Unboxing Acute Infectious Gastroenteritis: Causes, Symptoms, and Treatment

People of all ages on a global scale have a risk of developing acute infectious gastroenteritis, whose prominent symptoms include:

• ≥3 bowel movements due to watery/lose diarrhea
• Abdominal pain
• Nausea
• Fever
• Vomiting
• Nausea

Acute infectious gastroenteritis is a disease condition that manifests with severe inflammation of the intestine and stomach under the impact of a bacterial or virus infection.

Global Impact and Socioeconomic Burden

Nearly 10–12% of all hospitalizations in the world's industrialized nations account for acute infectious gastroenteritis. Nevertheless, each year, 0.7 million children in developing countries die due to severe health complications arising from this disease. While aged people also have a high risk for developing fatal complications of acute infectious diarrhea, fatality from this disease condition is rarely reported among healthy young people of age ≥18 years. However, the increased socioeconomic burden of acute contagious gastroenteritis is due to its high social, medical, and occupational expenses.

Common Viral and Bacterial Agents

Single-stranded ribonucleic acid (RNA) viruses, such as the Norwalk virus, are microorganisms that frequently cause acute infectious gastroenteritis in children, adults, and the elderly. The sapoviruses and noroviruses of the family Caliciviridae are known to cause viral gastroenteritis in human populations. Very occasionally, DNA viruses, such as adenoviruses (40/41) also trigger gastroenteritis complications in humans. Patients with acute infectious gastroenteritis develop a loss of appetite and have a consistent feeling of discomfort or restlessness. The bacteria that usually cause acute infectious gastroenteritis include Shigella, Campylobacter jejuni, Vibrio, Salmonella, and Escherichia coli.

Transmission and Prevalence

It is important to note that to date no animal models have been developed to classify human caliciviruses. Antibodies against these viruses are highly prevalent in adult populations, particularly in developing nations. This is because people in these countries are increasingly exposed to caliciviruses at an earlier age. The transmission of acute infectious gastroenteritis pathogens occurs through human excreta, and a high prevalence of this disease is observed during the cold weather months and in temperate climates.

The pathogen (i.e., virus/bacterium) for acute infectious gastroenteritis is also transmitted from the vomitus of a diseased person to a healthy individual. People with acute infectious gastroenteritis shed the pathogen during the acute phase of their illness. Individuals with a compromised immune system shed the pathogen for a long duration, compared to other asymptomatic or symptomatic patients.

The impact of the disease on the human immune system

The virus/bacterium responsible for acute infectious gastroenteritis attaches to the stomach lining of the infected individual and starts damaging the tiny finger-like projections (or villi) in the intestine, which consequentially triggers the accumulation of immune cells. The virus/bacterium, further deteriorates the digestive and immune systems, leading to symptoms, such as vomiting, chills, fever, nausea, and abdominal cramps. Vomiting and nausea usually occur due to the slowed function/movement of the stomach and the intestine. Acute infectious gastroenteritis reduces the concentration of a few enzymes in the patient’s body and lowers the capacity of the intestine to absorb fats and carbohydrates.

Symptoms and complications

The watery stools of the infected people contain white blood cells and mucus, and they experience a risk of dehydration, requiring immediate medical attention. While no vaccine or immunization can provide prolonged immunity, 50% of the infected people develop short-term immunity against acute infectious gastroenteritis.  

Diagnosis

Acute infectious gastroenteritis can be detected by observing its symptoms and with the help of diagnostic procedures, such as Polymerase Chain Reaction (PCR) and Enzyme immunoassays (EIAs).

What are the best treatment approaches for acute infectious gastroenteritis?

Acute infectious gastroenteritis, caused by viruses, is routinely treated with nutrition and hydration support. Antimotility drugs and antibiotics are never prescribed for treating patients with calciviruses.

However, patients with a bacterial infection mostly require supportive hydration therapy. The antibiotic prescription is recommended only for patients, exposed to Clostridium difficile or Shigella that cause severe diarrhea with blood in stool (or dysentery).

Some interesting facts about acute infectious gastroenteritis

• Regions with poor sanitation/hygiene have a higher prevalence of acute infectious gastroenteritis
• High disease burden is recorded in developed countries during the rainy season
• Bacteria take 1–7 days to trigger acute infectious gastroenteritis symptoms, following their exposure, in healthy individuals  
• Viruses take 1–3 days to trigger acute infectious gastroenteritis symptoms, following their exposure, in healthy individuals  
• Stool culture and complete blood count are the diagnostic methods, which are routinely used in clinical practice, to investigate acute infectious gastroenteritis  

References

Harrison's Principles of Internal Medicine. (2018). In D. L. Kasper, A. S. Fauci, S. L. Hauser, D. L. Longo, J. L. Jameson, & J. Loscalzo (Eds.), Harrison's Principles of Internal Medicine (20th ed.). New York, NY: McGraw-Hill Education.

National Center for Biotechnology Information. (n.d.). Acute gastroenteritis. In StatPearls. Retrieved August 3, 2024

Disclaimer: This content is for information only and does not qualify for prescription, prognosis, diagnosis, treatment/medical management, or medical education/teaching. You should individually consult a licensed medical professional/treatment provider for your health/wellness-related issues/concerns. Do not alter your current treatment/medical advice, and for any health emergency seek immediate medical attention.

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