Abdominal influenza

Gastrointestinal Influenza: description

In medical terminology, gastrointestinal influenza is also commonly referred to as gastroenteritis, that is, inflammation of the gastrointestinal tract. Strictly speaking, such a gastrointestinal inflammation does not have to be caused exclusively by an infection with pathogens such as viruses or bacteria, but can also be the result, for example, of cancer treatment. However, the term “gastroenteritis” usually refers to the infectious (contagious) form.

The colloquial term “gastrointestinal flu” is somewhat misleading because the infectious gastroenteritis is caused by other pathogens than the classical flu (influenza) and there is no connection between these diseases.

Ultimately, you can get a gastrointestinal flu at any age. But especially often it affects babies and toddlers. In the first three years of life children suffer on average once or twice a year from a gastrointestinal infection. Three-quarters of all sick children are between six and 24 months old. Even in the elderly, the likelihood of developing gastrointestinal influenza increases again.

What happens with the gastrointestinal flu?

A gastrointestinal flu is the result of infection with certain pathogens that attack the mucosa in the gastrointestinal tract. These germs, mostly viruses or bacteria, enter the stomach through ingestion via the mouth and then move on through the intestine, where they multiply before being excreted with the feces. According to this “walk” through the digestive tract are usually the symptoms of gastrointestinal flu: Symptoms in the initial stages are usually nausea and vomiting. They are later replaced by diarrhea.

What causes vomiting diarrhea?

When pathogens damage the gastric mucosa (either directly or through produced poisons), it can trigger a nausea in the brain. Vomiting is a protective reflex of the body, thus trying to get the unwanted invaders out of the body.

The often severe diarrhea in a gastrointestinal infection, however, is caused by the impairment of mucosal cells in the small and large intestine. Basically, the various pathogens cause diarrhea in different ways. There are three different mechanisms. It is often the combination of these mechanisms that causes diarrhea in gastrointestinal influenza:

• Secretory diarrhea
• Exudative diarrhea
• Osmotic diarrhea

Some pathogens, such as cholera bacteria, induce in the mucosal cells of the intestine an increased excretion of water (secretion) in the interior of the intestine. The porridge there is very fluid (secretory diarrhea).

Other pathogens of gastrointestinal influenza cause a strong inflammation of the mucous membrane, which subsequently secretes mucus and occasionally even blood (exudative diarrhea).

In addition, the food is no longer digested properly because many food components of the broken mucosal cells can not be taken. Through a physical process called osmosis, these undigested constituents draw water into the intestinal interior from the surrounding tissue, which in turn leads to or enhances diarrhea (osmotic diarrhea).

When does one speak of diarrhea?

More than three bowel movements a day and a very soft to watery stool consistency speak for diarrhea. However, the normal bowel habits of a human must be consulted as a comparison. For example, if a person habitually only has one or two days of bowel movements and suddenly has to go to the bathroom twice a day and excrete thin-bodied stools, then this case also involves diarrhea.

Diarrhea can have many causes. In addition to a gastrointestinal flu, for example, chronic inflammatory bowel disease can be behind it.

Gastrointestinal Influenza: Contagious from contact with feces and vomit

The infection with a gastrointestinal infection is usually fecal-oral. This means that the pathogens from the faeces (or vomit) of a person with gastrointestinal influenza somehow get into someone else’s mouth. This can happen, for example, if the person suffering from the illness does not wash their hands properly after being on the toilet. The pathogens can then find their way into food or objects from the hands and thus be absorbed by a still healthy person. This infection route is also called contact or smear infection.

Certain pathogens of a gastrointestinal flu, so-called noroviruses, can also spread airborne, so get over the airway from person to person and thereby transmit a gastrointestinal flu. This explains, among other things, the enormous risk of infection with Noroviruses. The viruses float enclosed in tiny droplets, which the patient releases into the surrounding air when talking, coughing or sneezing. They can be inhaled by other people. This transmission path is also called droplet infection.

Some pathogens of gastrointestinal influenza, such as EHEC (enterohaemorrhagic Escherichia coli) or Salmonella, can also be transmitted from animals to humans. Contagion occurs mainly through contaminated animal products such as raw eggs (such as tiramisu or mayonnaise) or milk. Often, inadequate refrigeration of food contributes to the spread of gastrointestinal influenza agents.

