Gastroenteritis Treatment
in Hyderabad, India
As the best hospital for gastroenteritis in Hyderabad, Telangana, India, PACE Hospitals delivers advanced, multidisciplinary care tailored to each patient. Our expert team of gastroenterologists, infectious disease specialists, and dietitians provides comprehensive care for the diagnosis and management of acute and chronic gastroenteritis caused by viral, bacterial, or parasitic infections.
We utilize advanced diagnostic tools such as stool analysis, blood tests, and imaging studies when needed to accurately identify the underlying cause of symptoms like diarrhea, abdominal cramps, vomiting, and dehydration.
Our multidisciplinary team develops personalized treatment plans that may include fluid and electrolyte replacement, medications (such as antibiotics or antivirals), probiotics, and dietary modifications. The focus is on rapid symptom relief, preventing complications like severe dehydration, and supporting full recovery with nutritional guidance and follow-up care.
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PACE Hospitals
HITEC City and Madeenaguda
Hyderabad, Telangana, India.
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Appointment Desk: 04048486868
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PACE Hospitals
HITEC City and Madeenaguda
Hyderabad, Telangana, India.
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Why Choose PACE Hospitals for Gastroenteritis Treatment?
State-of-the-art Endoscopy Suites and Laboratory Diagnostics
Top Gastroenterologists in Hyderabad for all forms of Gastroenteritis
Individualized Care with Probiotics, Electrolyte Correction & Hydration Therapy
24/7 Emergency & Inpatient Support for Acute or Severe Gastroenteritis
Gastroenteritis Diagnosis
Accurate diagnosis of gastroenteritis is crucial to identify the underlying cause and differentiate it from other gastrointestinal disorders. This involves a combination of clinical evaluation, selective laboratory investigations, and occasionally imaging or endoscopy for more complex cases. Here is an overview of the diagnostic tools commonly used:
Clinical Evaluation
- Presenting Symptoms
- Important History Clues
- Red Flags
- Physical examination
Laboratory Evaluation
- Stool Analysis
- Microscopic Examination
- Stool Culture
- Ova and Parasite Testing
- Faecal Lactoferrin Assay
- Viral Antigen Testing
Imaging Tests
- Upper GI Endoscopy (EGD – Esophagogastroduodenoscopy)
- Ultrasound (USG)
Endoscopic Evaluation
Clinical Evaluation
The clinical evaluation begins with a detailed history and physical examination to assess symptoms and possible risk factors.
Presenting Symptoms
Common signs include copious watery diarrhoea, nausea, vomiting, abdominal cramping, and fever. These symptoms help guide the suspected cause (viral, bacterial, or parasitic). The physician should elicit detailed information regarding the onset, duration, and progression of symptoms. In chronic or severe cases, patients may present with additional features such as hematochezia (bloody stools), purulent discharge in the stool (suggestive of invasive infections), and significant weight loss. A digital rectal examination may be performed to evaluate for occult or overt blood in the stool, which could indicate gastrointestinal bleeding or more serious underlying pathology.
Important History Clues
History of recent travel, consumption of potentially contaminated food or untreated water, exposure to infected individuals, recent antibiotic use and contact with individuals exhibiting similar symptoms can indicate the cause.
Red Flags
Presence of bloody diarrhoea, fever, or recent antibiotic use may suggest specific pathogens like E. coli O157:H7 or Clostridioides difficile infection.
Physical examination
The physical examination focuses on identifying signs consistent with gastroenteritis and assessing the severity of dehydration or systemic involvement. Common findings may include:
- Abdominal tenderness or distension
- Bowel sound abnormalities
- Signs of dehydration (e.g., dry mucous membranes, decreased skin turgor, hypotension, tachycardia)
- Fever, particularly in cases of bacterial gastroenteritis
- Generalised weakness or lethargy
Laboratory Evaluation
Laboratory investigations are primarily focused on stool analysis to detect the pathogen. Stool testing is guided by the type, duration, and severity of symptoms, as well as risk factors such as immunocompromised status.
