Talk:Gastroenteritis

From Wikipedia, the free encyclopedia

WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B This page has been rated as B-Class on the quality assessment scale
Top This article has been rated as Top-importance on the importance assessment scale

Contents

[edit] If

IIRC:

  • the present gastroenteritis article describes infectious gastroenteritis, which is a class of diseases, but
  • gastroenteritis is a symptom (it is sa disease ) whose causes can include ingestion of irritants like ethyl alcohol, aspirin, and cooking spices (and perhaps also overeating?).

IMO someone willing to do more research than i am at the moment should confirm this, rename, and convert the redir to a Dab between infectious gastroenteritis and something else ( non-infectious gastroenteritis is probably not what we need).
--Jerzy(t) 06:33, 2005 Feb 24 (UTC)

[edit] Accuracy

24.196.90.128 (talk · contribs) posted a self-referential complaint on the page that the page is incomplete, and posted the accuracy tag above. Without any further details, I'm inclined to ignore this. JFW | T@lk 12:36, 26 July 2005 (UTC)


Going by http://www.emedicine.com/EMERG/topic213.htm I see no problem with the article as it stands. GraemeLeggett 16:27, 28 July 2005 (UTC)

And I've edited the page suitably

The J series is far out when it comes to ICD 10 coding for gastroenteritis

[edit] News update

In November 2005, Singapore licensed a new vaccine, called Rotarix, developed by drug manufacturer GlaxoSmithKline (GSK) to protect infants against rotavirus gastroenteritis. [1] --Vsion 10:24, 8 November 2005 (UTC)

So? It was licensed in Mexico in 2004. GraemeLeggett 12:30, 8 November 2005 (UTC)

[edit] Children?

All of the information on this page seems to relate to children, not to adults. I know that gastroenteritis can be contracted by adults, so why is all the info on kids?

I suspect it is because it is a much more serious problem in children. Adults find gastroenteritis to be annoying. Children can find it to be deadly. --Mdwyer 18:10, 21 April 2006 (UTC)
Then that ought to be stated. --121.73.22.138 02:50, 14 November 2006 (UTC)
Still needs to be fixed. Gastroenteritis isn't a child-specific disease. If there are specifics that need to be stated for the treatment of children, they should be covered in their own section, perhaps. AllGloryToTheHypnotoad (talk) 17:57, 7 April 2008 (UTC)

[edit] Loperamide

Suggesting loperamide for gastroenteritis seems like a bad idea to me. I hope JFW will step in here. Loperamide is for treatment of diarrhoea -- which is usually a symptom of gastroenteritis. Diarrhoea is the body's way to flushing out toxins, so loperamide might actually cause the toxins to be retained in the body. This would seem to be a Bad Thing. It would be indicated in some cases, but certainly not in the case of gastroenteritis caused by poisoning or infection. --Mdwyer 18:10, 21 April 2006 (UTC)

Thank you, JFW and Nescio! --Mdwyer 17:33, 24 April 2006 (UTC)

I am a little confused, these conditions are apparently not forms of enteritis. What exactly is "erroneous" about it?

Holland Nomen Nescio 19:53, 24 April 2006 (UTC)

Crohns does not cause gastroenteritis sensu strictu, and ulcerative colitis does not cause gastritis at all (it is by definition limited to the colon or maximumally some backwash iliitis). Gastroenteritis is almost automatically infective. I would not support the forking of infective gastroenteritis. Lactose intolerance causes diarrhoea, but not vomiting, and certainly not gastroenteritis. Longstanding enteritis (especially giardiasis) can cause lactose intolerance.
As for loperamide, this is good for symptom control and is regarded as safe in uncomplicated diarrhoea (i.e. not associated with bleeding and fever). There is no evidence for the suggestion that toxins need to be flushed out. In gastroenteritis the causative agent is microbial or viral, and resolution depends on an immune response more than actual physical clearance of the agent. JFW | T@lk 20:58, 24 April 2006 (UTC)
I am no gastroenterologist, but I spent some time at oncology and my supervisor said people suffered from chemotherapy as result of mucositis, causing oesophagitis, gastritis or enteritis. Second, although mostly infection related, does not "inflammation" of the digestive tract (for whatever reason) also constitute gastroenteritis? That is, through infection, poisoning, inflammatory disease, drugs, et cetera? As to lactose intolerance, it works both ways. It can be the result, or the cause of gastroenteritis. At least that's what the textbooks say.Holland Nomen Nescio 21:30, 24 April 2006 (UTC)
Statistically gastroenteritis is infective, but I agree that severe mucositis can be listed as a cause for gastroenteritis. Which textbook lists gastritis as a consequence of lactose intolerance? I really would like to see that confirmed. JFW | T@lk 21:42, 24 April 2006 (UTC)

