Patients might visit you for acute gastroenteritis, though they may not recognize it by that name. Many refer to it as "the stomach flu" or "food poisoning," but these are forms of acute gastroenteritis (AGE).
AGE is an infection in the digestive system that is usually short in duration but can be contagious. There are 179 million cases every year in the U.S., and it is associated with 1.3 million deaths worldwide. Understanding your patient's risk factors and how to test for this condition can help manage any severe issues that may arise and support your patient's health outcomes.
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What is Gastroenteritis?
Gastroenteritis occurs when the stomach and intestines' inner linings become inflamed, often due to infections from bacteria or viruses. The two commonly known forms of gastroenteritis are viral gastroenteritis, often called stomach flu, and food poisoning, usually caused by bacteria. Gastroenteritis typically presents acutely and is termed acute gastroenteritis (AGE). It's important to note that bacteria and viruses are typically the main factors in this condition.
What Causes Gastroenteritis?
While infections are the leading cause, gastroenteritis can also occur from taking certain drugs, medications, or exposure to chemicals like metals or plant materials. This condition is contagious and can spread through food, water, person-to-person contact, or occasionally through zoonotic contact. The main culprits of AGE are norovirus, accounting for 20 million cases, and C. difficile, accounting for 400,000 infections.
Gastroenteritis Symptoms
Symptoms of gastroenteritis may include:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain or discomfort
- Loss of appetite
More severe symptoms can occur, indicating systemic involvement and inflammation from other body systems. More severe symptoms may include:
- Fever
- Chills
- Fatigue
- Body soreness
- Headaches
- Enlarged lymph nodes
What Are The Benefits of Regular Lab Testing For Patients With Gastroenteritis?
Gastroenteritis is usually self-limiting, meaning it often resolves on its own within a few days. However, individuals with weaker immune systems may experience complications and should seek medical attention. These complications are often due to dehydration and electrolyte loss, which are generally manageable in healthy individuals but can lead to severe issues in others. Symptoms such as changes in mental status, irritability, black stools, severe diarrhea, and high fevers may occur, particularly in children and older adults. Therefore, testing can help assess for gastroenteritis, support prevention strategies, and minimize the risk of complications.
Top Labs To Run Bi-Annually On Patients With Gastroenteritis
Diagnosis of gastroenteritis is typically accomplished through a clinical intake and stool culture. At times, polymerase chain reaction (PCR) testing and immunoassays are also used.
The following are the top functional labs that may be considered for patients with gastroenteritis:
Electrolyte and Dehydration Assessment
Dehydration and electrolyte imbalances are primary complications of gastroenteritis. Therefore, these statuses should be assessed in individuals with gastroenteritis to help ensure that complications do not escalate into emergency situations. A comprehensive metabolic panel (CMP) can analyze kidney function and electrolyte levels to identify imbalances. Dehydration status can also be assessed with a CMP test, including BUN (blood urea nitrogen) and creatinine levels. In dehydration, the BUN to creatinine ratio may be higher than 10 to 1. Running the CMP test in individuals with gastroenteritis can help manage dehydration and electrolyte loss complications.
Micronutrient Panel
Although nutrient deficiencies are not a cause of gastroenteritis, deficiencies such as zinc have been shown to potentially increase the severity of symptoms associated with gastroenteritis. This deficiency may lead to a decrease in resistance to AGE and can increase the severity of vomiting that can occur in this condition. A micronutrient panel is a useful functional lab test to assess nutrient status, including zinc levels. This test may be considered for populations at a higher risk of gastroenteritis, such as children and older adults.
Comprehensive Stool Analysis
A comprehensive stool analysis can be completed to identify pathogens that may be implicated in gastroenteritis. The GI-MAP is a useful stool test that can help determine if any infections are causing imbalances in the microbiome, potentially impacting gut and overall health. It assesses over 50 bacterial, viral, parasitic, and fungal infections. This test also uses PCR technology, commonly used to diagnose gastroenteritis. This test is frequently used in functional medicine for gastrointestinal issues.
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Summary
Many people will experience the stomach flu or food poisoning at some point in their lives. Both are types of gastroenteritis, which is inflammation of the gastrointestinal system, often due to bacterial or viral infections. This condition is uncomfortable for most people and typically resolves in a few days. However, for some individuals, gastroenteritis can lead to hospitalizations due to dehydration. Therefore, testing may be recommended if gastroenteritis is suspected to help prevent its spread and minimize the risk of more severe symptoms. Functional labs can be valuable tools to help investigate this condition and manage associated risks.
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