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Enteritis

Definition

Enteritis is inflammation of the small intestine.

Causes, incidence, and risk factors

Enteritis is usually caused by eating or drinking substances that are contaminated with bacteria or viruses. The germs settle in the small intestine and cause inflammation and swelling, which may lead to abdominal pain, cramping, diarrhea, fever, and dehydration.

Enteritis may also be caused by:

• An autoimmune condition such as Crohn's disease
• Certain drugs, including ibuprofen, naproxen sodium, and cocaine
• Damage from radiation therapy

The inflammation can also involve the stomach (gastritis) and large intestine (colitis).

Risk factors include recent family illness with intestinal symptoms, recent travel, or exposure to untreated or contaminated water.

Types of enteritis include:

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

Symptoms

The symptoms may begin hours to days after you become infected. Symptoms may include:

• Abdominal pain
• Diarrhea - acute and severe
• Loss of appetite
• Vomiting - rare

Signs and tests

A stool culture may be done to determine the specific type of infection, however, this test may not always identify the bacteria causing the illness.

Treatment

Mild cases usually need no treatment.

Antidiarrheal medication may delay the organism from leaving the digestive tract, and therefore may not be recommended.

Rehydration with electrolyte solutions may be necessary if dehydration occurs.

Persons with diarrhea (especially young children) who are unable to drink fluids because of nausea may need medical care and fluids through a vein ( intravenous fluids) .

If you take diuretics and develop diarrhea, you may need to stop taking the diuretic during the acute episode. Do not stop taking any medicine unless told to do so by your health care provider.

Support Groups

Expectations (prognosis)

Symptoms usually go away without treatment in a few days.

Complications

• Dehydration
• Prolonged diarrhea

Note: The diarrhea can cause rapid and extreme dehydration in babies.

Calling your health care provider

Call for an appointment with your health care provider if:

• Dehydration develops
• Diarrhea does not go away in 3 to 4 days
• You have a fever over 101 degrees Fahrenheit
• There is blood in the stools

Prevention

• Always wash hands after using the toilet and before eating or preparing food or drink. You may also clean your hands with a 60% alcohol based product.
• Avoid drinking from unknown sources, such as streams and outdoor wells, without boiling the water first.
• Use only clean utensils for eating or handling foods, especially when handling eggs and poultry.
• Cook food completely and properly.
• Store food appropriately in coolers.

References

DuPont HL. Approach to the patient with suspected enteric infection. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 305.

Steiner TS, Guerrant RL. Principles and syndromes of enteric infection. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 93.

Craig SA, Zich DK. Gastroenteritis. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 92.