Gastrointestinal Infections

Abstract

Gastrointestinal infections are second only to respiratory infectious diseases in frequency and morbidity. A conservative estimate places the annual worldwide mortality from gastroenteritis-related infections at six million children. Although stomatitis and esophagitis are occasionally seen as distinct entities, the vast majority of gastrointestinal infections manifest as vomiting and/or diarrhea syndromes, commonly referred to as gastroenteritis. In many cases the term "enterocolitis" describes the pathologic and clinical features more accurately. EpidemiologyDiarrhea is most pronounced in communities where undernutrition, poor hygiene, and poorly developed community facilities for sewage and drinking water exist. In such communities, as recently described for Bangladesh, the peak incidence of diarrhea syndromes occurs between 2 and 11 months of age, and most infants in their first year of life can be expected to have seven episodes of gastroenteritis. 38 Expression and frequency of infection are related to decreased host resistance secondary to nutritional deficiencies, and increased spread referable to crowded living quarters, contaminated water and food, inadequate washing and toilet facilities, abundant flies, and inadequate refrigeration and cooking technology.Young infants are most prone to the dehydrating and debilitating effects of acute gastroenteritis and have the highest attack rates. Some organisms, such as Shigella, predominate in the summer and fall months, whereas others, such as rotavirus, are frequent in the winter months in temperate climates 53 and year-round in the tropics. 38 Campylobacter and enterotoxigenic E. coli are also very prevalent in such areas. 94 M. I. Marks, Pediatric Infectious Diseases

Acute Gastroenteritis: Effect on Nutritional Status

“…The majority of episodes are mild, self‐limiting and managed at home. Patients with more severe or prolonged illness are often admitted to hospital, where management is usually supportive, with particular attention paid to rehydration 1 . Many hospitalised patients admit to significant weight loss during the illness and this is usually attributed to dehydration.…”