Gastrointestinal tract diesease

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A SEMINAR REPORT ON
GASTROINTESTINAL TRACT DISEASE
BY
Kawata Hassan Musa
14/57MB/404
MICROBIOLOGY DEPARTMENT,
COLLEGE OF PURE AND APPLIED SCIENCE
Kwara State University Malete
A SEMINAR REPORT SSUBMITTED IN PARTIAL FULFILLMENT OF
THE AWARD OF BACHELOR OF SCIENCE
(B.SC) IN MICROBIOLOGY

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Table of content
INTRODUCTION..................................................................................................................................3
CLASSIFICATION(S) OF GASTROINTESTINAL TRACT DISEASE...................................................................4
PEPTIC ULCER DISEASE........................................................................................................................8
Epidemiology................................................................................................................................10
Signs and symptoms......................................................................................................................10
Complications...............................................................................................................................12
Causes of peptic ulcer disease .......................................................................................................12
Diagnosis......................................................................................................................................14
Treatment....................................................................................................................................15
DIARRHEA.......................................................................................................................................17
Epidemiology................................................................................................................................18
Infections.....................................................................................................................................19
Causes..........................................................................................................................................20
Prevention....................................................................................................................................21
Treatment or Management...........................................................................................................24
GASTRITIS........................................................................................................................................28
Epidemiology................................................................................................................................29
Causes of gastritis disease.............................................................................................................30
Diagnosis......................................................................................................................................30
Treatment....................................................................................................................................31
GASTRIC CANCER..............................................................................................................................32
Epidemiology................................................................................................................................33
Causes of gastric cancer................................................................................................................35
Diagnosis......................................................................................................................................36
Prevention....................................................................................................................................37
Management................................................................................................................................37
CONCLUSION....................................................................................................................................38
SUMMARY .......................................................................................................................................39
REFERENCES.....................................................................................................................................40

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INTRODUCTION
Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the
esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of
digestion, the liver, gallbladder, and pancreas (Yamada, et al., 2009). They are those that affect
any section of the gastrointestinal tract, from the esophagus to the rectum, and the accessory
digestive organs, liver, gall bladder and pancreas (Nicki et al., 2010).
Ingested pathogens may cause disease confined to the gut or involving other parts of the
body , ingestion of pathogen can cause many different infections (Feriar et al.,1992) .these may
confined to the gastrointestinal tract or initiated in the guts before spreading to other parts of the
body (Gross ,1991).
A wide range of microbial pathogens is capable of infecting of infecting the
gastronintestinal.They are acquired by the fecal-oral route, from fecally contaminated, fluids or
fingers (Nair et al., 1996). For an infection to occur, the pathogen must be ingested in sufficient
numbers or possess attributes to elude the host defenses of the upper gastro intestinal tract and
reach the intestine, Here they remain localized and cause disease as a result of multiplication
and/or toxin production, or they may invade through the intestinal mucosa to reach the
lymphatics or the bloodstream (Maoyyedi and Anthony, 1995).
The digestive tract is a twisting tube about 30 feet long. It starts at the mouth and ends at
the anus. In between are the esophagus, stomach and bowels (intestines). The liver and pancreas
aid digestion by producing bile and pancreatic juices which travel to the intestines. The
gallbladder stores bile until the body needs it for digestion. The digestive system breaks down
food and fluids into much smaller nutrients. In this complex process, blood carries the nutrients

