Gastrointestinal Influenza - Symptoms and Complications

Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.

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Gastrointestinal flu symptoms usually only last a few days. Symptoms such as nausea, vomiting and severe diarrhea make the disease extremely uncomfortable during this period. But gastrointestinal flu (medical gastroenteritis) usually heals without any consequences. Complications rarely arise that can even be fatal without the right medical treatment. You can find out everything you need to know about gastroenteritis symptoms here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. A09K52A08J11

Typical gastrointestinal symptoms

In gastroenteritis, pathogens colonize and damage the digestive tract. The symptoms of gastrointestinal flu are therefore focused on this area:

• Nausea and vomiting
• diarrhea
• Abdominal cramps and pain

The symptoms typically develop very quickly, often within a few hours. How severe the symptoms are depends on the type of pathogen and on individual factors such as the patient's physical condition.

Nausea and vomiting

Nausea and vomiting can be massive in the acute phase of gastrointestinal flu. Some people vomit several times an hour. The mucous membrane of the stomach and intestines is so irritated in gastroenteritis that the body cannot hold anything to itself. This is sometimes very exhausting, especially because enormous amounts of fluids and salts (electrolytes) are lost with vomiting (and also with diarrhea).

Frequent vomiting can also roughen the teeth because the stomach acid in the vomit attacks the tooth enamel.

In addition, some people throw up not only through their mouths, but also through the nose, which is why the nasal mucous membranes swell. In the worst case, the vomit can get into the airways, which can lead to pneumonia, which is difficult to treat.

diarrhea

With diarrhea, the liquid stool consistency and frequent wiping irritate the skin on the anus. In unfavorable cases, the region can even catch fire.

How suddenly and vehemently the diarrhea sets in, the consistency of the stool and whether blood may have been mixed in with it also depends on the pathogen:

Most of the time, diarrhea and other gastrointestinal flu symptoms set in very suddenly, and with certain pathogens, such as bacteria of the Campylobacter genus, even explosively. The stool is often watery, but can be mushy, especially at the beginning.

Blood can be admixed with the stool, especially in the case of bacterial and amoebic dysentery, as well as infections with Campylobacter. Also certain E.coli strains such as EHEC can cause bloody diarrhea, mostly affecting the elderly. On the other hand, gastrointestinal flu caused by viruses is rarely accompanied by bloody diarrhea.

Sometimes the stool also appears slimy due to the many destroyed mucous membrane cells of the gastrointestinal tract. In amoebic dysentery, blood and mucus additions make the stool look like "raspberry jelly". Severe forms of cholera cause such watery diarrhea that they are also called "rice water stools".

Abdominal cramps and abdominal pain

The diarrhea is usually accompanied by abdominal cramps and abdominal pain, which occur at intervals. After using the toilet, these cramps often subside for a while.

General gastrointestinal flu symptoms

In addition to the typical gastrointestinal symptoms described above, there are usually general signs of illness - i.e. complaints that are not characteristic of a specific illness. A fever can also occur with gastrointestinal flu - a symptom that is more common from colds and flu-like infections.

Other examples of common gastrointestinal flu symptoms that may, but do not have to, occur include:

• headache
• Body aches
• fatigue

Sometimes such unspecific symptoms precede the vomiting diarrhea, in other cases they occur at the same time.

Gastrointestinal flu with no symptoms

In some cases, infections with pathogens that usually cause gastrointestinal flu are completely asymptomatic. For example, many adults do not develop any gastrointestinal symptoms with an EHEC infection. Infection with rotaviruses in this age group is also often subclinical, i.e. without noticeable symptoms.

This phenomenon is particularly pronounced in amoebic dysentery and cholera. Both illnesses are typical travel illnesses that occur in many countries with a low standard of hygiene. Many people are symptomless carriers of the amoeba or cholera bacteria without becoming ill themselves. In the case of cholera, only 15 percent of those infected show gastrointestinal symptoms or other symptoms.

Even if such infected people have no symptoms of the disease, they are contagious to other people!

Gastrointestinal flu: complications

The typical gastrointestinal infection symptoms are very unpleasant, but usually not seriously hazardous to health. Under certain circumstances, however, the course of the disease can be particularly severe. This can happen with a weakened immune system, for example. Sufferers need urgent medical treatment because otherwise there is a risk of serious complications:

Dehydration

If the classic gastrointestinal infection symptoms, vomiting and diarrhea, are very severe, a serious lack of fluids (dehydration) and electrolytes - especially sodium and potassium - can develop. In extreme cases this can be fatal without treatment!

Doctors refer to a lack of fluid in the body as dehydration. Massive dehydration is also called desiccosis.

