Gastro Medicine - Gastroenteritis

Question 1

What is gastroenteritis?

Answer 1

• Gastroenteritis may either occur whilst at home or whilst travelling abroad (travellers’ diarrhoea)
• Travellers’ diarrhoea may be defined as at least 3 loose to watery stools in 24 hours with or without one of more of abdominal cramps, fever, nausea, vomiting or blood in the stool. The most common cause is Escherichia coli
• Another pattern of illness is ‘acute food poisoning’. This describes the sudden onset of nausea, vomiting and diarrhoea after the ingestion of a toxin. Acute food poisoning is typically caused by Staphylococcus aureus, Bacillus cereus or Clostridium perfringens.

Question 2

Escherichia coli?

Answer 2

• Common amongst travellers
• Watery stools
• Abdominal cramps and nausea

Question 3

Giardiasis?

Answer 3

• Prolonged, non-bloody diarrhoea

Question 4

Cholera?

Answer 4

• Profuse, watery diarrhoea
• Severe dehydration resulting in weight loss
• Not common amongst travellers

Question 5

Shigella?

Answer 5

• Bloody diarrhoea
• Vomiting and abdominal pain

Question 6

Staphylococcusaureus?

Answer 6

• Severe vomiting
• Short incubation period

Question 7

Campylobacter?

Answer 7

• A flu-like prodrome is usually followed by crampy abdominal pains,
• Fever and diarrhoea which may be bloody
• Complications include Guillain-Barre syndrome

Question 8

Bacillus cereus?

Answer 8

Two types of illness are seen

• Vomiting within 6 hours, stereotypically due to rice
• Diarrhoeal illness occurring after 6 hours

Question 9

Amoebiasis?

Answer 9

• Gradual onset bloody diarrhoea,
• Abdominal pain and tenderness which may last for several weeks

Question 10

Incubation period?

Answer 10

• 1-6 hrs: Staphylococcus aureus, Bacillus cereus*
• 12-48 hrs: Salmonella, Escherichia coli
• 48-72 hrs: Shigella, Campylobacter
• > 7 days: Giardiasis, Amoebiasis

*vomiting subtype, the diarrhoeal illness has an incubation period of 6-14 hours