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throughout the body to nourish cells and provide energy. The GI tract is divided into two main
sections: the upper GI tract and the lower GI tract.
The GI tract, about 28 feet long, consists of the upper and lower GI sections.
 The upper GI tract consists of the mouth, pharynx, esophagus and stomach. The
esophagus extends through the chest stomach, which, in turn, leads to the small intestine.
 The lower GI tract comprises the small and large intestines (bowels) and anus.
 Related organs include the liver, which secretes bile into the small intestine (using the
gallbladder as a reservoir), and the pancreas, which secretes fluid and enzymes into the
small intestine. Both of these organs aid indigestion.
Gastrointestinal infections are viral, bacterial or parasitic infections that cause gastroenteritis,
an inflammation of the gastrointestinal tract involving both the stomach and the small intestine.
Symptoms include diarrhea, vomiting, and abdominal pain (Bryan, 2002). Dehydration is the
main danger of gastrointestinal infections, so rehydration is important, but most gastrointestinal
infections are self-limited and resolve within a few days (Bartlett, 2002). However, in a
healthcare setting and in specific populations (newborns/infants, immunocompromized patients
or elderly populations), they are potentially serious. Rapid diagnosis, appropriate treatment
and infection control measures are therefore particularly important in these contexts (Johannes
et al., 2006).
CLASSIFICATION(S)OF GASTROINTESTINALTRACT DISEASE
Gastro intestinal tract disease is classified in accordance to the of the body they affect,
the classifications are as follows:-
Oral disease - Even though anatomically part of the GI tract, diseases of the mouth are often not
considered alongside other gastrointestinal diseases (Yamada, et al., 2009). By far the most

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common oral conditions are plaque-induced diseases (e.g. gingivitis, periodontitis, and dental
caries).
Oesophageal disease
Oesophageal diseases include a spectrum of disorders affecting the esophagus. The most
common condition of the esophagus in Western countries is gastroesophageal reflux disease,
which in chronic forms is thought to result in changes to the epithelium of the esophagus, known
as Barrett's esophagus. Oesophageal disease may result in a sore throat, throwing up blood,
difficulty swallowing or vomiting (Nicki et al., 2010).
Gastric disease
Stomach diseases refer to diseases affecting the stomach. Inflammation of the stomach by
infection from any cause is called gastritis, and when including other parts of the gastrointestinal
tract called gastroenteritis. When gastritis is persists in a chronic state, it is associated with
several diseases, including gastric cancer, gastric ulceration, peptic ulcers (Peptic ulcers are most
commonly caused by a bacterial Helicobacter pylori infection).
Intestinal disease
The small and large intestines may be affected by infectious, autoimmune, and physiological
states. Inflammation of the intestines is called enterocolitis, which may lead to diarrhoea
Diseases of the intestine may cause vomiting, diarrhoea or constipation, and altered stool, such
as with blood in stool. Infectious disease may be treated with targeted antibiotics, and
inflammatory bowel disease with immunosuppression.

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The Small intestine -The small intestine consists of the duodenum, jejunum and ileum.
Inflammation of the small intestine is called enteritis, Diseases of the small intestine may present
with symptoms such as diarrhoea, malnutrition, fatigue and weight loss. Investigations pursued
may include blood tests to monitor nutrition, such as iron levels, folate and calcium, endoscopy
and biopsy of the duodenum, and barium swallow. Treatments may include renutrition, and
antibiotics for infections (Nicki et al., 2010).
The Large intestine- Diseases that affect the large intestine may affect it in whole or in part.
Appendicitis is one such disease, caused by inflammation of the appendix. Diseases affecting the
large intestine may cause blood to be passed with stool, may cause constipation, or may result in
abdominal pain or a fever. Tests that specifically examine the function of the large intestine
include barium swallows, abdominal x-rays, and colonoscopy.
Rectum and anus
Diseases affecting the rectum and anus are extremely common, especially in older adults.
Conditions such as anal cancer may be associated with inflammation of the colon or with
sexually transmitted infections such as HIV.
Other classifications of gastrointestinal tract disease involve the digestive gland and they are:
Hepatic - Hepatic diseases refers to those affecting the liver. Hepatitis refers to inflammation of
liver tissue, and may be acute or chronic. Infectious viral hepatitis, such as hepatitis A, B and C,
affect in excess of (X) million people worldwide (Yamada, et al., 2009) .
Pancreatic -Pancreatic diseases that affect digestion refers to disorders affecting the gland that
secretes externally through a duct (secretes pancreatic juice and insulin) which is a part of the
pancreas involved in digestion. One of the most common conditions of the exocrine pancreas is

