Gastrointestinal Influenza – symptoms and complications

Typical gastrointestinal symptoms

In gastroenteritis, the digestive tract is colonized and damaged by harmful pathogens. Therefore, a gastrointestinal flu triggers symptoms especially in the digestive system. Typically, the symptoms develop very quickly within a few hours. How much they go depends on the type of pathogen as well as on individual factors such as the patient’s physical condition. The classic gastrointestinal flu symptoms are:

• Nausea and vomiting
• diarrhea
• Abdominal cramps and pain

Nausea and vomiting

Nausea and vomiting can be massive in the acute phase of gastrointestinal influenza. Some sufferers have to vomit several times an hour. The mucous membrane of the stomach and intestines is so irritated in gastroenteritis that the body can not keep anything with it. This is sometimes very exhausting, especially because enormous amounts of liquid and salts (electrolytes) are lost with the vomiting (and also the diarrhea).

Due to the frequent vomiting, the teeth can also roughen because the gastric acid in the vomit attacks the enamel.

Some people do not just vomit over their mouths, but also over their nose, which is why the nasal mucous membranes swell up. In the worst case, the vomit can get into the airways, which can develop a difficult to treat pneumonia (pneumonia).

diarrhea

In diarrhea, the liquid stool consistency and frequent wiping irritate the skin on the anus. In unfavorable cases, the region even ignites.

How sudden and vehement the diarrhea sets in, what consistency the stool has and whether any blood is added to it, also depends on the pathogen. Most diarrhea and other symptoms of gastrointestinal influenza are very sudden, in certain pathogens such as bacteria of the genus Campylobacter even downright explosive. The stool is often watery, but may also be mushy at the beginning. An admixture of blood is mainly observed during bacterial and amoebic dysentery as well as infections with Campylobacter. Certain E. coli strains, such as EHEC, can also cause bloody diarrhea, mostly affecting older people. On the other hand, viral gastrointestinal influenza is rarely associated with bloody diarrhea.

Sometimes, the chair appears slimy due to the many destroyed mucosal cells of the gastrointestinal tract. In the case of amoebic dysentery, blood and mucus additions make the stool look like “raspberry jelly”. Severe forms of cholera cause such watery diarrhea that one speaks of “rice water chairs”.

Abdominal cramps and abdominal pain

The diarrhea is usually accompanied by abdominal cramps and abdominal pain, which occur at intervals. After using the toilet, these cramps usually subside for a while.

General gastrointestinal flu symptoms

The typical gastrointestinal symptoms described above are additionally accompanied by general signs of illness. Thus, there is a classic symptom, as occurs for example in colds and influenza infections, even with the gastrointestinal flu: fever. However, fever does not necessarily occur. Other examples of common gastrointestinal flu symptoms include:

• a headache
• body aches
• fatigue

These common gastrointestinal flu symptoms may or may not occur. Sometimes they go some time ahead of the vomiting diarrhea, in other cases they come in at the same time.

Gastrointestinal flu without symptoms

In some cases, infections with pathogens that cause gastrointestinal flu are also completely symptomless. For example, many adults do not develop any gastrointestinal symptoms associated with EHEC infection, and rotavirus infection is often subclinical in this age group, with no apparent signs of disease.

This phenomenon is especially pronounced in amoebic dysentery and cholera. Both diseases are among the typical travel illnesses that occur in many countries with low standards of hygiene. Many people are only symptomless carriers of amoebae or cholera bacteria, without even getting sick. In cholera, only 15 percent of those infected show gastrointestinal symptoms or other signs of disease. Nevertheless, these people are contagious!

Gastrointestinal Influenza: complications

The typical symptoms of gastrointestinal infection are very uncomfortable, but usually not seriously harmful. Under certain circumstances, such as a weakened immune system, however, particularly severe disease patterns may arise, which urgently require medical treatment.

dehydration

The most common complication associated with gastroenteritis is the loss of too much fluid (dehydration) and important electrolytes (especially sodium and potassium) as a result of classic gastrointestinal symptoms of infection such as vomiting and diarrhea. A slight dehydration is generally not a big problem. But if it continues to progress, it will lead to serious consequences. In extreme cases, a massive shortage of fluid and salts can be fatal without treatment.

