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Gastroenteritis
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{{Short description|Inflammation of the stomach and small intestine}} {{cs1 config|name-list-style=vanc}} {{Good article}} {{Infobox medical condition (new) | name = Gastroenteritis | image = Gastroenteritis viruses.jpg | caption = Gastroenteritis viruses: A = rotavirus, B = adenovirus, C = norovirus and D = astrovirus. The virus particles are shown at the same magnification to allow size comparison. | field = [[Infectious disease (medical specialty)|Infectious disease]], [[gastroenterology]] | synonyms = Gastro, stomach bug, stomach virus, stomach flu, gastric flu, gastrointestinitis, flu bug | symptoms = [[Diarrhea]], [[vomiting]], [[abdomen|abdominal]] pain, [[fever]]<ref name=EBMED2010/><ref name=Ci2013/> | complications = [[Dehydration]]<ref name=Ci2013/><ref name=Fer2015/> | onset = | duration = | causes = [[Viruses]], [[bacteria]], [[parasites]], [[fungus|fungi]]<ref name=Ci2013/><ref name=Helm2006/> | risks = | diagnosis = Based on symptoms, occasionally [[stool culture]]<ref name=Ci2013/> | differential = [[Inflammatory bowel disease]], [[malabsorption syndrome]], [[lactose intolerance]]<ref>{{cite book|last1=Caterino|first1=Jeffrey M.|last2=Kahan|first2=Scott|title=In a Page: Emergency medicine|date=2003|publisher=Lippincott Williams & Wilkins|isbn=978-1-4051-0357-2|page=293|url=https://books.google.com/books?id=O0LwFPZDKbsC&pg=PA293|language=en|url-status=live|archive-url=https://web.archive.org/web/20170908184604/https://books.google.com/books?id=O0LwFPZDKbsC&pg=PA293|archive-date=2017-09-08}}</ref> | prevention = [[Hand washing]], drinking [[clean water]], proper disposal of [[human waste]], [[breastfeeding]]<ref name=Ci2013/> | treatment = [[Oral rehydration solution]] (combination of water, salts, and sugar), [[intravenous fluids]]<ref name=Ci2013/> | medication = | prognosis = | frequency = 2.4 billion (2015)<!-- incidence table --><ref name=GBD2015Pre/> | deaths = 1.3 million (2015)<ref name=GBD2015De/> }} '''Gastroenteritis''', also known as '''infectious diarrhea''', is an [[inflammation]] of the [[Human gastrointestinal tract|gastrointestinal tract]] including the [[stomach]] and [[intestine]].<ref name="Sch2015">{{cite book|last1=Schlossberg|first1=David|title=Clinical infectious disease|date=2015|isbn=978-1-107-03891-2|page=334|publisher=Cambridge University Press |edition=Second|url=https://books.google.com/books?id=meFwBwAAQBAJ&pg=PA334|url-status=live|archive-url=https://web.archive.org/web/20170908184604/https://books.google.com/books?id=meFwBwAAQBAJ&pg=PA334|archive-date=2017-09-08}}</ref> Symptoms may include [[diarrhea]], [[vomiting]], and [[abdominal pain]].<ref name="EBMED2010">{{cite journal|last=Singh|first=Amandeep|title=Pediatric Emergency Medicine Practice Acute Gastroenteritis β An Update|journal=Pediatric Emergency Medicine Practice|date=July 2010|volume=7|issue=7|url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=229}}</ref> [[Fever]], lack of energy, and [[dehydration]] may also occur.<ref name=Ci2013/><ref name="Fer2015">{{cite book|title=Ferri's Clinical Advisor 2015: 5 Books in 1|date=2014|publisher=Elsevier Health Sciences|isbn=978-0-323-08430-7|page=479|url=https://books.google.com/books?id=icTsAwAAQBAJ&pg=PA479|url-status=live|archive-url=https://web.archive.org/web/20170908184604/https://books.google.com/books?id=icTsAwAAQBAJ&pg=PA479|archive-date=2017-09-08}}</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>{{cite book|last1=Shors|first1=Teri|title=The microbial challenge: a public health perspective|date=2013|publisher=Jones & Bartlett Learning|location=Burlington, MA|isbn=978-1-4496-7333-8|page=457|edition=3rd|url=https://books.google.com/books?id=TDcvAqyx7AIC&pg=PA457|url-status=live|archive-url=https://web.archive.org/web/20170908184604/https://books.google.com/books?id=TDcvAqyx7AIC&pg=PA457|archive-date=2017-09-08}}</ref> Gastroenteritis is usually caused by [[viruses]];<ref name="Helm2006" /> however, gut [[bacteria]], [[parasites]], and [[fungus|fungi]] can also cause gastroenteritis.<ref name="Ci2013" /><ref name="Helm2006">{{cite book|url=https://books.google.com/books?id=aVmRWrknaWgC&pg=PA2003|title=Textbook of therapeutics: drug and disease management|last1=A. Helms|first1=Richard|date=2006|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-5734-8|edition=8|location=Philadelphia [u.a.]|page=2003|archive-url=https://web.archive.org/web/20170908184604/https://books.google.com/books?id=aVmRWrknaWgC&pg=PA2003|archive-date=2017-09-08|url-status=live}}</ref> In children, [[rotavirus]] is the most common cause of severe disease.