Stool Analysis
Collection of a stool sample for microscopic examination, culture, and toxin testing helps identify specific pathogens. Tests include:
Microscopic Examination
This involves the identification of faecal leukocytes, red blood cells, and parasites. It is useful in detecting inflammatory changes and potential parasitic infestations. The Presence of faecal leukocytes or red blood cells suggests bacterial infection or intestinal inflammation.
Stool Culture
This test detects bacterial pathogens like Salmonella, Shigella, and E. coli, especially in patients with fever or bloody diarrhoea. While the overall diagnostic yield of routine stool cultures is low, the Infectious Diseases Society of America (IDSA) recommends their use in specific clinical settings. These include patients who are immunocompromised, those with bloody diarrhoea or fever, and individuals with underlying comorbidities that increase the risk of complications. When blood is detected in the stool, a Shiga toxin assay should also be performed to identify toxin-producing strains of E. coli.
Ova and Parasite Testing
O&P testing is indicated when the parasitic infection is suspected based on clinical presentation or epidemiological exposure. This is particularly relevant in cases of chronic diarrhoea, unexplained gastrointestinal symptoms in travellers, or suspected outbreaks linked to contaminated water sources.
Faecal Lactoferrin Assay
A sensitive marker for intestinal inflammation, especially useful for bacterial infections or inflammatory processes.
Viral Antigen Testing
This test is used to detect specific viral pathogens that can cause gastroenteritis, such as rotavirus and adenovirus. It is especially valuable in hospitalized patients or those with weakened immune systems, as they are at higher risk of severe or prolonged illness. The test involves identifying viral proteins (antigens) in stool samples, which provides a quicker and more accurate diagnosis compared to traditional viral culture. Rotavirus testing is particularly common in children, while adenovirus is more often tested in both children and adults. Rapid antigen tests can help guide appropriate treatment and infection control measures.
Imaging tests
Upper GI Endoscopy (EGD – Esophagogastroduodenoscopy)
This procedure is used to diagnose and treat issues in the upper gastrointestinal (GI) tract, which includes the oesophagus, stomach, and the first part of the small intestine (duodenum). It allows direct visualisation of the mucosal lining and can help identify conditions like ulcers, inflammation, or infections in these areas.
Ultrasound (USG)
Ultrasound is a non-invasive diagnostic test that provides detailed images of the abdomen, including the small bowel. It is particularly useful for identifying fluid-filled loops in the small intestine with slightly thickened walls and signs of hyperperistalsis, which may suggest an underlying gastrointestinal infection or inflammation.
Endoscopic Evaluation
Endoscopy is not routinely required, but is essential when the diagnosis is unclear or there are complications.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that allows direct visualisation of the lower part of the colon (sigmoid colon) and rectum. It is typically used in cases of gastroenteritis when there is grossly bloody diarrhoea or when symptoms are severe and unresponsive to initial treatment. The procedure helps identify mucosal abnormalities such as ulcerations, erosions, or inflammation, which may suggest an underlying infectious or inflammatory cause, like inflammatory bowel disease (IBD) or severe infectious colitis.
Colonoscopy
Colonoscopy involves a more extensive examination of the entire colon and rectum, offering a comprehensive view of the gastrointestinal tract. It is particularly useful in diagnosing conditions like infectious colitis, Clostridioides difficile infection, or IBD when initial stool testing is inconclusive. Colonoscopy can reveal deeper mucosal changes, such as pseudomembranes or chronic inflammation, and biopsy samples can be taken for further histopathological analysis, aiding in the differentiation of infectious vs. non-infectious causes of gastroenteritis.
Stool Testing Based on Diarrhoea Type
Stool testing is tailored to the type and duration of diarrhoea, as different pathogens cause distinct patterns of illness.
- Acute Watery Diarrhoea: Typically, viral (e.g., norovirus, rotavirus). Stool testing may include rapid antigen assays for rotavirus and adenovirus if symptoms are prolonged.
- Chronic or Subacute Watery Diarrhoea: Suggests parasitic infections. Ova and parasite (O&P) testing and antigen tests for Giardia, Cryptosporidium, or Entamoeba histolytica are recommended.
