritis is usually an acute and self-limiting disease that does not require medication.<ref name=NICE2009/> The preferred treatment in those with mild to moderate dehydration is oral rehydration therapy (ORT).<ref name=BMJ2007 /> For children at risk of dehydration from vomiting, taking a single dose of the anti vomiting medication metoclopramide or ondansetron, may be helpful,<ref name="Fedorowicz2011">Template:Cite journal</ref> and butylscopolamine is useful in treating abdominal pain.<ref>Template:Cite journal</ref>
RehydrationEdit
The primary treatment of gastroenteritis in both children and adults is rehydration. This is preferably achieved by drinking rehydration solution, although intravenous delivery may be required if there is a decreased level of consciousness or if dehydration is severe.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite journal</ref> Drinking replacement therapy products made with complex carbohydrates (i.e. those made from wheat or rice) may be superior to those based on simple sugars.<ref>Template:Cite journal</ref> Drinks especially high in simple sugars, such as soft drinks and fruit juices, are not recommended in children under five years of age as they may increase diarrhea.<ref name=NICE2009/> Plain water may be used if more specific ORT preparations are unavailable or the person is not willing to drink them.<ref name=NICE2009/> A nasogastric tube can be used in young children to administer fluids if warranted.<ref name=Webb2005/> In those who require intravenous fluids, one to four hours' worth is often sufficient.<ref>Template:Cite journal</ref>
DietaryEdit
It is recommended that breast-fed infants continue to be nursed in the usual fashion, and that formula-fed infants continue their formula immediately after rehydration with ORT.<ref name="MMWR2003">Template:Cite journal</ref> Lactose-free or lactose-reduced formulas usually are not necessary.<ref name=MMWR2003/> Children should continue their usual diet during episodes of diarrhea with the exception that foods high in simple sugars should be avoided.<ref name=MMWR2003/> The BRAT diet (bananas, rice, applesauce, toast and tea) is no longer recommended, as it contains insufficient nutrients and has no benefit over normal feeding.<ref name=MMWR2003/>
A Cochrane Review from 2020 concludes that probiotics make little or no difference to people who have diarrhea lasting 2 days or longer and that there is no proof that they reduce its duration.<ref>Template:Cite journal</ref> They may be useful in preventing and treating antibiotic associated diarrhea.<ref>Template:Cite journal</ref> Fermented milk products (such as yogurt) are similarly beneficial.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Zinc supplementation appears to be effective in both treating and preventing diarrhea among children in the developing world.<ref>Template:Cite journal</ref>
AntiemeticsEdit
Antiemetic medications may be helpful for treating vomiting in children. Ondansetron has some utility, with a single dose being associated with less need for intravenous fluids, fewer hospitalizations, and decreased vomiting.<ref name=Fedorowicz2011 /><ref>Template:Cite journal</ref><ref name="pmid17279195">Template:Cite journal</ref><ref name=Cochrane2011/> Metoclopramide might also be helpful.<ref name="Cochrane2011">Template:Cite journal</ref> However, the use of ondansetron might possibly be linked to an increased rate of return to hospital in children.<ref>Template:Cite journal</ref> The intravenous preparation of ondansetron may be given orally if clinical judgment warrants.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Dimenhydrinate, while reducing vomiting, does not appear to have a significant clinical benefit.<ref name=EBMED2010/>
AntibioticsEdit
Antibiotics are not usually used for gastroenteritis, although they are sometimes recommended if symptoms are particularly severe<ref>Template:Cite journal</ref> or if a susceptible bacterial cause is isolated or suspected.<ref>Template:Cite journal</ref> If antibiotics are to be employed, a macrolide (such as azithromycin) is preferred over a fluoroquinolone due to higher rates of resistance to the latter.<ref name=Bact2007/> Pseudomembranous colitis, usually caused by antibiotic use, is managed by discontinuing the causative agent and treating it with either metronidazole or vancomycin.<ref name="Mandell"/> Bacteria and protozoans that are amenable to treatment include Shigella<ref>Template:Cite journal</ref> Salmonella typhi,<ref>Template:Cite journal</ref> and Giardia species.<ref name=Giar2010/> In those with Giardia species or Entamoeba histolytica, tinidazole treatment is recommended and superior to metronidazole.<ref name=Giar2010/><ref>Template:Cite journal</ref> The World Health Organization (WHO) recommends the use of antibiotics in young children who have both bloody diarrhea and fever.<ref name=EBMED2010/>