What is the risk of infection with the gastrointestinal flu?

How contagious a gastrointestinal flu is depends primarily on the causative agent. The risk of infection increases, for example, if the germs are relatively robust and can survive outside the human body for a long time. In other pathogens even the contact with the smallest amounts enough to trigger a gastrointestinal flu, because they multiply particularly fast and strong (such as norovirus). On the other hand, if the pathogens are more sensitive or can cause disease only in large numbers, the risk of infection is lower.

In general, gastrointestinal infections have a high potential for infection, which is why many family members often get sick or more frequent outbreaks occur in community facilities. The more viruses the sufferer excretes, the more contagious he is. Therefore, especially the danger of a “gastrointestinal infection” is particularly high, as long as the typical vomiting diarrhea is present. But even a few days before and after a gastrointestinal flu is infectious.

Gastrointestinal Influenza: duration

Everything about the duration of the gastrointestinal flu and how long it is contagious, you will find under Gastrointestinal Influenza – duration.

Gastrointestinal Influenza: Symptoms

You can read more about the symptoms of gastroenteritis as well as the possible complications in the article Gastrointestinal Influenza – Symptoms.

Gastrointestinal Influenza: Causes and Risk Factors

The term “gastrointestinal flu” generally refers to a condition in which an infection with a pathogen leads to typical symptoms in the gastrointestinal tract. Depending on the pathogen incubation time, intensity and duration of the disease vary. Incubation time refers to the period from the infection to the onset of the first symptoms.

In most cases, viruses are behind a gastrointestinal flu, especially noroviruses and rotaviruses, more rarely other viruses such as astro- or sapoviruses. In addition, there are also a number of bacteria and some parasites, which can cause a gastrointestinal infection.

rotavirus

Rotaviruses are very often responsible for gastrointestinal influenza in children. Up to 70 percent of infectious diarrheal diseases in infants are caused by rotavirus. In developing countries, they are also responsible for the high infant mortality.

In the course of the first years of life more frequent antibodies are formed by the body through more frequent contact with rotaviruses, which protect against later infections or make them weaker. Because of this, rotaviruses in adulthood are less likely to cause a gastrointestinal infection than in children. However, as there are different types of rotavirus, the body can never be completely immune to it. For example, rotaviruses may also be responsible for traveler’s diarrhea. In this case, the gastrointestinal influenza, because the person has not yet formed antibodies to the Rotaviruses distributed in the travel country.

noroviruses

Noroviruses are even more contagious than rotaviruses. In addition, they occur in countless variations, so that the immune system of infection usually can not oppose effective antibodies. Noroviruses are among the major contributors to adult gastrointestinal influenza, accounting for about half of all cases of non-bacterial gastroenteritis in this age group. Since noroviruses are also transmitted by air (aerogen) as a droplet infection, whole families often suffer from gastrointestinal influenza. In hospitals and nursing homes, patients are immediately isolated and doctors and nurses wear protective clothing to prevent the disease from spreading.

In case of an infection with Noro or Rotaviruses the symptoms set in at the earliest after approximately ten hours and at the latest after three days – depending on virus type and virus quantity.

salmonellae

Salmonella is one of the best known bacteria that can cause gastrointestinal influenza. The gastroenteritis caused by them is also called salmonellosis. The genus of Salmonella can be divided into other subgroups, with only the salmonella species “Salmonella Enteritidis” triggers a classic gastrointestinal influenza. Other types of salmonella cause typhus or paratyphus. These two diseases can also be associated with diarrhea, but these are serious general conditions and not the typical gastrointestinal infection.

Although salmonellosis can also be transmitted by sick persons, animal products such as raw eggs or insufficiently heated meat are usually the source of infection. Caution is advised especially with poultry products. Because salmonella is not killed by freezing, it can also be in the thawing water of poultry products, for example, and cause gastrointestinal ingestion when ingested. Therefore, you should always drain the condensation and, if possible, do not put frozen food in warm water to thaw, as Salmonella will multiply very well in it. For a contagion, however, a certain minimum amount of salmonella must be included.