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acute pancreatitis, which in the majority of cases relates to gallstones (A calculus formed in the
gall bladder or its ducts)
Gallbladder and biliary tract -Diseases of the gallbladder and bile ducts are commonly diet-
related, and may include the formation of gallstones that impact in the gallbladder, or in the
common bile duct
Base on this particular seminar, I will be talking on four gastrointestinal diseases and they are:
 Peptic ulcer disease
 Diarrhea
 Gastritis, and
 Gastric cancer

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PEPTIC ULCER DISEASE
Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer, is a break in the lining
of the stomach, first part of the small intestine, or occasionally the lower esophagus (Najm,
2011). An ulcer in the stomach is known as a gastric ulcer while that in the first part of the
intestines is known as a duodenal ulcer (Rao and Devaji, 2014). The most common symptoms of
a duodenal ulcer are waking at night with upper abdominal pain or upper abdominal pain that
improves with eating .With a gastric ulcer the pain may worsen with eating. The pain is often
described as a burning or dull ache (Najm, 2011). Other symptoms include belching, vomiting,
weight loss, or poor appetite. About a third of older people have no symptoms. Complications
may include bleeding, perforation, perforation, and blockage of the stomach. Bleeding occurs in
as many as 15% of people. Common causes include the bacteria Helicobacter pylori and non-
steroidal anti-inflammatory drugs (NSAIDs). Other less common causes include tobacco
smoking, stress due to serious illness, Behcet disease (Milosavljevic et al., 2011).
Older people are more sensitive to the ulcer causing effects of NSAIDs(An
organic compound that does not contain a steroid made in drugs or medicine to reduce
inflammation). Helicobacter. pylori can be diagnosed by testing the blood for antibodies, a urea
breath test, testing the stool for signs of the bacteria, or a biopsy (Examination of tissues or
liquids from the stomach a living body to determine the existence or cause of a disease) Other
conditions that produce similar symptoms include stomach cancer, and inflammation of the
stomach lining or gallbladder (Najm, 2011).
Diet does not play an important role in either causing or preventing ulcers. Treatment includes
stopping smoking, stopping NSAIDs, stopping alcohol, and medications to decrease stomach
acid (Wang, 2011). The medication used to decrease acid is usually either a proton pump

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inhibitor (PPL) Ulcers due to H. pylori are treated with a combination of medications such as
amoxicillin, clarithromycin, and a PPI (Najm, 2011). Antibiotic resistance is increasing and thus
treatment may not always be effective. Bleeding ulcers may be treated by endoscopy, with open
surgery typically only used in cases in which it is not successful (Milosavljevic et al., 2011).
Endcopy is the visual examination of the interior of a hollow body organ by use of an endoscope
(A long slender medical instrument for examining the interior of a bodily organ or performing
minor surgery).
Peptic ulcers are present in around 4% of the population (Najm, 2011). They newly began
in around 53 million people in 2013.About 10% of people develop a peptic ulcer at some point in
their life (Wang, 2011).They resulted in 301,000 deaths in 2013 down from 327,000 deaths in
1990. The first description of a perforated peptic ulcer was in 1670 in Princess Henrietta of
England (Snowden, 2008). H. pylori was first identified as causing peptic ulcers by Barry
Marshall and Robin Warren in the late 20th century, a discovery for which they received the
Nobel Prize in 2005 (Milosavljevic et al., 2011).
Picture showing a deep Gastric ulcer
Source: (The Nobel Prize in Physiology or Medicine, 2005)