Antimotility agentsEdit
Antimotility medication has a theoretical risk of causing complications, and although clinical experience has shown this to be unlikely,<ref name="Oxford"/> these drugs are discouraged in people with bloody diarrhea or diarrhea that is complicated by fever.<ref name="Harrison">Template:Cite book</ref> Loperamide, an opioid analogue, is commonly used for the symptomatic treatment of diarrhea.<ref name="SleisengerFordtran">Template:Cite book</ref> Loperamide is not recommended in children, however, as it may cross the immature blood–brain barrier and cause toxicity. Bismuth subsalicylate, an insoluble complex of trivalent bismuth and salicylate, can be used in mild to moderate cases,<ref name="Oxford"/> but salicylate toxicity is theoretically possible.<ref name=EBMED2010/>
EpidemiologyEdit
It is estimated that there were two billion cases of gastroenteritis that resulted in 1.3 million deaths globally in 2015.<ref name=GBD2015Pre/><ref name=GBD2015De/> Children and those in the developing world are most commonly affected.<ref name=Web09/> As of 2011, in those younger than five, there were about 1.7 billion cases resulting in 0.7 million deaths,<ref name=Walk2013/> with most of these occurring in the world's poorest nations.<ref name=M93/> More than 450,000 of these fatalities are due to rotavirus in children under five years of age.<ref name=Rota2012/><ref>Template:Cite journal</ref> Cholera causes about three to five million cases of disease and kills approximately 100,000 people yearly.<ref name=Cholera11/> In the developing world, children less than two years of age frequently get six or more infections a year that result in significant gastroenteritis.<ref name=M93/> It is less common in adults, partly due to the development of acquired immunity.<ref name=Eck2011/>
In 1980, gastroenteritis from all causes caused 4.6 million deaths in children, with the majority occurring in the developing world.<ref name="Mandell">Template:Cite book</ref> Death rates were reduced significantly (to approximately 1.5 million deaths annually) by 2000, largely due to the introduction and widespread use of oral rehydration therapy.<ref name="Victora2000">Template:Cite journal</ref> In the US, infections causing gastroenteritis are the second most common infection (after the common cold), and they result in between 200 and 375 million cases of acute diarrhea<ref name=M93/><ref name=Eck2011/> and approximately ten thousand deaths annually,<ref name=M93/> with 150 to 300 of these deaths in children less than five years of age.<ref name=EBMED2010/>
Society and cultureEdit
Gastroenteritis is associated with many colloquial names, including "Montezuma's revenge", "Delhi belly", "la turista", and "back door sprint", among others.<ref name=M93/> It has played a role in many military campaigns and is believed to be the origin of the term "no guts no glory".<ref name=M93/>
Gastroenteritis is the main reason for 3.7 million visits to physicians a year in the United States<ref name=EBMED2010/> and 3 million visits in France.<ref>Template:Cite journal</ref> In the United States gastroenteritis as a whole is believed to result in costs of US$23 billion per year,<ref>Template:Cite book</ref> with rotavirus alone resulting in estimated costs of US$1 billion a year.<ref name=EBMED2010/>
TerminologyEdit
Template:Anchor The first usage of "gastroenteritis" was in 1825.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Before this time it was commonly known as typhoid fever or "cholera morbus", among others, or less specifically as "griping of the guts", "surfeit", "flux", "colic", "bowel complaint", or any one of several other archaic names for acute diarrhea.<ref name="archaic">Rudy's List of Archaic Medical Terms Template:Webarchive</ref> Cholera morbus is a historical term that was used to refer to gastroenteritis rather than specifically cholera.<ref>Template:Cite book</ref>
AnimalsEdit
Many of the same agents cause gastroenteritis in cats and dogs as in humans. The most common organisms are Campylobacter, Clostridioides difficile, Clostridium perfringens, and Salmonella.<ref>Template:Cite journal</ref> A large number of toxic plants may also cause symptoms.<ref>Template:Cite book</ref>
Some agents are more specific to a certain species. Transmissible gastroenteritis coronavirus (TGEV) occurs in pigs resulting in vomiting, diarrhea, and dehydration.<ref>Template:Cite book</ref> It is believed to be introduced to pigs by wild birds and there is no specific treatment available.<ref>Template:Cite book</ref> It is not transmissible to humans.<ref name="ZimmermanKarriker2012">Template:Cite book</ref>
See alsoEdit
ReferencesEdit
NotesEdit
External linksEdit
- Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years – NICE Clinical Guidelines, No. 84.
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