This inflammatory disorder of the digestive tract is known by many
names; such as traveler’s tummy, upset stomach, salmonellosis,
dysentery, botulism, giardiasis, food poisoning etc. and all of
these are simply various forms of it. Basically, in gastroenteritis,
there is an inflammation of the stomach and the intestines.
It is usually due to a bacterial or viral infection and is normally
accompanied by acute diarrhea and vomiting and severe spasmodic
abdominal pain and mild fever. An attack can last anything from 6
hours to a few (read 3) days.
Gastroenteritis may occur quite suddenly and in most cases, clears
up within a few days and is therefore not considered a serious
ailment; but there are cases when it becomes chronic and requires
urgent medical attention and lots of self care.
Vomiting accompanied by spasmodic abdominal cramps,
colic
·
Acute diarrhea which may lead to anal irritation and
acute rectal pains
·
Fever and shivering
·
Loss of appetite
·
Fatigue
·
Intense thirst due to dehydration as diarrhea and
vomiting make you loose water
·
Flatulence
·
In case of dysentery – significant weight loss usually
accompanied by severe diarrhea which may last for months
and produces foul smelling stools, gas and a feeling of
bloatedness. Both forms of dysentery; bacillary which
is caused by bacteria and amoebic dysentery or amoebiasis which is caused by amoeba, have nearly the
same symptoms (even the disease giardiasis has exactly
the same symptoms) and therefore only a doctor can
evaluate the exact cause and the requisite treatment
There are so many probable causes and so little difference in the
symptoms of various forms and sub-forms of gastroenteritis that one
tends to get terribly confused as regards to the exact problem one
is facing. Still, as is our practice, we have tried to give brief
details on almost all the important and well known causes and hope
they will help you in self-diagnosing and in fruitful discussions
with your doctor.
·
Gastroenteritis is commonly caused by viruses, bacteria
and other micro-organisms usually getting transferred by
contaminated water and food. The usual suspects and
habits associated are:
›Poor hygiene and carelessness at the end of an
individual or other family members at home (remember, at
home, as most people feel that they catch these symptoms
only while they are traveling or eating out but that is
usually not the case)
›Partly cooked meals such as raw and lightly cooked egg
dishes or those with cracked shells, shellfish from
dubious sources, and undercooked poultry and meat
›
Dairy products and seafood that are not at their
freshest, e.g. spoilt oily fish. This is slightly easy
to find as they do smell bad with time
›
There are some other foods which may not smell bad
even after they have actually ‘gone off’ and they are
the most riskiest ones like rice that has been kept warm
for a long time or inadequately heated. So better take
care in storing foods and use them before their use-by
date in case of ready to eat types or as early as
possible in case of ones bought fresh
·
Some of the viral gastroenteritis may be epidemic in
nature as it spreads rapidly through personal contact
and/or coughs and sneezes. This type of intestinal flu
is also transmitted through food handled by infected
people.
·
Food poisoning also comes under gastroenteritis. Most
food products harbor bacteria and if not kept under
right conditions like hot foods piping hot and cold
foods chilled, these bacteria breed rapidly and increase
the chances of food poisoning dramatically. Warm weather
makes perfect conditions for food poisoning as any food
which is kept as such in this weather for more than an
hour and a half, increases chances of bacterial
proliferation. The various bacterial forms, causes,
incubation periods and certain symptoms of food
poisoning are:
›Cooked rice which has been kept warm for a while or
inadequately reheated develops bacteria bacillus cereus.
This can be avoided if the rice is either kept very hot
or cooled quickly and refrigerated. Usually the symptoms
of severe vomiting come within an hour of having food,
followed by diarrhea. But, the recovery is also very
fast.
›
In case of salmonellosis, there is an incubation
period of 8 to 48 hours after this salmonella bacteria
strikes and the first symptoms come which are sudden
onset of watery diarrhea with abdominal pain. Chances of
nausea, vomiting and mild fever also exist. These
symptoms last for 2-5 days in the normal course but may
extend their stay. Common sources are raw or lightly
cooked eggs, undercooked poultry and cooked foods and
salads that have been kept out, unrefrigerated, for more
than a couple of hours.
