What are the Symptoms?

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Gastroenteritis commonly presents with diarrhoea, often with abdominal colic and nausea or vomiting.  A fever may also be present.  Stools may be watery or semi-solid, and passed with increased frequency.

Dehydration can sometimes develop if there is inability to retain fluids (due to nausea or vomiting), associated with persistent diarrhoea.  Dehydration can occur fairly quickly especially in very young, which is why young children who develop severe gastroenteritis, commonly require intravenous hydration therapy in a hospital setting.

Diagnosis and Tests

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Doctors generally make the diagnosis of gastroenteritis based on a careful review of symptoms and a thorough physical examination.  This is done with the objective of ruling out other causes of diarrhoea (such as lactose intolerance, side effect from medication etc), and to differentiate viral gastroenteritis from that caused by other pathogens (which may require treatment with antibiotics).

Conditions such as appendicitis, mesenteric adenitis, hepatitis, spurious diarrhoea from constipation, gallbladder inflammation and bowel obstruction will also need to be considered and ruled out.

Careful evaluation of hydration status is done to determine if there is a need for more aggressive forms of hydration therapy, such as intravenous fluid therapy.

Investigations are usually not required since the majority of cases of gastroenteritis is mild and self-limiting.  However, tests may need to be done under the following situations:

• Bloody diarrhoea with mucous discharge
• Diarrhoea lasting longer than 1 week
• Diarrhoea in an immunocompromised patient
• Diarrhoea in a very ill patient

Investigation that may be performed include:

• Examination of stools for microscopy and culture
• Sigmoidoscopic examination when a pathology in the lower colon is suspected