Stomach and intestines are the central digestive organs. Stomach juices soften food and break it down into essential nutrients – carbohydrates, minerals and vitamins – with the help of the body's own enzymes. They enter the bloodstream through the intestines. Water contained in food also enters the bloodstream in this way before the digestive remains are excreted. A gastrointestinal infection can significantly impair food. digestion considerably impaired. Due to diarrhea and vomiting, there is a great loss of water – sufferers are at risk of dehydration from within. Since infants and children have a lower resistance than adults, the disease occurs more often in them and can also be more severe or in rare cases even life-threatening.
Affected persons often suffer from loss of appetite, abdominal pain, nausea, vomiting and diarrhea. The diarrhea may be watery, bloody or mucous and accompanied by persistent flatulence. Fever can also occur. The younger a child is, the faster his or her body dries out due to water and electrolyte loss. Signs of this dehydration include scanty, dark-colored urine and dry mucous membranes, as well as fatigue, sluggishness and apathy. "The loss of fluid also causes the skin to lose tone, so that it "stops" in folds after a slight pinch, says Volker Stephan, chief physician at the Lindenhof Children's and Youth Clinic in Lichtenberg. "In this case at the latest, a doctor should be consulted immediately."
Gastrointestinal infections are usually caused by viruses such as rotavirus or notovirus, and less frequently by bacteria or parasites. In Europe, bacteria such as salmonella cause. Campylobacter particularly severe courses of the disease. In countries with lower hygiene standards, the spectrum of possible pathogens is far greater, and so is the number of severe gastrointestinal diseases such as cholera and typhoid fever. The germs that damage the gastrointestinal tract usually enter the body with contaminated food. Are normally killed in the stomach by the acidic gastric juice. With a very large number of germs, however, some survive and enter the intestine. There they colonize the intestinal mucosa and cause an increased release of water and mucus into the intestine. Since they also inhibit the absorption of water by the mucous membrane, diarrhea occurs. In addition, some pathogens attack and destroy the cells of the intestinal wall, which can lead to bleeding and ulcers.
In Germany, a total of around 430.000 rotavirus illnesses occur. In around 10 percent of children, the disease is so severe that they have to be treated in hospital. About 90 percent of all children in Germany suffer at least once from a rotavirus infection by the age of three. After two infections, the immune system is usually so trained that the virus no longer causes serious illnesses.
The loss of fluids through vomiting and diarrhea has a particularly negative effect on the body of infants and children. Therefore, if a gastrointestinal infection is suspected, they require early medical attention – especially if diarrhea, vomiting and fever occur together, you should see a doctor with them immediately. Diagnosis of gastrointestinal infections is mainly based on medical history and physical examination. Further examinations, such as those of the blood, stool or urine, are only necessary in severe cases, for example if the diarrhea lasts for a very long time or is accompanied by a high fever.
"During a gastrointestinal infection, it is particularly important, especially in infants and children, to compensate for the body's loss of water and electrolytes in order to counteract dehydration", says pediatrician Stephan. Bed rest is recommended, but drug therapy is usually not necessary. This often only alleviates the symptoms, but does not eliminate the cause of the disease, Stephan emphasizes. Therefore, if a child is vomiting only slightly or not at all, he or she should drink plenty of fluids. The World Health Organization (WHO) recommends the following formula for this purpose: four level teaspoons of sugar, three-quarters of a teaspoon of salt, one teaspoon of bicarbonate and one cup of orange juice to one liter of water. If the sick child is bottle-fed, he or she should be given undiluted infant milk; infants who are breastfed should continue to be breastfed during the gastrointestinal infection.
However, if the vomiting persists and the child is unable to absorb or retain fluids, "immediate medical attention is required." This may require a stay in a clinic. Medications should be given to the sick child only after consultation with a doctor, because in some cases they can have a negative effect on the course of the disease: Antibiotics, for example, not only kill the pathogens but also the protective intestinal flora, which can make the infection worse. Therefore, they are prescribed only in exceptional cases, such as for infants in the first three months or for premature babies. Diarrhea medications that solidify the stool also often prolong the illness because they delay the elimination of the pathogens from the body.
Important: To prevent infection, simple hygienic measures such as washing hands after going to the toilet and before every meal can help. In order to prevent a severe course of the disease, a vaccination against the rotavirus has been available since 2006. Depending on the vaccine, the oral vaccination includes two or three individual doses. It can be given from the completed sixth week of life, the last dose must be given to the child before the end of the 24.