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Part of the body in which ulcer affects can be used to classify ulcer E.g. the duodenum (called
duodenal ulcer), Esophagus (called esophageal ulcer) and the Stomach (called gastric ulcer)
Epidemiology
The lifetime risk for developing a peptic ulcer is approximately 10% (Snowden, 2008).They
resulted in 301,000 deaths in 2013 down from 327,000 deaths in 1990.
In Western countries the percentage of people with Helicobacter pylori infections roughly
matches age (i.e., 20% at age 20, 30% at age 30, 80% at age 80 etc.). Prevalence is higher in
third world countries where it is estimated at about 70% of the population, whereas developed
countries show a maximum of 40% ratio. Overall, H. pylori infections show a worldwide
decrease, more so in developed countries (Brown, 2000). Transmission is by food, contaminated
groundwater, and through human saliva (such as from kissing or sharing food utensils).
A minority of cases of H. pylori infection will eventually lead to an ulcer and a larger proportion
of people will get non-specific discomfort, abdominal pain or gastritis (Johannessen 2010).
Signs and symptoms
Signs and symptoms of a peptic ulcer can include one or more of the following:
 Abdominal pain, classically at the anterior walls of the abdomen (Epigastric) strongly
correlated to mealtimes. In case of duodenal ulcers the pain appears about three hours
after taking a meal.
 Bloating (Swollen or puff up) and abdominal fullness.

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 Nausea and copious vomiting (Excess vomiting).
 Loss of appetite and weight loss.
 Hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric
ulcer, or from damage to the esophagus from severe/continuing vomiting.
 Melena (tarry, foul-smelling feces due to presence of oxidized iron from hemoglobin-A
hemoprotein composed of globin and heme that gives red blood cells their characteristic
color; function primarily to transport oxygen from the lungs to the body tissues).
 Rarely, an ulcer can lead to a gastric or duodenal perforation, which leads to acute
peritonitis (Inflammation of the abdominal cavity), extreme, stabbing pain, and requires
immediate surgery (Bhat, 2013).
Medicines associated with peptic ulcer include NSAIDs (non-steroid anti-inflammatory
drugs). Also, the symptoms of peptic ulcers may vary with the location of the ulcer and the
patient's age. Furthermore, typical ulcers tend to heal and recur and as a result the pain may
occur for few days and weeks and then wane or disappear. Usually, children and the elderly
do not develop any symptoms unless complications have arisen. Burning or gnawing feeling
in the stomach area lasting between 30 minutes and 3 hours commonly accompanies ulcers.
This pain can be misinterpreted as hunger, indigestion or heartburn. Pain is usually caused by
the ulcer but it may be aggravated by the stomach acid when it comes into contact with the
ulcerated area. The pain caused by peptic ulcers can be felt anywhere from the navel up to
the sternum (The flat bone that articulates with the clavicles and the first seven pairs of ribs)
it may last from few minutes to several hours and it may be worse when the stomach is
empty. Also, sometimes the pain may flare at night and it can commonly be temporarily
relieved by eating foods that buffer stomach acid or by taking anti-acid medication (Merck,

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2006). However, peptic ulcer disease symptoms may be different for every sufferer (Sriram
et al., 2013).
Complications
 Gastrointestinal bleeding is the most common complication. Sudden large bleeding can
be life-threatening (Cullen et al., 1997).
 Perforation (a hole in the wall of the gastrointestinal tract) often leads to catastrophic
consequences if left untreated (Merck, 2006).
 Penetration is a form of perforation in which the hole leads to and the ulcer continues into
adjacent organs such as the liver and pancreas (Merck, 2006).
Causes ofpeptic ulcer disease
The factors that cause peptic ulcer disease are as follows:-
a) Helicobacter pylori -A major causative factor (60% of gastric and up to 50–75% of
duodenal ulcers) is chronic inflammation due to Helicobacter pylori that colonizes the
antral mucosa. The immune system is unable to clear the infection, despite the appearance
of antibodies. Thus, the bacterium can cause a chronic active gastritis (type B gastritis)
Gastrin (Polypeptide hormone secreted by the mucous lining of the stomach ;) stimulates
the production of gastric acid by parietal cells (Cullen et al., 1997). In H. pylori
colonization responses to increased Gastrin, the increase in acid can contribute to the
erosion of the mucosa (secreting membrane lining all body cavities or passages that
communicate with the exterior) and therefore ulcer formation.
b) NSAIDS (Non-anti-steroidal inflammatory drugs) - Another major cause is the use of
NSAIDs, such as ibuprofen and aspirin. The gastric mucosa protects itself from gastric
acid with a layer of mucus, the secretion of which is stimulated by certain prostaglandins.