In principle, however, this risk can be averted if the patient absorbs fluids and electrolytes in good time. This is particularly important for babies and toddlers: a lack of fluids can be dangerous for them much more quickly than for adults. Because the small patients have fewer reserves in relation to their body volume.

Elderly people can also develop a serious lack of fluids and salt particularly quickly if they have severe diarrhea and vomiting.

If babies, toddlers or old people develop gastrointestinal flu symptoms, a visit to a doctor is always advisable!

Signs of dehydration

Depending on the extent of the lack of fluids, different warning signals appear:

• dry skin and especially dry mucous membranes
• sunken eyes
• decreased blood flow and cold extremities
• standing folds of skin (e.g. folds of skin drawn with the fingers on the back of the hand remain for some time after letting go)
• Severe and sudden weight loss: In babies, weight loss of ten percent or more is very worrying.
• increasingly deteriorating general condition
• Drowsiness and unusual sleepiness (somnolence). Sometimes, however, those affected initially show strong restlessness (agitation) as long as the lack of water persists.
• feeling very thirsty, at some point where people stop drinking as they become more drowsy.
• Dizziness when standing up with risk of falling (orthostatic hypotension)
• increased heart rate with reduced blood pressure at the same time

In severe cases, there are other signs: gastrointestinal flu patients who have lost massive amounts of fluid (desiccosis) also develop

• Seizures
• Kidney pain
• Decrease in the amount of urine (oliguria / anuria)

Signs of electrolyte deficiency

In the case of gastrointestinal flu, salts, bases and acids, the so-called electrolytes, are lost along with the liquid. If it is more pronounced, this can lead to changes in the pH value in the blood and subsequently cause cardiac arrhythmias and nerve damage.

Other complications

Complications of the following types can also develop with gastrointestinal flu:

• Enlargement and occlusion of the intestine: In the case of gastrointestinal flu, the intestine may, in unfavorable cases, be invaginated (intestinal invagination). As a result, an intestinal obstruction can occur with severe pain, which often requires an operation. If left untreated, those affected can die!
• Intestinal breakthrough: In extreme cases, certain pathogens (such as Shigella and Entamoeba histolytica) not only cause the classic gastrointestinal flu symptoms, but also lead to an intestinal breakthrough (intestinal perforation). Food residues and pathogens get from the intestine into the abdominal cavity and can cause peritonitis there. Then there is often mortal danger!
• Toxic megacolon: In connection with some gastroenteritis pathogens, a toxic megacolon can also be observed in rare cases. Here the large intestine becomes inflamed and expanded very much. There is danger to life!
• Kidney failure: Some toxins that gastroenteritis pathogens (especially EHEC and Shigella) produce can attack the kidneys and cause hemolytic uremic syndrome (HUS). It is characterized by damage to the blood vessel walls and acute kidney failure. As in the other cases, those affected need medical help quickly!

Risk group: patients with immunodeficiency

Gastrointestinal flu can become problematic in patients with immunodeficiency (for example due to certain diseases such as AIDS or as a result of chemotherapy): The gastrointestinal symptoms can last longer than normal. In addition, those affected are more prone to certain complications that otherwise occur very rarely.

For example, gastrointestinal flu caused by noroviruses can cause symptoms even weeks after the onset of the disease (prolonged form). In addition, there is a risk of systemic infection (sepsis) in these high-risk patients - the pathogens originally confined to the digestive tract also spread to the rest of the body. An example of this is salmonella sepsis, in which salmonella can settle on the pericardium, in the meninges and bones, among other things.

Discomfort after the gastrointestinal flu

Doctors speak of post-infectious symptoms when certain symptoms occur as a result of an infection, although the respective pathogen can usually no longer be detected. The actual trigger for these symptoms is the immune system, which attacks and damages the body's own structures in connection with the previous infection.

A prime example of this is reactive arthritis. Days, sometimes even weeks after the typical gastrointestinal flu symptoms (or those of another infection) have subsided, then suddenly inflammations occur in various joints, in the eye and in the urethra (formerly known as Reiter's triad). Overall, however, this phenomenon is very rare. The causative agents of reactive arthritis include, for example, Shigella and Campylobacter.

In rare cases, the latter also cause Guillain-Barré syndrome. This is an inflammatory disease of the nerves that can lead to severe symptoms of paralysis and often requires intensive medical treatment.

Complications are rare

So there are some complications that are far more dangerous than the classic gastroenteritis symptoms. However, gastrointestinal flu patients do not have to worry unnecessarily because such complications are very rare. In the vast majority of cases - especially in otherwise healthy patients - the typical gastrointestinal flu symptoms are overcome after a few days without any complications.

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