Infectious diarrhea - bacterial gastroenteritis; Acute gastroenteritis; Gastroenteritis - bacterial

Many different types of bacteria can produce the symptoms associated with bacterial gastroenteritis, including:

• Campylobacter jejuni
• Clostridium
• E. coli
• Salmonella
• Shigella
• Staphylococcus
• Yersinia

Some sources of the infection are:

• Bakery products
• Dairy products
• Improperly prepared food
• Reheated meat dishes
• Seafood

Risk factors are:

• Consumption of improperly prepared foods or contaminated water
• Travel or residence in areas of poor sanitation

The incidence is 1 in 1,000 people.

Related topics:

• Campylobacter enteritis
• E. coli enteritis
• Food poisoning
• Salmonella enteritis
• Shigella enteritis
• Staph aureus food poisoning

Each organism causes slightly different symptoms but all result in diarrhea. Other symptoms include:

• Abdominal cramps
• Abdominal pain
• Bloody stools
• Colitis
• Loss of appetite
• Nausea and vomiting

• Examination of food for toxin and bacteria
• Stool culture positive for the organism that causes the infection
• White blood cells in the stool

• Fecal smear
• Stool gram stain

The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost by diarrhea. Blood transfusions are rarely required.

Antibiotic or antimicrobial therapy is usually not needed unless the rest of the body is affected. Ask your doctor before using any antidiarrheal medicines.

Self-care measures to avoid dehydration include:

• Drinking electrolyte solutions to replace fluids lost by diarrhea
• Eating no solid food until the diarrhea has passed

People with diarrhea, especially young children, who are unable to drink fluids due to nausea may need medical attention and intravenous fluids. People taking "water pills" (diuretics) need to be careful with diarrhea and may need to stop taking the medication during an acute episode, as directed by the health care provider.

With most infections, symptoms improve with fluid and electrolyte replacement within a week. There are rare cases of patients with renal failure and even death due to the infection.

There have been increasing incidents of local outbreaks of severe infection with certain strains of E. coli bacteria. These outbreaks can be dangerous, especially to the elderly or very young children.

• Arthritis
• Dehydration
• Kidney failure (rare)
• Irritable bowel syndrome
• Low blood counts (anemia)
• Systemic infection

Call for an appointment with your health care provider if:

• You have blood or pus in your stools or your stool is black
• You have abdominal pain that is not relieved by a bowel movement
• You have symptoms of dehydration
• You have a fever above 101° F, or your child has a fever above 100.4° F, along with diarrhea
• You have foul-smelling or oily-looking stools
• You have recently traveled to a foreign country
• You have eaten with other people who also have diarrhea
• You have started on a new medication
• Your diarrhea does not get better in 5 days (2 days for an infant or child), or worsens before that
• Your child has been vomiting for more than 12 hours (in a newborn under 3 months you should call as soon as vomiting or diarrhea begins)

Proper handling, storage, and preparation of food -- in addition to good sanitation -- are principles of prevention.

Goldman L, Ausiello DA. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.