Viral gastroenteritis in adults - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Viral gastroenteritis is typically a self-limited condition lasting <14 days. Frequent symptoms are nausea, vomiting, and diarrhea, which may be accompanied by fever, abdominal pain, and anorexia.
Viral gastroenteritis is the most common cause of acute gastroenteritis in the US and worldwide.
Person-to-person transmission is responsible for infection in most sporadic cases. Foodborne and waterborne epidemic outbreaks have the potential to involve large numbers of people.
Mostly caused by norovirus.
Rotavirus is the most common cause of severe diarrhea in young children. It also causes symptomatic infection in older people and in immunocompromised adults.

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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.[Abstract][Full Text]
Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016 May;111(5):602-22.[Abstract]
Farthing M, Salam MA, Lindberg G, et al. Acute diarrhea in adults and children: a global perspective. J Clin Gastroenterol. 2013 Jan;47(1):12-20.[Abstract]

Referenced Articles

1. Thielman NM, Guerrant RL. Clinical practice: acute infectious diarrhea. N Engl J Med. 2004 Jan 1;350(1):38-47.[Abstract]
2. Lanata CF, Fischer-Walker CL, Olascoaga AC, et al. Global causes of diarrheal disease mortality in children <5 years of age: a systematic review. PLoS One. 2013 Sep 4;8(9):e72788.[Abstract][Full Text]
3. Mead PS, Slutsker L, Dietz V, et al. Food-related illness and death in the United States. Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25.[Abstract][Full Text]
4. Deneen VC, Hunt JM, Paule CR, et al. The impact of foodborne calicivirus disease: the Minnesota experience. J Infect Dis. 2000;181(suppl 2):S281-3.[Abstract][Full Text]
5. Fankhauser RL, Noel JS, Monroe SS, et al. Molecular epidemiology of "Norwalk-like viruses" in outbreaks of gastroenteritis in the United States. J Infect Dis. 1998 Dec;178(6):1571-8.[Abstract][Full Text]
6. Patel MM, Widdowson MA, Glass RI, et al. Systematic literature review of role of noroviruses in sporadic gastroenteritis. Emerg Infect Dis. 2008 Aug;14(8):1224-31. [Abstract][Full Text]
7. Centers for Disease Control and Prevention. Norovirus. 4 May 2022 [internet publication].[Full Text]
8. Clark B, McKendrick M. A review of viral gastroenteritis. Curr Opin Infect Dis. 2004 Oct;17(5):461-9.[Abstract]
9. Hallowell BD, Parashar UD, Curns A, et al. Trends in the laboratory detection of rotavirus before and after implementation of routine rotavirus vaccination - United States, 2000-2018. MMWR Morb Mortal Wkly Rep. 2019 Jun 21;68(24):539-43.[Abstract][Full Text]
10. Wilhelmi I, Roman E, Sanchez-Fauquier A. Viruses causing gastroenteritis. Clin Microbiol Infect. 2003 Apr;9(4):247-62.[Abstract][Full Text]
11. Blutt SE, Kirkwood CD, Parreno V, et al. Rotavirus antigenaemia and viraemia: a common event? Lancet. 2003 Nov 1;362(9394):1445-9.[Abstract]
12. Cortese MM, Parashar UD; Centers for Disease Control and Prevention (CDC). Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009 Feb 6;58(RR-2):1-25.[Abstract][Full Text]
13. Ball JM, Tian P, Zeng CQ, et al. Age-dependent diarrhea induced by a rotaviral nonstructural glycoprotein. Science. 1996 Apr 5;272(5258):101-4.[Abstract]
14. Hall AJ, Vinjé J, Lopman B, et al. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention: updated norovirus outbreak management and disease prevention guidelines. MMWR Recomm Rep. 2011 Mar 4;60(RR-3):1-18.[Abstract][Full Text]