In principle, this danger can easily be averted by replacing the lost fluid and electrolytes, provided that it is done on time. But especially in developing countries with poor medical care, this is often not possible, which is why a gastrointestinal flu there still significantly contributes to high infant mortality: A lack of fluids in babies and toddlers shows much faster dangerous effects than in adults, because small patients in proportion to have less reserves to body volume. Therefore, you should always consult a doctor for symptoms of gastrointestinal flu in this age group. Even old people are among the risk groups.

The condition of a strong fluid loss is also called exsiccosis. Typical signs of exsiccosis are:

• Standing skin folds (For example, if you pull a skin fold on the back of your hand, it will stop for a while after you release it.)
• Dry skin and especially dry mucous membranes
• Strong and sudden weight loss: In babies, a weight loss from 10 percent of body weight is already very worrying.
• The general condition is getting worse and worse.
• Drowsiness and unusual drowsiness (somnolence). Sometimes, however, sufferers initially show a strong restlessness (agitation), as long as the lack of water continues.
• Strong thirst, with the patients eventually stop drinking with increasing dizziness.
• Dizziness when getting up with danger of falling (orthostatic hypotension)
• Increased heart rate with reduced blood pressure

Other consequences of exsiccosis include:

• seizures
• kidney pain
• Decrease in the amount of urine (oliguria / anuria)

In addition, there are other signs of increased fluid loss: Severe dehydrated gastrointestinal patients may experience sunken eyes, cold extremities, and prolonged capillary filling.

With a gastrointestinal flu, the loss of fluid always involves a shift in the electrolyte balance. This can sometimes lead to changes in the pH value in the blood and to cardiac arrhythmia and nerve damage.

Other complications

In addition to the dehydration or exsiccosis, there are a few more, indicative of complications symptoms. In unfavorable cases, gastrointestinal influenza-affected persons, for example, may suffer from a bowel invasion, ie an invagination of the intestine. The result is a bowel obstruction with severe pain that often needs to be treated surgically.

Certain pathogens such as Shigella and Entamoeba histolytica cause in extreme cases, not only the classic symptoms of gastrointestinal influenza, but even lead to a bowel perforation (intestinal perforation). Intestinal contents and pathogens pass from the stool into the abdominal cavity where they can cause inflammation of the peritoneum (peritonitis). The affected people are usually in great pain. Only immediate surgery can help the patient here.

In connection with some pathogens of gastroenteritis, a so-called toxic megacolon is observed in rare cases. Here the large intestine inflames and expands very much.

Certain gastroenteritis pathogens (especially EHEC and Shigella) produce toxins called toxins. Some of these can attack the kidneys and trigger hemolytic uremic syndrome (HUS). It is characterized by damage to the blood vessel walls and acute renal failure.

Risk group: Patients with immunodeficiency

A gastrointestinal flu in patients with immunodeficiency can be problematic (such as certain diseases such as AIDS or as a result of chemotherapy): The gastrointestinal symptoms can last longer than usual here. In addition, those affected are more susceptible to certain complications that are otherwise very rare.

For example, a gastrointestinal flu caused by norovirus can still show symptoms even weeks after onset of the disease (prolonged course of the disease). In addition, these risk patients are at risk of systemic infection (sepsis) with the pathogens, which is no longer limited to the gastrointestinal tract. An example of this is the Salmonella sepsis, in which the Salmonella can settle among other things on the pericardium, in the meninges and bones.

Complaints after the gastrointestinal flu

Finally, it can also lead to so-called post-infectious symptoms. These are certain symptoms that occur as a result of an infection, although the respective pathogen is usually no longer detectable. The actual trigger is the immune system, which attacks and damages the body’s own structures in connection with the previous infection.

An important example of this is reactive arthritis. In days, sometimes even weeks after the typical symptoms of gastrointestinal influenza (or any other infection) have subsided, inflammation suddenly occurs in various joints, on the eye and on the urethra (Reiter’s triad). Overall, this phenomenon is very rare. For example, the causative agents of reactive arthritis include Shigella and Campylobacter. The latter, in rare cases, also cause Guillain-Barré syndrome, an inflammatory disease of the nerves that can lead to serious paralysis and often needs intensive care.

Complications are rare

So there are some complications that are far more dangerous than the classic gastroenteritis symptoms. However, gastrointestinal influenza patients do not have to worry about it unnecessarily because the complications mentioned are very rare. In most cases, especially if the patients are otherwise healthy, only the typical ones occur for a few days Gastrointestinal flu symptoms before recovery starts relatively quickly.