Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- diarrhoea
- vomiting
- nausea
- abdominal pain
Other diagnostic factors
- malaise
- anorexia
- fever
- volume depletion
Risk factors
- exposure to contaminated food or water sources
- close contact with infected people
- poor hygiene
- extreme ages
- HIV infection
- organ transplantation
- chronic illness
Diagnostic investigations
1st investigations to order
- clinical diagnosis
- full blood count
- urea and electrolytes
- creatinine
Investigations to consider
- stool for culture, ova, and parasites
- stool viral culture
Treatment algorithm
mild to moderate dehydration
severe dehydration or unable to tolerate oral fluids
Contributors
Expert advisers
Alexander Alexiou, MB, BS, BSc, DCH, FRCEM, DipIMC RSEd
Consultant in Emergency Medicine
Royal London Hospital
Consultant in Physician Response Unit
Barts Health NHS Trust/London Air Ambulance
London
UK
Disclosures
AA declares that he has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:
Kyle E. Brown MD, FAASLD
Associate Professor of Internal Medicine
University of Iowa
Carver College of Medicine
Iowa City
IA
Jenny Currigan
ST6 Emergency Medicine Trainee
Royal London Hospital
Barts Health NHS Trust
London
UK
Johann Grundlingh MBChB, FCEM, FFICM, EDICM, DFMS, DipMedTox, MMedTox, MSB, ERT, MEWI, MBA
Emergency Medicine Consultant
Royal London Hospital
Barts Health NHS Trust
London
Honorary Senior Lecturer
Queen Mary University
London
UK
Disclosures
KEB, JC and JG declare that they have no competing interests.
Peer reviewers
Adam Evans
Consultant Physician
Acute Medicine and Infectious Diseases Physician
Royal Victoria Infirmary
Newcastle upon Tyne
UK
Disclosures
AE declares that he has no competing interests.
References
Key articles
Bányai K, Estes MK, Martella V, et al. Viral gastroenteritis. Lancet. 2018 Jul 14;392(10142):175-86. Abstract
Barr W, Smith A. Acute diarrhea. Am Fam Physician. 2014 Feb 1;89(3):180-9. Abstract
Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018 Mar 1;378(9):829-39.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Bacterial gastroenteritis
- Protozoal infections
- Helminthic infections
More DifferentialsGuidelines
- Intravenous fluid therapy in adults in hospital
- General information to prepare for and manage norovirus in care settings
More GuidelinesPatient information
Diarrhoea in adults
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer