Treatment of Enteritis and Gastroenteritis

Introduction to Treatment

The primary treatment for both enteritis and gastroenteritis is oral rehydration therapy (ORT) with reduced osmolarity oral rehydration solution (ORS), with intravenous fluids reserved for cases of severe dehydration or inability to tolerate oral intake, as recommended by the Infectious Diseases Society of America 1

Enteritis is inflammation specifically of the small intestine, which may present with diarrhea but less commonly with vomiting, according to the Clinical Infectious Diseases journal 1
Gastroenteritis is inflammation of both the stomach and intestines, typically presenting with both diarrhea and vomiting, as defined by the Clinical Infectious Diseases journal 1

Evaluate hydration status through physical examination looking for signs such as decreased skin turgor, dry mucous membranes, sunken eyes, altered mental status, tachycardia, and decreased urine output, as suggested by the Clinical Infectious Diseases journal 1
Categorize dehydration as mild (<4% body weight loss), moderate (4-6% body weight loss), or severe (>6% body weight loss), based on guidelines from the Clinical Infectious Diseases journal 1

For mild to moderate dehydration, provide ORS as first-line therapy with a dosage of 50-100 mL/kg over 3-4 hours for children and 2-4 L for adults, as recommended by the Clinical Infectious Diseases journal 1
For severe dehydration, administer isotonic intravenous fluids (lactated Ringer's or normal saline) at 20 mL/kg boluses, as suggested by the Clinical Infectious Diseases journal 1

Continue breastfeeding throughout the diarrheal episode in infants, as recommended by the Clinical Infectious Diseases journal 1
Resume age-appropriate diet during or immediately after rehydration, as suggested by the Clinical Infectious Diseases journal 1

Loperamide may be given to immunocompetent adults with acute watery diarrhea, but avoid antimotility drugs in children under 18 years of age, as recommended by the Clinical Infectious Diseases journal 1

Empiric antimicrobial therapy is generally not recommended for either condition in immunocompetent patients, except in cases of suspected bacterial etiology, fever, abdominal pain, and bloody diarrhea, as suggested by the Clinical Infectious Diseases journal 1
Avoid antimicrobial therapy for STEC O157 and other Shiga toxin-producing organisms, as it may increase the risk of hemolytic uremic syndrome, according to the Clinical Infectious Diseases journal 1

Practice proper hand hygiene after using the toilet, changing diapers, before/after food preparation, and use infection control measures including gloves, gowns, and hand hygiene with soap and water when caring for patients with diarrhea, as recommended by the Centers for Disease Control and Prevention 2
Rotavirus vaccination is recommended for prevention of severe gastroenteritis in infants, as suggested by the Centers for Disease Control and Prevention 4