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February 10, 2012

Gastroenteritis (cont.)

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What causes gastroenteritis?

Gastroenteritis, as defined above, has many causes, but the most frequent causes are viral and bacterial. Other causes vary greatly, such as parasites, toxins, food allergies, and medications. Many of the causes of gastroenteritis actually go on to develop additional gastrointestinal symptoms that are considered specific diseases themselves. The following lists the major causes of gastroenteritis, and also lists the diseases that have symptoms of gastroenteritis as part of their specific disease process; this list is not all-inclusive but does include the large majority of causes of gastroenteritis that may be encountered worldwide.

Viruses

  • Norovirus: causes about 50% to 70% of all gastroenteritis in adults, the most common cause of gastroenteritis in the US.

  • Rotavirus: common cause of diarrhea in infants, occasionally producing dehydration

  • Adenovirus: usually respiratory, but some strains cause gastroenteritis symptoms

  • Astrovirus: common cause of diarrhea in infants

  • Sapovirus: common cause of mild gastroenteritis in children

Bacteria

  • Staphylococcus: - a frequent cause of diarrhea and abdominal cramps; disease - Staphylococcus food poisoning

  • Escherichia coli: food poisoning; diseases - E. coli infections, especially strain 0157:H7 that may cause HUS (hemolytic-uremic syndrome) or TTP (thrombotic thrombocytopenic purpura)

  • Salmonella: food poisoning; disease - salmonellosis

  • Shigella: food poisoning; disease - shigellosis

  • Clostridium difficile: bacterial overgrowth and toxin production due to antibiotic suppression of competing intestinal bacteria; disease - C. difficile toxin production

  • Listeria: usual source is contaminated dairy products; disease - listeriosis

  • Campylobacter: contaminated dairy foods

  • Vibrio: contaminated drinking water and seafood; disease - cholera

  • Bacillus: usual source is contaminated rice

  • Aeromonas: seafood contamination

  • Yersenia: pork meat contamination

  • Plesiomonas: oysters and other seafood

Parasites

  • Giardia: common source of diarrhea from contaminated water; disease - giardiasis

  • Cryptosporidium: food, water sources of diarrhea; disease - cryptosporidiosis

  • Entamoeba: contaminated water; disease - amebiasis

Other causes of gastroenteritis

  • Food allergies: many types; eggs, nuts, milk, and shellfish are fairly common

  • Antibiotics: many antibiotics allow bacterial/fungal overgrowth (see Clostridium difficile previously mentioned)

  • Toxins: algal toxin in shellfish, heavy metal toxins. (aluminum, cadmium, arsenic, lead, and mercury) and others

  • Medications: side effects of many medications are diarrhea

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