Campylobacter

Even bacteria of the genus Campylobacter can cause a gastrointestinal flu. In the vast majority of cases it is Campylobacter jejuni, sometimes Campylobacter coli. These pathogens are transmitted by contact with animals and the consumption of contaminated food (poultry, raw milk). Campylobacter enteritis is the most common food-borne cause of gastrointestinal influenza before salmonellosis. Symptoms occur about two to five days after infection.

Escherichia coli (E. coli)

Most representatives of this bacterial species are completely harmless and even very useful to humans. “Coli” is the genitive of Colon, the Latin word for colon. This is exactly where trillions of these bacteria settle and support digestion. However, there are also some E. coli strains that are pathogenic to humans, that cause diseases in humans. These include, for example, poison-producing E. coli (enterotoxin-producing E. coli, abbreviated to ETEC). With traveler’s diarrhea ETEC are the responsible pathogens in about 40 percent of cases. Other harmful strains are EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroaggregative E. coli) and EHEC (enterohaemorrhagic E. coli).

The public became aware of EHEC in the spring of 2011, when several people in Germany died of the so-called hemolytic uremic syndrome (HUS). It is a disease of the small blood vessels, which in these cases occurred as a complication of a particularly aggressive EHEC infection. Basically, an EHEC disease rarely leads to HUS.

EHEC and other E. coli strains are transmitted fecally-orally, on the one hand, and salmonella on the other hand, via animal products such as raw meat or unpasteurized milk. The incubation period is about two to ten days.

Shigella

Shigelles cause the bacterial dysentery, also called shigellosis. This form of gastrointestinal influenza prevails especially when low hygiene standards prevail, such as in war zones or developing countries. The infection is usually via infected water and food. In Germany, Shigellosis are rare and, if so, mostly as a souvenir of holiday travel from countries such as India, Tunisia or Egypt. The incubation period is between one and four days.

Clostridium difficile

Clostridium difficile is a type of bacteria that is found everywhere, including soil and dust. To a certain extent, these bacteria are also found naturally in the human gut. But if they get out of hand there, they can trigger a gastrointestinal flu. This can happen, for example, by taking antibiotics if they disturb the microbiotic balance in the gastrointestinal tract. The Clostridium difficile bacteria may then multiply too much and cause gastroenteritis. This is not the classic gastrointestinal flu, but a severe inflammation of the intestine. In particular, the severe course of this intestinal inflammation is feared, which is also referred to as “pseudomembranous colitis”.

Yersinia and cholera bacteria

Yersinia bacteria are rather rare in Western Europe and responsible for only about one percent of diarrhea. The cholera caused by Vibrio cholerae is a rarity in western countries, but worldwide there are more than six million cases every year. Although only 15 percent of infected people show symptoms, in severe cases and poor medical care, cholera can be very dangerous. Due to the sometimes massive diarrhea (“rice water chair”) sufferers, especially children, lose a lot of fluid in a short time.

Food poisoning

Some bacteria indirectly damage the mucosal cells of the gastrointestinal tract by producing special poisons (toxins). Such toxin-forming agents include, for example, the bacteria Staphylococcus aureus, Bacillus cereus and Clostridium perfringens. These pathogens can occur in large numbers in spoiled foods and, after a certain amount, after only a few hours, cause the symptoms of severe gastrointestinal influenza.

parasites

In addition to viruses and bacteria, there are also certain parasites that can cause gastroenteritis. For example, the amoeba Entamoeba histolytica is the trigger of amoebic dysentery. This disease occurs mainly in tropical and subtropical areas. A common parasitic pathogen, which causes diarrhea, is the single-celled Giardia lamblia.

risk factors

In general, gastrointestinal influenza agents are always easier when the immune system is weakened. This is generally the case for children and the elderly. Therefore, these age groups are particularly prone to gastrointestinal flu. In addition, the risk of a complicated course is greater for them. The same applies to people who, for other reasons, have immunodeficiency, such as AIDS patients and patients receiving chemotherapy or immunocompromising drugs.

