Acute gastroenteritis: Difference between revisions

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{{AdultPage|acute gastroenteritis (peds)}}
{{AdultPage|acute gastroenteritis (peds)}}
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==Background== <!--T:2-->
==Background==


<!--T:3-->
*Blood diarrhea suggests bacterial etiology
*Blood diarrhea suggests bacterial etiology
*Viral AGE usually lasts <7d
*Viral AGE usually lasts <7d
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===Causes=== <!--T:4-->
===Causes===


<!--T:5-->
{| class="wikitable"
{| class="wikitable"
|+ Noninvasive AGE
|+ Noninvasive AGE
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|}
|}


<!--T:6-->
{| class="wikitable sortable"
{| class="wikitable sortable"
|+ Invasive AGE
|+ Invasive AGE
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==Clinical Features== <!--T:7-->
==Clinical Features==


<!--T:8-->
*[[Special:MyLanguage/Vomiting|Vomiting]]/[[Special:MyLanguage/diarrhea|diarrhea]]
*[[Special:MyLanguage/Vomiting|Vomiting]]/[[Special:MyLanguage/diarrhea|diarrhea]]
*Crampy/diffuse [[Special:MyLanguage/abdominal pain|abdominal pain]]
*Crampy/diffuse [[Special:MyLanguage/abdominal pain|abdominal pain]]




==Differential Diagnosis== <!--T:9-->
==Differential Diagnosis==


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{{Nausea and vomiting DDX}}
{{Nausea and vomiting DDX}}
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{{Abdominal Pain DDX Diffuse}}
{{Abdominal Pain DDX Diffuse}}
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==Evaluation== <!--T:10-->
==Evaluation==


<!--T:11-->
*Assess hydration status
*Assess hydration status
**Cap refill, skin turgor, respiratory rate
**Cap refill, skin turgor, respiratory rate
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==Management== <!--T:12-->
==Management==


<!--T:13-->
#Rehydration (PO preferred)
#Rehydration (PO preferred)
#*30mL(1oz)/kg/hr
#*30mL(1oz)/kg/hr
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===[[Special:MyLanguage/Antibiotics|Antibiotics]]=== <!--T:14-->
===[[Special:MyLanguage/Antibiotics|Antibiotics]]===


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*''Only consider in patients with invasive infection''
*''Only consider in patients with invasive infection''
**[[Special:MyLanguage/Shigella|Shigella]], [[Special:MyLanguage/campylobacter|campylobacter]], [[Special:MyLanguage/E. coli|E. coli]], [[Special:MyLanguage/yersinia|yersinia]], [[Special:MyLanguage/vibrio|vibrio]]
**[[Special:MyLanguage/Shigella|Shigella]], [[Special:MyLanguage/campylobacter|campylobacter]], [[Special:MyLanguage/E. coli|E. coli]], [[Special:MyLanguage/yersinia|yersinia]], [[Special:MyLanguage/vibrio|vibrio]]
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==Disposition== <!--T:16-->
==Disposition==


<!--T:17-->
*Most can be discharged
*Most can be discharged




===Admit=== <!--T:18-->
===Admit===


<!--T:19-->
*Unable to tolerate PO
*Unable to tolerate PO
*Hemodynamic instability
*Hemodynamic instability
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==See Also== <!--T:20-->
==See Also==


<!--T:21-->
*[[Special:MyLanguage/Nausea and vomiting|Nausea and vomiting]]
*[[Special:MyLanguage/Nausea and vomiting|Nausea and vomiting]]
*[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]]
*[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]]
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==References== <!--T:22-->
==References==


<!--T:23-->
<references/>
<references/>


<!--T:24-->
[[Category:GI]]
[[Category:GI]]
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Revision as of 13:17, 17 January 2026

This page is for adult patients. For pediatric patients, see: acute gastroenteritis (peds)


Background

  • Blood diarrhea suggests bacterial etiology
  • Viral AGE usually lasts <7d
  • Do not diagnose isolated vomiting as AGE


Causes

Noninvasive AGE
Species Onset Symptoms Transmission Preformed Toxin
Viral (norovirus, adenovirus, rotavirus) 11-72 hrs
  • Nausea, vomiting, watery diarrhea
  • Mild abdominal cramps, myalgia
  • Fecal-oral
  • Contaminated food or water
 No
Staph 1-6 hrs
  • Nausea, severe vomiting, diarrhea,
  • Mild abdominal cramping
  • Previously cooked foods (mayonaise, ham, salads)
 Yes
B. cereus 1-6 hrs
  • Abrupt onset of nausea, vomiting, mild diarrhea
  • Previously cooked foods (rice, vegetables, dried fruits, meat)
 Yes
C. perfringens 8-24 hrs
  • Nausea, minimal vomiting, watery diarrhea
  • Abd cramps
  • Previously cooked or reheated meats and poultry
 Yes
V. cholerae 11-72 hrs
  • Explosive rice-water diarrhea
  • Vomiting, abdominal cramps
  • Fever
  • Fecal-oral
  • Contaminated food or water
 Yes
Giardia 1-4 wks
  • Flatus, bloating
  • Foul-smelling and fatty stools (steatorrhea)
  • Fecal-oral
  • Contaminated water
 No
Invasive AGE
Species Onset Symptoms Transmission
Salmonella 6-72 hours
  • Eggs
  • Poultry
  • Water
  • Reptiles
Shigella 1-3 days
  • Food
  • Fecal-Oral
Yersinia 1-5 days
  • Water
  • Milk
  • Pork
  • Wild Animals
  • Fecal-Oral
Campylobacter 1-7 days
  • Water
  • Poultry
  • Pets/Animals
C. Diff 1-11 Weeks
  • Copious FOUL diarrhea
Entamoeba 1-11 weeks
  • Water
  • Sanitation
  • Travel


Clinical Features


Differential Diagnosis

Nausea and vomiting

Critical

Emergent

Nonemergent

Diffuse Abdominal pain


Evaluation

  • Assess hydration status
    • Cap refill, skin turgor, respiratory rate
  • Consider stool labs if:


Management

  1. Rehydration (PO preferred)
    • 30mL(1oz)/kg/hr
  2. Antiemetic


Antibiotics


Disposition

  • Most can be discharged


Admit

  • Unable to tolerate PO
  • Hemodynamic instability
  • Significant comorbidities


See Also


References

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