[edit] Treatment

The paragraph beginning: "The treatment for the stomach flu is simple" contradicts medical recommendations, specifically regarding the consumption of water to comabat diarrhea. For childen in particular, water is insufficient to replenish the electrolytes that they will lose from the diarrhea; if too many electrolytes are lost, severe illness or death can result (see Water Intoxication) See [2], [3], and [4]. Besides, the tone is wrong--more like a book of folk medicine than Wikipedia. Making recommendations for treatments rather than restating the typical treatments endorsed by the medical community seems pretty questionable, too.--H-ko 23:58, 27 January 2007 (UTC)

I agree this paragraph has a wrong tone: it is written as a personal story ("I remember, when I got stomach flu, I started craving tatinos pizza and greasy food") and recommendations that seem wrong ("your urine should not have any yellow in it. If it does, just drink water."). I would rework/remove that paragraph but I do not know enough about wikipedia to do it (this is my first ever "edit"). It would be great if someone of experience could take a look and improve the article. Thanks. 216.239.85.91 02:30, 31 January 2007 (UTC)

Where did that "pint of flat Diet Coke" line come from? 69.70.158.197 15:21, 26 February 2007 (UTC)

Honestly, everyone in our (pretty big) family was suffering from stomach flu at least once in his lifetime. And we found that drinking too much just makes everything worse. What really helped everyone so far (in our family at least) was severely cutting down on food for a day (i.e. nothing, or a slice of toast at max.), little to drink and paracetamol. Because then the stomach finally gets some rest and it is much better next day already. What you should not do then though is consuming milk products. Instead, work on the electrolytes then :) pooch 82.12.249.229

This morning, my doctor just gave me Motilium (domperidone) for the bloatedness, Carbellon for the diarrhea, and something for the pain.. =.= and advised me not to take any dairy, spicy, or oily foods. dunno if it helps.. Lowch1 (talk) 10:07, 7 January 2008 (UTC)

I'm concerned about the treatment advice. I really think wikipedia should refrain from giving such advice unless they are 100% certain it is correct. It currently says "he person's usual foods and drinks should not be withheld", which is strange given my doctor just placed me on a 36 hour fast. 84.201.158.100 (talk) 09:51, 2 April 2008 (UTC)

The World Health Organization recommends not withholding food and drink. However, as 84.201.158.100 says, it is very common for MDs to recommend fasting. If the person with gastroenteritis is otherwise healthy and well fed, fasting does little harm and lessens some unpleasantness. But if the person is already malnourished or ill, fasting can cause greater harm than good. The article could do a better job of explaining this. --Una Smith (talk) 14:03, 2 April 2008 (UTC)

[edit] How it is spread

I think it would be great if someone could add to this article about how various viruses/bacteria that cause gastroenteritis are spread and how to prevent them? Flyerhell 06:06, 9 March 2007 (UTC)

Fecal - oral seems to make sense. Fecal - hands - oral. WASH YOUR HANDS. Tkjazzer 02:48, 14 May 2007 (UTC)

[edit] Types of viruses that cause

please list the type of viruses that cause. Tkjazzer 02:49, 14 May 2007 (UTC)

[edit] Proposal to merge other articles into Gastroenteritis

I agree with the proposed merger with Bacterial gastroenteritis because the articles overlap. Viral gastroenteritis is covered by three articles: Rotavirus, Norovirus and Astrovirus although the last two (imo) require some work. GrahamColmTalk 18:32, 1 December 2007 (UTC)

I propose also to merge Gastritis and Enteritis into this article. Both are stubs and the natural overlap with gastroenteritis is very large. I would like to move some content from Rotavirus to this article, primarily the information about diagnosis and treatment. I think those two subjects would be better addressed in the broader context of identifying the causal agent of gastroenteritis. --Una Smith 19:33, 1 December 2007 (UTC)

Rotavirus is getting large, a link to a good article on gastroenteritis would benefit it. GrahamColmTalk 19:45, 1 December 2007 (UTC)

Gastritis is a completely separate condition to gastroenteritis, despite the similar sounding names. Both conditions have different causes, clinical symptoms and treatments. Please leave as individual articles.