15. Hall AJ, Wikswo ME, Manikonda K, et al. Acute gastroenteritis surveillance through the National Outbreak Reporting System, United States. Emerg Infect Dis. 2013 Aug;19(8):1305-9.[Abstract][Full Text]
16. Fankhauser RL, Monroe SS, Noel JS, et al. Epidemiologic and molecular trends of "Norwalk-like viruses" associated with outbreaks of gastroenteritis in the United States. J Infect Dis. 2002 Jul 1;186(1):1-7. [Abstract][Full Text]
17. Vesikari T, Matson DO, Dennehy P, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006 Jan 5;354(1):23-33. [Abstract][Full Text]
18. Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med. 2006 Jan 5;354(1):11-22. [Abstract][Full Text]
19. Soares-Weiser K, Bergman H, Henschke N, et al. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev. 2019 Oct 28;(10):CD008521. [Abstract][Full Text]
20. Centers for Disease Control and Prevention. Postmarketing monitoring of intussusception after RotaTeq™ vaccination - United States, February 1, 2006-February 15, 2007. March 2007 [internet publication].[Full Text]
21. Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.[Abstract][Full Text]
22. Miller JM, Binnicker MJ, Campbell S, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5:ciae104.[Abstract][Full Text]
23. Messacar K, Parker SK, Todd JK, et al. Implementation of rapid molecular infectious disease diagnostics: the role of diagnostic and antimicrobial stewardship. J Clin Microbiol. 2017 Mar;55(3):715-23.[Abstract][Full Text]
24. National Institute for Health and Care Excellence. Integrated multiplex PCR tests for identifying gastrointestinal pathogens in people with suspected gastroenteritis (xTAG Gastrointestinal Pathogen Panel, FilmArray GI Panel and Faecal Pathogens B assay). 11 January 2017 [internet publication].[Full Text]
25. American Society for Clinical Laboratory Science. Ten things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2022 [internet publication]. [Full Text]
26. Kaplan JE, Feldman R, Campbell DS, et al. The frequency of a Norwalk-like pattern of illness in outbreaks of acute gastroenteritis. Am J Public Health. 1982;72:1329-1332.[Abstract]
27. Centers for Disease Control and Prevention. Rotavirus. 5 March 2021 [internet publication].[Full Text]
28. American College of Radiology. ACR appropriateness criteria: right upper quadrant pain. 2022 [internet publication].[Full Text]
29. Alberta Clinical Practice Guidelines. Ordering stool test for investigation of suspected infectious diarrhea. April 2014 [internet publication].[Full Text]
30. Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016 May;111(5):602-22.[Abstract]
31. Elliott EJ. Acute gastroenteritis in children. BMJ. 2007 Jan 6;334(7583):35-40.[Abstract][Full Text]
32. King CK, Glass R, Bresee JS, et al. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003 Nov 21;52(RR-16):1-16.[Abstract][Full Text]
33. Farthing M, Salam MA, Lindberg G, et al. Acute diarrhea in adults and children: a global perspective. J Clin Gastroenterol. 2013 Jan;47(1):12-20.[Abstract]
34. Gregorio GV, Gonzales ML, Dans LF, Martinez EG. Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2016 Dec 13;(12):CD006519. [Abstract][Full Text]
35. Bines JE, At Thobari J, Satria CD, et al. Human neonatal rotavirus vaccine (RV3-BB) to target rotavirus from birth. N Engl J Med. 2018 Feb 22;378(8):719-30.[Abstract][Full Text]
36. Witte D, Handley A, Jere KC, et al. Neonatal rotavirus vaccine (RV3-BB) immunogenicity and safety in a neonatal and infant administration schedule in Malawi: a randomised, double-blind, four-arm parallel group dose-ranging study. Lancet Infect Dis. 2022 May;22(5):668-78.[Abstract][Full Text]