Gastrointestinal Influenza: Examinations and Diagnosis

The right contact for a gastrointestinal flu is your family doctor. A typical gastrointestinal flu is usually uncomplicated and can be quickly recognized by the symptoms of the doctor. However, the exact questioning of the patient to the disease is indispensable to distinguish a gastrointestinal flu with certainty against other diseases with similar symptoms (food intolerances, autoimmune diseases, appendicitis, etc.). In addition, the survey of medical history (anamnese) important to detect a possibly more complicated course of gastrointestinal influenza early. So that the doctor can properly classify a gastrointestinal infection, the doctor asks the following questions, for example:

• Do you have diarrhea besides vomiting?
• How long have the complaints already been?
• Do you suspect a connection with a particular food?
• Have you eaten raw milk, uncooked meat or raw eggs?
• Are other people in the immediate vicinity (workplace, school, family) affected by gastrointestinal influenza?
• Do you have fever?
• Did you notice blood in your stool?
• Have you been abroad in the last few days or weeks?
• Do you take any medications or have you recently taken any (for example antibiotics)?

In addition, the doctor asks the patient for other, already known diseases. In the case of gastrointestinal influenza in children, the question of a recent diet change also makes sense.

Subsequently, the physical examination: In doing so, the doctor pays particular attention to signs that indicate a lack of fluid (dehydration), such as dry mucous membranes, sunken eyes or standing skin folds. Especially in small children and infants, it is very important to notice a lack of fluid in time and treat.

In most cases, the medical history shows that uncomplicated gastrointestinal influenza is present. On further investigations can then be waived as a rule. However, if some of the above questions, such as blood in the stool or stay abroad, have been answered in the affirmative, the pathogen is tried to be determined precisely. This allows the therapy to be specifically adapted. Typical procedures for pathogen detection are stool cultures (in bacteria), studies with the light microscope (in amoebae and cholera bacteria) and the detection of the genome of pathogens (in the case of viruses). In certain cases, the patient’s blood and urine are also examined. If necessary, an ultrasound examination or an endoscopy (colonoscopy) are used in order to assess the extent of gastrointestinal influenza.

Gastrointestinal Influenza: Treatment

Drink a lot

What to do with gastrointestinal flu? This question arises after the diagnosis has been made. The answer is usually very simple: drink as much as possible! First of all, it is important to compensate for the loss of fluid caused by vomiting and diarrhea. In the case of a simple gastrointestinal infection, this means drinking a lot of unsweetened tea or water (preferably without carbon dioxide). Pure juices or soda are rather unsuitable, because the high sugar content makes the already irritated gastrointestinal tract additionally.

The body also loses salts (electrolytes) with the fluid. A severe electrolyte deficiency can be life-threatening, especially for children. In the pharmacy you get electrolyte powder, which remedy the electrolyte deficiency again. Especially in children with severe diarrhea and vomiting, they make sense.

Light food

Electrolyte powders are usually not necessary if those affected manage to consume small amounts of food. Although in the acute phase of a gastrointestinal flu, it is often difficult to keep anything at all without vomiting, yet the body still needs some food.

On the one hand, electrolytes lost through food can be taken up again, on the other hand, the intestine gets the building blocks for the healing of the damaged mucous membrane directly from the food. Therefore, a few days after onset of symptoms, people with gastrointestinal influenza should try to eat easily digestible food. Well tolerated in the acute phase, for example, a soup broth, in the further course but also bread, pasta, rice dishes, oat or semolina pudding and pretzel sticks. Too heavy, fatty food should be avoided.

Oral rehydration solutions (ORL)

Doctors also use so-called oral rehydration solutions (ORL), a special dextrose-salt mixture with ideally matched sugar and electrolyte content. It is usually taken by mouth (orally). If a more severe fluid deficiency already exists, similar preparations can also be infused directly via venous access. Since the 1970s, ORL has been used by default worldwide for the treatment of gastrointestinal influenza and other diarrheal diseases, which has significantly reduced child mortality in crisis countries.