›
Poor kitchen hygiene at home or at fast food joints
results in poorly cooked foods, especially beef burgers
that harbor bacteria called Escherichia Coli (E. coli),
responsible for some of the deadliest food poisoning
cases. Patients have severe diarrhea which may contain
blood along with vomiting within 12-60 hours and the
condition may stay bad for as long as 10 days.
Sometimes, even hospitalization is required.
›
The bacteria called Campylobacter Jejuni may enter and
multiply when blood from raw poultry drips over cooked
foods and salads. Incubation period inside our bodies is
usually 2-6 days and symptoms are fever, abdominal pain
and nausea along with bloody diarrhea. The symptoms may
go in a day or last for as long as 10 days.
›Botulism is caused by the bacteria Clostridium Botulinium which produces toxins in imperfectly
preserved foods like that of damaged cans (especially
the rusted ones) and inadequately sterilized tinned or
bottled vegetables, meats or fishes. This rare disease
is serious and, if unchecked, can cause paralysis.
Symptoms of slurred speech, difficulty in swallowing,
vision impairment, respiratory failure along with watery
diarrhea and crampy abdominal pain start within 8-24
hours and usually last for a day.
›
Some other bacteria that multiply and create symptoms
similar to above are Staphylococcus Aureus (ham,
poultry, cream or custard filled baked goods), Listeria
Monocytogenes (soft cheeses, reproducing even at
refrigerator temperatures) and Clostridium Perfringens
(gives the milder form of botulism and found in warm
meat, gravy, stuffing like casserole or saucepan of
mince at low heat or in warm temperatures).
·
Traveler’s diarrhea is due to a variety of reasons
including fatigue, altitude sickness, travel anxiety,
bacterial imbalance and of course the action of n
numbers of bacteria that may attack your digestive
system after you eat those highly seasoned foods.
·
Dysentery
is caused either by amoeba or bacteria. Both forms have
nearly the same symptoms but amoebic dysentery is very
dangerous as the small parasite is difficult to kill and
may cause abscesses in the liver and lungs.
·
Bottle fed babies – Bottles pose a double whammy for
your innocent child. Firstly, he is not getting the
natural immunity which is present in abundance in
mother’s milk and secondly, there is no way you can
keep the bottle clean and completely sterilized
always.
Also, the chances of milk, the formula itself and the
water used to prepare milk being contaminated cannot be
ruled out.
Excessive caffeine consumption, especially in the form
of coffee is also attributed to be a reason for
upset stomach.
·
This problem has also been pinned down to too much of
smoking in many a cases.
·
Chronic gastroenteritis is usually attributed to
food
allergies which make this problem re-occur whenever you
are subjected to the allergen foods. Your doctor only
can study your eating pattern and with the help of
different aids tell you about your enemy, your allergen
food or foods. Usual suspects are milk (lactose
intolerance), eggs, fish and soya.
·
Eating food with too much of spices has another
disadvantage in the name of gastroenteritis. So, beware
as your chronic gastroenteritis problem may be simply
due to highly spiced up food.
·
In certain people, certain drugs, more specifically antibiotics, may produce a bacterial imbalance in the
digestive tract, thereby causing gastroenteritis.
Medications that can be taken to relieve GI problems include
antacids and H2 blockers. Avoid using laxatives and non steroidal
anti-inflammatory drugs as they may irritate the stomach. More
serious cases of gastroenteritis may require a continuous
course of antibiotics which comes with its own set of possible side
effects.
Herbal and homeopathic remedies have been used for man years to
provide natural support for the entire digestive system and
relieve gastrointestinal problems. These remedies are safe and
gentle to use on the body’s system without any harsh side effects.
Herbs such as Matricaria recutita (German Chamomile) and Filipendula
ulmaria (Meadowsweet) support ongoing health in the entire digestive
system and stomach lining and also act as a tonic and a soothing
remedy. In addition, Ulmus fulva (Slippery Elm) and Sutherlandia
frutescens promote healthy levels of digestive acids in the stomach
and absorption of nutrients.
In
adults:
·
Mentha piperita is one of the most effective of
the mint herbs, has been used for centuries to relieve
indigestion, nausea and heartburn. Modern research has
demonstrated its effectiveness in soothing the symptoms
of diverticulosis, IBS and other digestive disorders.
