Gastro-enteritis

A gastro-enteritis (commonly called wrongly intestinal influenza ) is a inflammatory infection characterized by the brutal and frequent emission of liquid and abundant saddles (Diarrhée). In general, gastro-enteritises are due to Bactérie S, such as the colon bacilli or the Salmonelle S, or (in the large majority of the cases, in particular infantile gastro-enteritis GEI in the child) with a Virus such as the Rotavirus. Symptoms of gastro-enteritis can be also due to parasite S interns, causes particularly frequent in the Pays in the process of development.

The diarrhea is often accompanied by Vomissement S and from pushed Fièvre but the symptoms vary according to the individuals. Indeed, some are satisfied to vomit, others do not have any symptoms, and some have only the diarrhea. If it is too important, it can lead to a Déshydratation of the organization.

If the diarrhea perdure, it can leave after-effects on the intestinal wall, driving with a pathology called Malabsorption.

Epidemiology

The Rotavirus is the most current cause of Diarrhée and Déshydratation in the child, in particular in the developed countries. In the world, one estimates that 125 million diarrheas is caused by this virus (either more 1 900 cases for 100 000 inhabitants), which represents 6 % of died of less than five years, and 25 % of died by Diarrheas. It is estimated that each year, 800 000 people die of gastro-enteritis in the world, of which 500 000 children of less than five years.

With the the United States, one estimates that it touches 80% of the children of less than one year; each year, 500 000 children must make the object of medical care, and 50 000 must be hospitalized.

In France, at the time of the peak of the winter epidemic 2005 - 2006, one estimates that 1 850 000 people consulted their general doctor in 8 weeks for gastro-enteritis; the incidence was of 367 cases for 100 000 inhabitants (the epidemic threshold being fixed at 260 cases for 100 000 inhabitants). The monitoring of the evolution of the incidence in France is carried out by the Réseau Sentinels of the Inserm.

It is thus about big problems of Public health. The more so as each year, the epidemic of Gastro-enteritis to rotavirus harmony often with the epidemics of Bronchiolite and Influenza, being able to put in difficulty the pediatric health-care systems.

Diagnosis

The usual Symptôme S of gastro-enteritis are nausea S, abdominal cramps and Vomissement S which appears brutally, of the Diarrhée, the Fièvre and the Céphalée S (headaches).

The symptoms commonly associated with gastro-enteritis, i.e. mainly the vomiting and the diarrhea, can also be signs of a poisoning (seafood, toxic mushrooms) or of systemic Infection S (Pneumonie, Septicémie, etc…). By a precise interrogation and the clinical context, it will be possible to eliminate these assumptions.

Gastro-enteritis can sometimes lead to complications such as the Déshydratation, being able even to lead to a hospitalization. The people at the risk are the young children and let us nourissons them, the elderly, and the people having a Immune system weakened by a disease (HIV for example). The signs of the Déshydratation are a dryness of the skin and mouth, the eyes and the soft parts of cranium (at let us nourissons) inserted, of the weaknesses, cramps, and weight loss, and of the urines less frequent and darker than usually.

Treatment

The majority of people are restored themselves in one or two days without particular treatment other that following measurements:

- to rest, with the bed ideally.

- not to eat or drink during a few hours to allow the digestive System to recover.

- then, drinking of small water mouthfuls for an equivalent from 8 to 16 glasses per day. According to the " Corporation of Sciences of the Health of Atlantique" , do not take a drink for athlete, of fizzy drink or fruit juice (even dégazéifiée). These drinks contain an excessive quantity of sugar and an insufficient quantity of electrolytes to replace those which are eliminated because of the diarrhea. To avoid alcohol and the drinks which contain cafeine, which has the effect not desired to increase the rock salt and water losses.

- once the nausea S disappeared, to gradually take again a solid food by privileging certain food easier to digest (see the councils of food below). To cease eating in the event of faintness.

In addition to a possible medicamentous treatment, drinking of water to avoid the Dehydration; to avoid eating vegetable fibers (fruit and vegetables), preferring starchy foods, the meats. Often that is not enough. To eat and drink in minor amounts: to prefer sweetened drinks, (herb teas with honey, degassed soda…) Use the Diète BRATT (banana, rice, stewed apples, the, and toast)

Symptomatic treatment of the nausea S and Vomiting S by the Antagonistic S of the Dopamine

Use of the Dompéridone ( Motilium® ), Métopimazine ( Vogalène® ), Métoclopramide ( Primpéran® ), Chlorpromazine ( Largactil® ), Alizapride ( Plitican® ).

Treatment of the diarrhea

Racécadotril (Inhibiting of the intestinal enképhalinase) ( Tiorfan® ), Lopéramide ( Imodium® ).

Against dehydration (especially for the young children)

To prevent the Dehydration, to give a solution of oral rehydration, which will be absorbed even in the presence of vomiting. That is essential for the infants and the young children who had several diarrheal saddles. It is the best means of replacing lost water and salts, but that does not even fight against the diarrhea it. To use solutions like Pedialyte® , Gastrolyte® or Infalyte® , sold in pharmacy without medical ordinance, or a solution prepared at the house (to mix one liter of sterile water, six spoonfuls with sugar and a spoonful with salt the). The nursed children must continue to be it while taking Solution of rehydration.

Prevention

Gastro-enteritis is transmitted by consuming contaminated food or water, like by direct contact with the patients. In period at the risk (winter) or when a family member is sick, the following actions make it possible to fight against the propagation of gastro-enteritis. They are simple gestures like the following, which makes it possible to avoid the epidemics:

Attention with the hygiene of the hands and surfaces: to wash the hands before preparing and taking the meals, particularly in period of epidemic (winter). It is also necessary to wash the hands after being gone with the toilets or having changed an infant…
Attention with the preparation of the meals . During the preparation of the meals, to observe strict rules of hygiene (washing of the hands, etc…). The sick people should not obviously take part in the preparation of the meals. To also avoid dividing water glasses or covers with table.

Two Vaccin S is available : in 2006, two Vaccin S anti Rotavirus were put on the market in France. Their effectiveness was shown against the most widespread stocks in Europe and in the United States. The Superior council of public health decided to differ for the moment the recommendation for the infants from less than 6 months.

When one is reached gastro-enteritis: to fight against the Dehydration (caused by the Fever and the Diarrhea S)! For example, the Solutions of rehydration constitute the best prevention of the complications of the Diarrhée S. They allow an early rehydration, and are refunded by the social security.

The prevention of this disease is not always easy, especially for the people eating in Cantines or restaurant-U. There exist however very practical and easy to use liquid gel. Indeed, they are sold by bottle of 50ml and do not require any other intervention: one pours some a little in the hand, one rubs them, and freezing dries all alone, without rinsing. Containing alcohol, this gel fights effectively against viruses like that of the Herpès or (especially) that of gastro-enteritis. They are sold in pharmacy, like freezing Bacide Gel Hand for a variable price between 3€ and 6€.

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