I came here looking for information on Gastritis, which I have. Merging the Gastritis info with something that I do NOT have would have been confusing & harder to get the info I wanted. Why would you want to merge 2 completely different conditions? My symptoms & treatments are completely different. I strongly suggest, as a sufferer of Gastritis that you do NOT merge these completely different conditions! —Preceding unsigned comment added by 67.168.197.164 (talk) 18:58, 2 December 2007 (UTC)

The "merge" templates are there to indicate the page is being examined as part of a project to edit several pages. I agree that gastritis should not be merged with gastroenteritis, and I have made edits to both pages accordingly. --Una Smith 19:33, 2 December 2007 (UTC)

Current plan:

  • Norovirus: improve linkage to related pages

--Una Smith 21:26, 2 December 2007 (UTC)

[edit] Update

Still needing work: Bacterial gastroenteritis, Infectious diarrhea, Enteritis. --Una Smith (talk) 16:31, 3 January 2008 (UTC)

Bacterial gastroenteritis has been merged into Gastroenteritis. --Una Smith (talk) 16:03, 8 January 2008 (UTC)

[edit] Death rate

A table showing the estimated death rate per year would be very interesting. Help gathering data (and references) would be appreciated! --Una Smith 19:32, 1 December 2007 (UTC)

Una, I can do this, or at least make a good start, can you give me a week? And what do you think about a pie-chart of the causative agents? Graham. --GrahamColmTalk 19:53, 1 December 2007 (UTC)

[edit] Images

I liked the previous, "close up" image of rotavirus in stool: it clearly showed the characteristic shape; I have in mind to gather comparable images here for norovirus, coronavirus, etc, to assist differential diagnosis by a non-specialist. Mention of the magnification of images would help too, else showing all images at approximately the same magnification for direct visual comparison. --Una Smith 19:31, 2 December 2007 (UTC)

The images are misleading because they do not show the relative sizes of the viruses. This one does:

Image:Gastroenteritis viruses.jpg--GrahamColmTalk 19:01, 9 December 2007 (UTC)

Good composite figure. Thanks! The individual images are from Commons? Sources should be indicated on the Commons page for this image. Why is label D a different color from the others? --Una Smith (talk) 19:22, 9 December 2007 (UTC)
The rotavirus, astrovirus and adenovirus are mine. The norovirus is from Commons. The D label is blue because when I used black or white it was very hard too see. I can change it if you want.--GrahamColmTalk 19:28, 9 December 2007 (UTC)

[edit] Inappropriate treatments

draft, collected here pro tem. --Una Smith (talk) 16:02, 8 January 2008 (UTC)

  • Withholding food/drink until diarrhea stops.
  • Drinking cola, carbonated or flat.
I was actually told (at a hospital, yes, by a doctor, yes) to stay away from food and take Imodium and Gatorade til the diarrhoea & vomiting was halted, after which to eat burned toast exclusively until I could tolerate white rice, applesauce and bananas; then to stay with just that until I could start digesting something else. And slowly add foods back into my diet one at a time. Definitely I'd think you'd have to avoid coffee, alcohol and milk until the gastroenteritis is well passed. Dairy products in particular, since gastroenteritis may cause secondary lactose intolerance! So the idea of "just keep eating normally" seems kinda nuts. I'd like to see proper references. AllGloryToTheHypnotoad (talk) 18:03, 7 April 2008 (UTC)
See Managing Acute Gastroenteritis Among Children: Oral Rehydration, Maintenance, and Nutritional Therapy, MMWR Recommendations and Reports, November 21, 2003 / 52(RR16);1-16 here. --Una Smith (talk) 20:30, 7 April 2008 (UTC)
Well, that write-up is for infants and toddlers, mainly in the third world. Anything for people who aren't infants and toddlers? I think a problem here is that while gastroenteritis might be a major problem in the third world, the average person looking up this article would be an English-speaking first-world adult who'll experience projectile diarrhea like I did when I tried to add solid food back into my diet within a week of getting gastroenteritis. AllGloryToTheHypnotoad (talk) 20:52, 9 April 2008 (UTC)
As the article says, prevention of dehydration is the first priority, followed by preservation of nutritional status. Comfort and convenience come a distant third. Here is an NIH page about treatment of viral gastroenteritis in both adults and children. It recommends withholding food for a few hours. PMID 8945701 has the title The management of infective gastroenteritis in adults. A consensus statement by an expert panel convened by the British Society for the Study of Infection. --Una Smith (talk) 23:39, 9 April 2008 (UTC)