- Acute Inflammatory Diarrhoea (without gross blood): Likely caused by bacteria (e.g., Salmonella, Shigella). Stool culture and faecal leukocyte or lactoferrin assays are performed.
- Acute Inflammatory Diarrhoea (with gross blood): Indicates Enterohemorrhagic E. coli (e.g., O157:H7). Specialised stool culture and Shiga toxin assays are performed.
| Type of Diarrhoea | Likely Cause | Recommended Tests |
|---|---|---|
| Acute Watery Diarrhoea | Viral (e.g., Norovirus, Rotavirus) | Usually self-limiting. Rapid antigen assays for Rotavirus and Adenovirus may be considered if prolonged or severe |
| Subacute or Chronic Watery Diarrhoea | Parasitic infections | - O&P testing with stained stool examination - Antigen tests for Giardia, Cryptosporidium, Entamoeba histolytica |
| Acute Inflammatory Diarrhoea (without gross blood) | Bacterial (e.g., Salmonella, Shigella) | - Stool culture - Faecal leukocyte/lactoferrin testing |
| Acute Inflammatory Diarrhoea (with gross blood) | Enterohemorrhagic E. coli (e.g., O157:H7) | - Specific stool culture on special media - Shiga toxin assay (EIA or PCR) |
Staging of the Disease
Gastroenteritis is classified into different stages, with the first two stages being asymptomatic, and the latter stages reflecting the severity of symptoms.
- Incubation Period: This is the time interval between the initial infection and the onset of symptoms. The duration of the incubation period can vary depending on the causative organism, ranging from a few hours to several days.
- Prodromal Phase: This is the early stage of the infection, where the patient may experience mild to moderate symptoms such as stomach discomfort, nausea, and vomiting. It marks the onset of infection, but with relatively less severe symptoms.
- Acute Phase: During this phase, patients typically experience the most severe symptoms, including vomiting and diarrhoea. This stage often represents the height of the infection, with significant discomfort and risk of dehydration.
- Recovery Phase: This phase begins when the patient starts to recover from the infection. Symptoms like vomiting and diarrhoea subside, and the patient may regain their appetite and energy, signalling the resolution of the infection.
Gastroenteritis Differential Diagnosis
Differential diagnosis is the list of possible medical conditions or diseases that can share the same symptoms in a person. Below are some of the conditions that are included in the differential diagnosis of gastroenteritis:
Appendicitis
Nausea, vomiting, loss of appetite, fever, abdominal pain.
Volvulus
Vomiting bile, abdominal pain, diarrhoea or constipation, bloody stools.
Inflammatory Bowel Disease (IBD)
Diarrhoea, abdominal pain, cramping, bloating, weight loss.
Urinary Tract Infection (UTI)
Changes in urination, frequency, pain or burning during urination.
Diabetes Mellitus
Increased urination, fatigue, unintended weight loss, blurred vision.
Short Bowel Syndrome
Weight loss, dehydration, digestive issues, malnutrition.
Whipple’s Disease
Abdominal pain, diarrhoea, weight loss, low-grade fever.
Considerations of Gastroenteritis Before Treatment
Before planning the treatment for gastroenteritis, healthcare professionals consider several key factors that may influence the course of management, including:
- Patient Age: Age plays a crucial role in treatment decisions. Young children and the elderly are at higher risk for dehydration and complications and may require more immediate or intensive care. It is important to assess whether the patient’s age affects their ability to tolerate fluids, medications, or any interventions.
- Persistence of Diarrhoea: If diarrhoea persists despite medication, this may suggest a more severe or complicated infection. It could be an indication of bacterial, parasitic, or viral causes, requiring a reassessment of the diagnosis and possibly a change in treatment plan.
- Pain Associated with Passing Stool: If the abdominal pain is linked to passing stool, this may suggest an underlying condition such as inflammatory bowel disease or an infection that affects the large intestine. This requires careful evaluation to ensure the correct diagnosis and avoid unnecessary treatments.