Mentha piperita is widely cultivated for medicinal uses
and also has anti-inflammatory and anti-spasmodic
properties. It relaxes the muscles of the digestive
tract and stimulates the flow of natural digestive
juices and bile, thereby assisting healthy digestion.
·
Sutherlandia frutescens ('Cancer Bush'
or 'Kankerbossie')
is a medicinal herb exclusively found in Southern Africa
and has been used by indigenous people for thousands of
years to treat chronic and acute digestive complaints,
internal cancers and as a powerful tonic. Recent
research has confirmed its adaptogenic properties.
Sutherlandia contains a number of highly active
compounds, including pinitol, L-canavanine and the amino
acid, GABA. L-canavanine is a strong L-argine antagonist
that has documented anti-cancer and anti-viral activity.
·
Pelargoneum graveolens('maagpyn bossie'
or stomach pain bush) is a traditional medicinal herb used by indigenous
people of South Africa. It has a wide variety of uses
and is an effective calmative and anti-spasmodic herb,
reducing stomach cramps and pain."
·
Matricaria recutita (German Chamomile) - With its daisy
like flowers throwing aromatic scents everywhere, this
wild herb is found throughout Europe. The essential oil
of German chamomile flower contains bisabols, flavonoids
and azulenes that give this herb its anti-inflammatory,
antispasmodic and muscle relaxing properties. This makes
it an excellent remedy for digestive disorders. Bisabol
which gives German chamomile anti-inflammatory
properties, helps relieve inflammation on the mucous
membranes and promotes healing. It’s a good remedy for
stomach pains and flatulence.
·
Filipendula ulmaria (Meadowsweet) is an
anti-inflammatory, soothing digestive remedy which helps
to protect the digestive tract and reduce stomach acid
secretions. It is also effective in reducing the pain of
digestive disorders and ulcers and is similar in
structure to the synthetic drug called acetylsalicylate,
or aspirin - without the side effects commonly
associated with aspirin.
·
Ulmus fulva (Slippery Elm) is one of the most effective
herbs used in reducing digestive pain and irritation,
and also protects and soothes the lining of the stomach
and digestive tract due to its high mucilage content.
Only bark from top quality Slippery Elm is used in Gastronic Dr.
·
Calcium phosphate (D6) is a biochemic tissue salt
that assists the body in its natural function of
creating new cells. Effective blood cell production is
important to ensure good blood circulation. The cells in
our body are continually dying and being replaced every
day. As we grow older, it is important to keep cellular
production happening as fast as cellular deterioration.
Calcium phosphate (also called Calc. phos.) promotes
nutritional health; it is a vital component for
effective digestion, cell growth and energy levels. It
is an excellent general tonic for people of all ages.
·
Carbo. veg. (30C) is well known for its
supportive capacity on digestion, including the
discouragement of common gas and wind. Carbo. veg. tends
to suit those individuals who prefer clothing loose
around the abdomen who also tend to lie down after
eating or drinking. This remedy also supports healthy
circulation and healthy energy levels.
·
Arctium lappa (Burdock) is well-known as an
herbal blood and system supporter. Burdock supports
routine detoxification carried out by the body and
supports the digestive system helping to lessen common
wind, non-recurrent bloating, and healthy bowel
movements.
In children (usually in addition to the above herbs and tissue
salts):
·
Alpinia galangal, a relative of Ginger, is a South
East Asian spice with a long history of therapeutic and
culinary use. By toning the tissues and supporting
normal digestive processes, Alpinia is an effective
remedy for maintaining digestive balance.
·
Arsen alb. (6C) is a well known remedy for digestive
health. It is often prescribed for maintaining health
and harmony in the digestive tract and is an excellent
ingredient for naturally sensitive tummies
·
Alchemilla vulgaris (Lady’s Mantle) is an
astringent herb (decreases secretions) that has been
used since the Middle Ages for maintaining healthy
stools and bowel functioning.
First things first, take plenty of fluids, especially
water, as there is tremendous water loss due to diarrhea
and vomiting. Re-hydration solution is the best and very
easy to make. You just have to mix around 8 teaspoon of
sugar and a teaspoon of salt to a liter of water and sip
throughout the day. Actually, the ideal intake is at
least two glasses of this solution for every bout of
diarrhea.
