Patients probably already see you for acute gastroenteritis. But they might not know that's the medical term for what they're feeling. Most would describe this as "the stomach flu" or "food poisoning," but really, these are a form 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 causes 1.3 million deaths around the world. Knowing your patient's risk factors and how to test for this condition can help mitigate any severe issues that may occur from this condition and improve your patient's health outcomes.
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What is Gastroenteritis?
Gastroenteritis is when the stomach and the intestines' inner linings become inflamed, usually due to infections of bacteria or viruses. The two commonly known forms of gastroenteritis are viral gastroenteritis, which is 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?
Although infections are the leading cause, gastroenteritis can also occur from taking certain drugs, medications, or chemicals like metals or plant materials. This condition is contagious and is spread through food, water, person-to-person contact, or occasionally spread through zoonotic contact. The main culprits to AGE are norovirus, accounting for 20 million cases, and C. difficile, accounting for 400,000 infections.
Gastroenteritis Symptoms
Symptoms of gastroenteritis include:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain or discomfort
- Loss of appetite
More severe symptoms can occur, meaning it's systemic and represents inflammation from other body systems. More severe symptoms 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 will resolve on its own within a few days. However, people with weaker immune systems can have complications with gastroenteritis and should seek emergency medical attention. This complication is most often due to dehydration and electrolyte loss, which is generally easily managed in healthy individuals. Yet, it can lead to severe issues in others, which can present as changes in mental status, irritability, black stools, severe diarrhea, and high fevers. Severe symptoms occur more often in children and older adults. Therefore, testing should be completed to assess for gastroenteritis to help prevent the spread and minimize the risk of complications. Testing can ensure that appropriate treatment and prevention strategies are put in place.
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 should be completed on patients with gastroenteritis:
Electrolyte and Dehydration Assessment
Dehydration and electrolyte imbalances are the primary complications of gastroenteritis. Therefore, these statuses should be assessed in individuals with gastroenteritis to ensure that complications don't escalate into emergency situations. A comprehensive metabolic panel (CMP) will analyze kidney function and electrolyte levels to determine 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 would be higher than 10 to 1. Running the CMP test in individuals with gastroenteritis can help mitigate dehydration and electrolyte loss complications.
Micronutrient Panel
Although nutrient deficiencies aren't a cause of gastroenteritis, nutrient deficiencies such as zinc have been shown to increase the severity of symptoms associated with gastroenteritis. This deficiency can 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 an excellent functional lab test to assess nutrient status, including zinc levels. This test should be considered for populations who are at a higher risk of gastroenteritis, which includes children and older adults.
Comprehensive Stool Analysis
A comprehensive stool analysis can be completed to pinpoint pathogens that are implicated in gastroenteritis. The GI-MAP is a great stool test that will determine if any infections cause imbalances in the microbiome and can cause issues in the gut and impact 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 one of the most often used tests in functional medicine for gastrointestinal issues.
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Summary
Many people will get the stomach flu or food poisoning at some point in their lives. Both of these are types of gastroenteritis. Gastroenteritis is inflammation of the gastrointestinal system and mainly occurs from bacteria or virus infections. This condition is uncomfortable for most people and typically resolves in a few days. However, for some individuals, gastroenteritis can cause hospitalizations due to dehydration. Therefore, testing is recommended if you suspect gastroenteritis to help prevent the spread to others and minimize the risk of more severe symptoms. Functional labs are excellent tools to help investigate this condition and to mitigate the associated risks.
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