- Presence of Blood or Pus in Stool: The presence of blood or pus in the stool indicates a potentially serious infection or an inflammatory condition. This could suggest bacterial gastroenteritis (e.g., from Salmonella or Shigella), and antibiotic treatment or further investigations may be necessary.
- Pregnancy Status: In pregnant patients, the safety of treatments must be carefully considered. Some medications, particularly certain antibiotics or anti-diarrhoeal drugs, may not be safe for the foetus. Alternative treatment strategies should be considered to minimize risks to both the mother and the baby.
- Previous Treatments: It is important to know whether the patient has tried any treatments for gastroenteritis before. Previous ineffective treatments may indicate the need for a different approach, such as a change in medication, or a deeper investigation into the cause of symptoms.
- History of Recurrence: A history of recurrent gastroenteritis can point to chronic conditions, such as irritable bowel syndrome (IBS) or chronic infections. Recurring episodes may require more comprehensive treatment, including long-term dietary adjustments, probiotic use, or further diagnostic testing to identify the root cause.
- Severity of Symptoms and Need for Surgery: If the infection is severe, characterised by high fever, dehydration, and significant pain, surgical intervention may be required, especially in cases like appendicitis or volvulus. Treatment plans should consider whether the infection is self-limiting or if it demands more aggressive interventions.
By carefully evaluating these factors, healthcare professionals can tailor treatment to ensure the best outcomes for patients with gastroenteritis.
The treatment of gastroenteritis depends on the patient's age, severity of symptoms, and their response to the medication. The treatment plan generally includes both non-pharmacological and pharmacological approaches. Below are the steps involved in managing gastroenteritis:
- Non-Pharmacological Treatment of Gastroenteritis
- Hydration
- Pharmacological Treatment of Gastroenteritis
- Supportive Management
- Antibiotic Therapy
- Symptomatic Therapy
- Surgical Management of Gastroenteritis
Non-Pharmacological Treatment of Gastroenteritis
Although medication therapy plays a major role in treating gastroenteritis, several non-pharmacological methods are also recommended to support recovery. These include:
- Hydration: Oral rehydration solutions (ORS) or natural alternatives are essential, particularly for children and individuals with severe diarrhoea. These solutions help to replace lost fluids and electrolytes, preventing dehydration, especially crucial in viral gastroenteritis.
Pharmacological Treatment of Gastroenteritis
Gastroenteritis, which involves inflammation of the gastrointestinal tract due to infections from viruses, bacteria, or parasites, requires symptom management and prevention of dehydration. Pharmacological treatment options are as follows:
- Supportive Management: If oral rehydration is insufficient, intravenous rehydration may be necessary. Intravenous fluids help manage dehydration when oral intake is not adequate or feasible.
- Antibiotic Therapy: Antibiotics are used in certain bacterial infections. However, antibiotics should not be used for E. coli strains that produce Shiga toxin. In severe cases, particularly in individuals over 70, immunocompromised patients, or those with invasive infections, certain antibiotics can be helpful. Antibiotic therapy should be discontinued if EHEC (enterohemorrhagic E. coli) is isolated.
- Symptomatic Therapy: In patients who are afebrile and have non-bloody diarrhoea, antidiarrheal agents can be used to manage symptoms, however, they should be used cautiously.
Surgical Management of Gastroenteritis
In most cases, gastroenteritis is treated with medications and home-based treatments, and surgery is not required. However, in specific circumstances, surgical interventions may be necessary, particularly in cases of severe infections or complications. Gastrointestinal surgery can be either open surgery or minimally invasive, depending on the condition.
Treatment of Gastroenteritis during Pregnancy
Treatment of gastroenteritis during pregnancy focuses on hydration, symptom relief, and ensuring the safety of both the mother and baby. Oral rehydration solutions (ORS) are commonly recommended to prevent dehydration. If vomiting is severe, antiemetic medications like ondansetron may be used under medical supervision. Antibiotics are generally avoided unless a bacterial infection is confirmed. A bland diet, like the BRAT diet (bananas, rice, applesauce, and toast), can help ease digestion. It's crucial to monitor for signs of dehydration or complications and seek medical attention if symptoms persist or worsen
Gastroenteritis Prognosis
If left untreated, acute gastroenteritis can turn into chronic gastroenteritis and stomach ulcers, leading to dehydration, metabolic acidosis, electrolyte imbalances, carbohydrate intolerance, increased susceptibility to reinfection, and the development of food intolerances and haemolytic uremic syndrome.