37. Nguyen TT, Chiu CH, Lin CY, et al. Efficacy, safety, and immunogenicity of an inactivated, adjuvanted enterovirus 71 vaccine in infants and children: a multiregion, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. 2022 Apr 30;399(10336):1708-17.[Abstract]
38. Rossignol JF, El-Gohary YM. Nitazoxanide in the treatment of viral gastroenteritis: a randomized double-blind placebo-controlled clinical trial. Aliment Pharmacol Ther. 2006 Nov 15;24(10):1423-30.[Abstract][Full Text]
39. Rossignol JF, Abu-Zekry M, Hussein A, et al. Effect of nitazoxanide for treatment of severe rotavirus diarrhoea: randomised double-blind placebo-controlled trial. Lancet. 2006 Jul 8;368(9530):124-9.[Abstract]
40. Morris J, Brown W, Morris CL. Nitazoxanide is effective therapy for norovirus gastroenteritis after chemotherapy and hematopoietic stem cell transplantation (HSCT). Blood 2013;122:4581.[Full Text]
41. Waddington CS, McLeod C, Morris P, et al. The NICE-GUT trial protocol: a randomised, placebo controlled trial of oral nitazoxanide for the empiric treatment of acute gastroenteritis among Australian Aboriginal children. BMJ Open. 2018 Feb 1;8(2):e019632.[Abstract][Full Text]
42. ClinicalTrials.gov. Oral nitazoxanide in acute gastroenteritis in Australian indigenous children (NICEGUT). NCT02165813. 5 October 2020 [internet publication].[Full Text]
43. Collinson S, Deans A, Padua-Zamora A, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2020 Dec 8;12:CD003048.[Abstract][Full Text]
44. Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016 Dec 20;(12):CD005436.[Abstract][Full Text]
45. World Health Organization. Implementing the new recommendations on the clinical management of diarrhoea. January 2006 [internet publication].[Full Text]
46. Szajewska H, Dziechciarz P, Mrukowicz J. Meta-analysis: smectite in the treatment of acute infectious diarrhoea in children. Aliment Pharmacol Ther. 2006 Jan 15;23(2):217-27.[Abstract][Full Text]
47. Florez ID, Veroniki AA, Al Khalifah R, et al. Comparative effectiveness and safety of interventions for acute diarrhea and gastroenteritis in children: a systematic review and network meta-analysis. PLoS One. 2018;13(12):e0207701.[Abstract][Full Text]
48. Khediri F, Mrad AI, Azzouz M, et al. Efficacy of diosmectite (smecta) in the treatment of acute watery diarrhoea in adults: a multicentre, randomized, double-blind, placebo-controlled, parallel group study. Gastroenterol Res Pract. 2011;2011:783196.[Abstract][Full Text]
49. ClinicalTrials.gov. Efficacy of diosmectite (Smecta®) in the symptomatic treatment of acute diarrhoea in adults (ADIASE). November 2020 [internet publication].[Full Text]
50. MacCannell T, Umscheid CA, Agarwal RK, et al. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings. Infect Control Hosp Epidemiol. 2011 Oct;32(10):939-69.[Abstract][Full Text]
51. Wingate D, Phillips SF, Lewis SJ, et al. Guidelines for adults on self-medication for the treatment of acute diarrhoea. Aliment Pharmacol Ther. 2001 Jun;15(6):773-82.[Abstract][Full Text]
52. Health Protection Surveillance Centre (Ireland). Clinical features of viral gastroenteritis and advice about decontamination following sickness. January 2015 [internet publication].[Full Text]
53. Barbara G, Grover M, Bercik P, et al. Rome Foundation Working Team report on post-infection irritable bowel syndrome. Gastroenterology. 2019 Jan;156(1):46-58;e7.[Abstract][Full Text]
54. Hübner NO, Hübner C, Wodny M, et al. Effectiveness of alcohol-based hand disinfectants in a public administration: impact on health and work performance related to acute respiratory symptoms and diarrhoea. BMC Infect Dis. 2010 Aug 24;10:250. [Abstract][Full Text]