<ref name="Rota2012">{{cite journal |vauthors=Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD |title=2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis |journal=The Lancet Infectious Diseases |volume=12 |issue=2 |pages=136β41 |date=February 2012 |pmid=22030330 |doi=10.1016/S1473-3099(11)70253-5 |url=https://zenodo.org/record/1260248 }}</ref> In adults, [[norovirus]] and ''[[Campylobacter]]'' are common causes.<ref name="pmid21695033">{{cite journal |vauthors=Marshall JA, Bruggink LD |title=The dynamics of norovirus outbreak epidemics: recent insights |journal=International Journal of Environmental Research and Public Health |volume=8 |issue=4 |pages=1141β9 |date=April 2011 |pmid=21695033 |pmc=3118882 |doi=10.3390/ijerph8041141|doi-access=free }}</ref><ref name="pmid22025030">{{cite journal |author=Man SM |title=The clinical importance of emerging Campylobacter species |journal=Nature Reviews Gastroenterology & Hepatology |volume=8 |issue=12 |pages=669β85 |date=December 2011 |pmid=22025030 |doi=10.1038/nrgastro.2011.191|s2cid=24103030 }}</ref> Eating improperly prepared food, drinking contaminated water or close contact with a person who is infected can [[#Transmission|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 [[infant formula|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">{{cite journal|last=Webb|first=A|author2=Starr, M|title=Acute gastroenteritis in children.|journal=Australian Family Physician|date=April 2005 |volume=34|issue=4|pages=227β31|pmid=15861741}}</ref> [[Zinc]] supplementation is recommended in children.<ref name="Ci2013">{{cite journal|last1=Ciccarelli|first1=S|last2=Stolfi|first2=I|last3=Caramia|first3=G|title=Management strategies in the treatment of neonatal and pediatric gastroenteritis.|journal=[[Infection and Drug Resistance]]|date=29 October 2013|volume=6|pages=133β61|pmid=24194646|doi=10.2147/IDR.S12718|pmc=3815002|doi-access=free}}</ref> [[Antibiotic]]s are generally not needed.<ref>{{cite journal |last1=Zollner-Schwetz |first1=I |last2=Krause |first2=R |date=August 2015 |title=Therapy of acute gastroenteritis: role of antibiotics. |journal=Clinical Microbiology and Infection |volume=21 |issue=8 |pages=744β9 |doi=10.1016/j.cmi.2015.03.002 |pmid=25769427 |doi-access=free}}</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">{{cite journal|vauthors=((GBD 2015 Disease and Injury Incidence and Prevalence Collaborators))|title=Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990β2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=8 October 2016|volume=388|issue=10053|pages=1545β1602|pmid=27733282|doi=10.1016/S0140-6736(16)31678-6|pmc=5055577}}</ref><ref name="GBD2015De">{{cite journal|vauthors=((GBD 2015 Mortality and Causes of Death Collaborators))|title=Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980β2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=8 October 2016|volume=388|issue=10053|pages=1459β1544|pmid=27733281|doi=10.1016/s0140-6736(16)31012-1|pmc=5388903}}</ref> Children and those in the [[developing world]] are affected the most.<ref name="Web09">{{cite book|last=Webber|first=Roger|title=Communicable disease epidemiology and control : a global perspective|year=2009|publisher=Cabi|location=Wallingford, Oxfordshire|isbn=978-1-84593-504-7|page=79|url=https://books.google.com/books?id=pZ9fpHtvOGYC&pg=PA79|edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20151026161644/https://books.google.com/books?id=pZ9fpHtvOGYC&pg=PA79|archive-date=2015-10-26}}</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">{{cite journal|last=Walker|first=CL|author2=Rudan, I |author3=Liu, L |author4=Nair, H |author5=Theodoratou, E |author6=Bhutta, ZA |author7=O'Brien, KL |author8=Campbell, H |author9= Black, RE |title=Global burden of childhood pneumonia and diarrhoea.|journal=Lancet|date=Apr 20, 2013|volume=381|issue=9875|pages=1405β16|pmid=23582727|doi=10.1016/S0140-6736(13)60222-6|pmc=7159282}}</ref> In the developing world, children less than two years of age frequently get six or more infections a year.<ref name="M93">{{cite book |chapter=Chapter 93 |editor1-last=Dolin |editor1-first=Raphael |editor2-last=Mandell |editor2-first=Gerald L. |editor3-last=Bennett |editor3-first=John E. |year=2010 |title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|publisher=Churchill Livingstone/Elsevier|location=Philadelphia|isbn=978-0-443-06839-3|edition=7th}}</ref> It is less common in adults, partly due to the development of [[immunity (medical)|immunity]].<ref name="Eck2011">{{cite journal |vauthors=Eckardt AJ, Baumgart DC |title=Viral gastroenteritis in adults |journal=Recent Patents on Anti-Infective Drug Discovery |volume=6 |issue=1 |pages=54β63 |date=January 2011 |pmid=21210762 |doi=10.2174/157489111794407877}}</ref>
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