Medical therapy

In uncomplicated gastrointestinal influenza usually no drugs are used, especially since there are no specific drugs against the viral pathogens. Under certain circumstances, however, a drug therapy is useful. For example, antibiotics can shorten the duration of the disease in a proven bacterially caused gastrointestinal influenza. Basically, however, antibiotics are used in a gastrointestinal infection very reserved and only in the following cases:

• In premature babies
• In the first third of pregnancy
• In people with known immunodeficiency
• In severe disease
• When bloody diarrhea occurs
• In the detection of pathogens such as Salmonella typhi, Vibrio cholerae, amoebae and Clostridium difficile

The use of antibiotics in EHEC infections can be dangerous, because it destroys enterohaemorrhagic E. coli in large numbers, but its decay products may trigger a hemolytic uremic syndrome (HUS). Therefore, antibiotics should be used with caution in EHEC infections.

In addition to antibiotics, there are other medicines to relieve the symptoms of gastrointestinal influenza: These include antiemetics that help against nausea, as well as so-called motility inhibitors (for example, loperamide), which slow down the intestinal movement and thus the diarrhea. The active substance Racecadotril can also be used against severe diarrhea. The spasmolytic butylscopolamine is effective against spasmodic abdominal pain. However, all these medications are not always useful, which is why the treating physician must decide on their use individually.

Gastrointestinal Influenza: home remedies

Which home remedies that can help against a gastrointestinal flu, you can find under Gastrointestinal Influenza: home remedies

Gastrointestinal Influenza: Prevention

hygiene

A gastrointestinal flu can be prevented only insofar as one avoids the closer contact with patients as possible and pay attention to thorough hygiene. This includes, above all, thorough and regular hand washing. Especially the feces and the vomit of people with gastrointestinal influenza are highly infectious. Therefore, the toilet is the place where infection is particularly likely, even if it is used by sufferers. Before each use, the toilet should be cleaned and disinfected. After each visit to the toilet you should wash your hands with soap for two to three minutes. This significantly reduces the risk of infection with gastrointestinal influenza.

Nevertheless, a close physical contact with patients should be avoided as much as possible. In addition, the sheets and clothing of sick people should be washed at least 60 ° C, better at 90 ° C.

Stay at home

Anyone who already sees signs of gastrointestinal flu should definitely not go to school or to work. Only in this way can a further spread of the disease be prevented, especially if highly contagious viruses are responsible for the gastrointestinal flu.

vaccinations

In the meantime, an active immunization in infancy from the sixth week of life (oral uptake) against Rotaviruses is recommended by default. Although such a vaccine can not guarantee 100% immunity, it has been shown that it reduces the number of infections.

Although there is also a vaccine against the cholera, it is not recommended for normal tourism. Specific recommendations on the travel destination can be given by a doctor as part of a medical travel consultation.

Preventing gastrointestinal flu travel

Otherwise, travel-related gastrointestinal infections can essentially be avoided by following the advice given below: “Cook it, peel it or leave it”, in English: “Cook, peel or let it go”. So in countries with dubious hygiene standards you should always boil water before use or sterilize with special tablets or use only original sealed water bottles. You should also refrain from raw and insufficiently heated food such as seafood, fish and half-cooked meat. Also, ice cubes and ice cream harboring pathogens of gastrointestinal influenza in unfavorable cases.

Gastrointestinal Influenza: disease course and prognosis

Depending on the causative agent and the physical condition of the person concerned, the symptoms of gastrointestinal influenza can last only a few days or longer. For example, a Norovirus infection usually takes several days, an acute food poisoning can sometimes be fully recovered after 24 hours. In contrast, an amoebic dysentery may last for weeks without treatment.

As a rule, an acute gastrointestinal flu but passes as fast as it came. It generally stops after a short time and heals without consequences. However, caution is required in special situations: for example, babies and toddlers can massively lose fluid and electrolytes due to severe vomiting. In extreme cases, this results in a life-threatening condition due to the gastrointestinal flu. Pregnancy and breastfeeding are also situations in which close medical care of mother and child is necessary in order to be able to react to possible complications in a timely manner.

Although gastrointestinal influenza is in the majority of cases an unpleasant, but rather harmless disease. The right symptomatic treatment can often prevent complications. A doctor’s visit is recommended in any case, since only a doctor can determine for sure how difficult the Abdominal influenza is and what action is needed.