Frequently Asked Questions (FAQs) on Gastroenteritis
Can acute gastroenteritis be prevented?
Acute gastroenteritis can be prevented through proper handwashing and regular cleaning of surfaces to reduce exposure to harmful germs. Safe food handling and preparation are also important measures to prevent infections that cause gastroenteritis. Additionally, vaccines are available for infants to protect against rotavirus infection, which is a common cause of gastroenteritis.
What are the typical symptoms of gastroenteritis?
The symptoms of gastroenteritis commonly include diarrhoea, vomiting, stomach cramps, and fever. Some individuals may also experience headaches, muscle aches, and fatigue. The severity of symptoms can vary depending on the cause of the infection, but they usually last for a few days.
What are the risk factors for gastroenteritis?
Risk factors for gastroenteritis include consuming contaminated food or water, close contact with infected individuals, and poor hygiene practices. Children, older adults, and individuals with weakened immune systems are at higher risk. Additionally, travelling to areas with poor sanitation and handling food improperly can increase the likelihood of contracting gastroenteritis.
What should I eat or drink if I have gastroenteritis?
In cases of gastroenteritis, staying hydrated is crucial, with recommended fluids including water, ice chips, and diluted fruit juice. Sugary sports drinks should be avoided, and mild, easy-to-digest foods are advised. For children, oral rehydration solutions are helpful for replenishing lost fluids. Resting at home is important, and caution should be taken with antidiarrheal medications, especially if a fever, bloody stool, or a young child or older adult is involved. In rare cases, severe dehydration may necessitate intravenous (IV) fluids.
Is gastroenteritis an infection?
Gastroenteritis is an infection caused by inflammation of the stomach and intestines. It can be triggered by viruses, bacteria, or parasites, which are often transmitted through contaminated food or direct contact with an infected individual. Essentially, gastroenteritis is a type of bowel infection.
Can acute gastroenteritis cause fever?
Acute gastroenteritis can cause a fever, along with symptoms like diarrhoea, vomiting, and stomach cramps. The fever typically occurs as part of the body's immune response to the infection. In some cases, the fever may be mild, while in others, it can be more pronounced, especially with bacterial or viral infections.
When does dehydration occur in acute gastroenteritis?
Dehydration occurs in acute gastroenteritis when excessive fluid is lost through vomiting and diarrhoea, leading to an imbalance of electrolytes and water in the body. It is more likely to happen in severe cases, especially if fluids are not adequately replaced. Young children, older adults, and those with weakened immune systems are at a higher risk of dehydration.
What are the common bacteria that can cause gastroenteritis?
Several bacteria can cause gastroenteritis, including Salmonella, Escherichia coli (E. coli), Campylobacter, and Shigella. These bacteria are typically spread through contaminated food or water and can lead to symptoms such as diarrhoea, vomiting, and abdominal cramps. In some cases, they can cause severe illness, especially in vulnerable populations.
Is rotavirus a common cause of gastroenteritis in children?
Yes, rotavirus is one of the most common causes of gastroenteritis in young children. It is highly contagious and can lead to severe diarrhoea, vomiting, and dehydration. Vaccines are available to protect against rotavirus, significantly reducing the incidence of severe cases.
What are the different types of gastroenteritis?
Gastroenteritis occurs when individuals are exposed to unfamiliar pathogens while traveling. Foodborne gastroenteritis can be further divided into three categories: one caused by pathogens that produce toxins in food before consumption (performed toxins), another by pathogens that produce toxins in the gastrointestinal tract after ingestion, and a third by pathogens that invade the bowel wall, leading to inflammation and diarrhea. Antibiotic-associated gastroenteritis occurs as a side effect of antibiotic use, which disrupts the normal balance of gut bacteria.