·
Initially, only liquids like the re-hydration solution
above, water and at max, equal quantity if fruit juice
(specifically apple juice) mixed with water, should be
administered to the patient. Raspberry leaf tea (avoid
in early pregnancy) and cinnamon tea with some honey
mixed not only quench the thirst and make up for fluid
loss but also give the much needed energy as well as
soothe the digestive tract.
Another re-hydration solution goes like this; fruit juice
(for potassium) with ½ a teaspoon of honey and a pinch
of table salt. This serves like a electrolyte and taste
much better.
·
One more very effective home made remedy is a decoction
of basil leaves. Take 15-20 basil leaves in a liter of
water and boil for ten minutes. Strain the solution and
mix a pinch of rock salt in it. Sip it throughout the
day.
·
The below mentioned foods may form a part of your
regular diet also, but they are extremely important in
the very beginning of the treatment to subside the
symptoms as soon as possible.
›Bananas for energy and potassium which helps in
keeping good balance of fluid in the body
›
Low-fiber carbohydrates in the form of plain white
boiled rice
›Apples as they have an excellent cleansing agent
property which is helpful in washing the toxins away
›Coconut water along with normal water as it also
provides vital minerals and vitamins
›Dry white toast to settle the stomach and give energy
(due to the carbohydrates present)
Once the condition improves, some other foods like
potato or potato juice, cooked vegetables like carrot
that are easy on the tummy and egg may be taken.
Actually, an all fruit diet has also been recommended by
doctors, but it may not be (and usually it is not) to the taste of the
patient.
People with gastroenteritis normally develop lactose
intolerance and hence dairy products must be the last
foods to be introduced back in the diet. Curd and
cottage cheese are the best ones and they actually help
in keeping the digestion and acid level normal.
Finally, you can fall back to the required balanced diet
containing fruits, vegetables and grains.
·
Eat yoghurt – yoghurt is wonderful in what it is,
as the organisms that produce it also produce lactase
that helps digest lactose present in it. Lactose
intolerance is anyway high as you become old and
therefore digesting milk becomes very difficult, more so
when you are down with gastroenteritis. But, as milk
based products are the main source of calcium and
are inherently consumed by everybody, it makes sense to
choose wisely the form of dairy product which will be
good for your tummy.
Yoghurt has only 75% of the lactose as compared to an
equal amount of milk; hence nearly everybody digests
yoghurt easily. Care should be taken that only regular
yoghurt is taken instead of the frozen one as the very
idea of tolerating yoghurt may wither away. Also choose
non-fat yoghurt and take everyday, especially before
ice-creams if you really can’t do without them.
·
As fluid and electrolyte loss as well as blood loss in
some cases makes the patient extremely weak and possibly
anemic, vitamins A, C and E become very important. They
are wonderful antioxidants who mop up the free radicals
which attack at increasing speed when you are sick and
also fight anemia. As most foods rich in these vitamins
(barring a few like some citrus fruits) are to be
avoided, at least at an early stage, it is recommended
that you take supplements or capsules of these vitamins
but only on the prescription of your doctor.
The
following are the precautions one should take at home and also see
for oneself if possible while traveling or eating out. Basically,
it is all about the way the cook cooks and you eat. Still,
just to make things more clear and categorical, precautions required
while traveling or eating out have been separated.
Precautions while traveling or eating out:
·
Avoid uncooked vegetables, specifically salads and
fruits which cannot be peeled.
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·
Shellfish and fish in general, unless in a reputable
hotel or restaurant
·
Totally avoid uncooked shellfish such as oysters and
also undercooked or raw meat.
·
Any undercooked food, or food that has been served
lukewarm or has been kept slightly warm for some time.
·
Ice cubes and drinks made from impure water, as also
diluted soft dinks (including orange squash). Remember,
even the alcohol cannot kill the bacteria
contained in these drinks.
·
If you are really fond of salads (which actually one
should be), then make sure the salad is washed in
bottled or boiled water.
·
Avoid ice-creams from street vendors or unreliable
sources and foods exposed to flies.
·
Don’t swallow swimming pool water; or swim in lakes,
ponds or rivers if you are not quite sure about their
hygienic condition.
·
Brush your teeth using bottled water only. Do check the
label and seal on the bottle.
·
Acidic drinks like colas and orange juice help in
bringing down the E. Coli count, hence their intake
should be increased, but should be had only after
de-fizzing them. Same holds true for yoghurt, as it
fills your stomach with beneficial bacteria reducing the
chances of an invasion.
·
Make sure that your food is served in absolutely cleaned
dishes as an un-cleaned dish spills water on all the
other precautions taken.
Precautions at home:
·
Remember; bacteria are there in and on all the foods and
therefore you may 'safely' assume that all you eat may
become unsafe due to contamination by poisonous
bacteria, if the below mentioned precautions are not
taken.
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·
You must wash your hands before handling any
food and definitely cover any cuts or sores on your
hands. Bacteria such as staphylococcus which is usually
found on the skin and in the throat and shigella which
is passed on from fecal matter can easily get passed on
to the food you are preparing. Wash your hands even
after handling the food, specifically eggs and raw meat.
·
Pets carry bacteria and hence must not enter your
kitchen and should also be away from the dining table
when you have your food.
·
A separate chopping board and utensils for raw meat,
fish and poultry are mandatory to avoid cross
contamination.
·
Cooked and raw foods must be kept separately. Any
stuffing from cooked poultry must also be removed before
putting inside the refrigerator.
·
Don’t taste for testing purposes midway through the
cooking process, especially while preparing raw pork
sausage stew or fish chowder.
·
Also, although reheating thoroughly the already cooked
food is a must, never repeat the process, i.e. don’t reheat
the cooked food more than once. Never keep cooked dishes
warm over a low heat as bacteria multiply rapidly in
warmth. Same holds true for dishes kept at room
temperatures for more than 1 ½ hours. Be particularly
cautious while dealing with protein rich food like meat,
egg based foods, cream filled pastries and potato
salads.
·
You should either heat or chill raw foods as bacteria
cannot multiply over 176°F (80°C) and below 41°F (5°C).
·
Never allow raw meat juice to fall on the already cooked
harmless food as it may contaminate it
·
While microwaving large meat pieces, using a meat
thermometer makes complete sense as nobody can be quite
sure of the temperature inside the big fat piece. Using
the thermometer ensures complete cooking.
·
Sponges should be replaced quite often and counters must
be cleaned with paper towels. Similarly, can openers and
countertops must be cleaned thoroughly with specific
attention on their crevices so as to avoid harboring
bacteria.
·
Refrigerating leftovers immediately is a must, even if
they are hot. Always cut, slice the large stews into
smaller portions before putting them in the
refrigerator.
·
Always reheat home canned food properly else there are
chances of contamination as canning may and usually is
improper.
·
And, at last, never taste any food that smells or looks
bad. Dairy products and seafood announce their expiry
date explicitly but some others may not. Therefore
ruthlessly discard food products that have gone beyond
their expiry date or in case of fresh products, look
old. Don’t even allow your pets to come near them. This
holds true for foods and drinks that smell ‘off’ when
their cans or bottles are opened. Cracked jars and
dented/cracked cans allow dangerous bacteria to enter
and multiply on the food inside.
Some other precautionary measures:
·
Gastroenteritis, especially in the form of food
poisoning hits mainly pregnant women, kids, elderly and
those with weak immune system. So, these people should
take extra care while having and cooking food. Good
hygiene is of prime importance. Extra care is required
in summers as food related problems crop up drastically
in warm climate.
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·
Pregnant women should specifically avoid soft-rinded
cheese, unpasteurised milk and cream, salads, coleslaw
and inadequately cooked chilled foods as they all
contain Listeria monocytogenes, which causes listeriosis.
It may ultimately result in meningitis and even force a
miscarriage or serious damage to the unborn child.
·
It is sometimes said that if you feel you have had a
food poisoning attack, you should induce vomiting.
It is not true and you should let your digestive system
decide if it is necessary.
·
In case of vomiting, sip anything slowly so as to avoid
even more vomiting.
·
Don’t take cold drinks, instead go for drinks at room
temperatures. Drink plenty of fluids to the extent that
your urine is not too yellow.