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NSAIDs block the function of cyclooxygenase ( Either of two related enzymes that
control the production of prostaglandins and are blocked by aspirin ) which is essential
for the production of these prostaglandins-( a potent substance that acts like a hormone
and is found in many bodily tissues (and especially in semen); produced in response to
trauma and may affect blood pressure and metabolism and smooth muscle activity).
These are less essential in the gastric mucosa, and roughly halve the risk of NSAID-
related gastric ulceration (Merck, 2006).
c) Stress - Stress due to serious health problems such as those requiring treatment in an
intensive care unit is well described as a cause of peptic ulcers, which are termed stress
ulcers (Merck, 2006)..
While chronic life stress was once believed to be the main cause of ulcers, this is no longer
the case. It is, however, still occasionally believed to play a role. This may be by increasing the
risk in those with other causes such as H. pylori or NSAID use.
d) Diet - Dietary factors such as spice consumption were hypothesized to cause ulcers until
late in the 20th century, but have been shown to be of relatively minor importance.
Caffeine and coffee, also commonly thought to cause or exacerbate (make worse) ulcers,
appear to have little effect. Similarly, while studies have found that alcohol consumption
increases risk when associated with H. pylori infection, it does not seem to independently
increase risk. Even when coupled with H. pylori infection, the increase is modest in
comparison to the primary risk factor (Yeomans, 2011).
e) Smoking - Although some studies have found correlations between smoking and ulcer
formation,(Kato et al., 1992) others have been more specific in exploring the risks

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involved and have found that smoking by itself may not be much of a risk factor unless
associated with H. pylori infection (Kurata et al., 1997).
Diagnosis
The diagnosis is mainly established based on the characteristic symptoms. Stomach pain is
usually the first signal of a peptic ulcer. In some cases, doctors may treat ulcers without
diagnosing them with specific tests and observe whether the symptoms resolve, thus indicating
that their primary diagnosis was accurate (Merck, 2006).
More specifically, peptic ulcers erode the muscularis mucosae, at least to the level of the
submucosa (contrast with erosions, which do not involve the muscularis mucosae).
Confirmation of the diagnosis is made with the help of tests such as endoscopies or barium
contrast x-rays. The tests are typically ordered if the symptoms do not resolve after a few weeks
of treatment, or when they first appear in a person who is over age 45 or who has other
symptoms such as weight loss, because stomach cancer can cause similar symptoms. Also, when
severe ulcers resist treatment, particularly if a person has several ulcers or the ulcers are in
unusual places, a doctor may suspect an underlying condition that causes the stomach to
overproduce acid (Merck, 2006).
An esophagogastroduodenoscopy (EGD), a form of endoscopy, also known as a gastroscopy, is
carried out on patients in whom a peptic ulcer is suspected. By direct visual identification, the
location and severity of an ulcer can be described. Moreover, if no ulcer is present, EGD can
often provide an alternative diagnosis (Kurata et al., 1997).
One of the reasons that blood tests are not reliable for accurate peptic ulcer diagnosis on their
own is their inability to differentiate between past exposure to the bacteria and current infection.

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Additionally, a false negative result is possible with a blood test if the patient has recently been
taking certain drugs, such as antibiotics or proton-pump inhibitors.
The diagnosis of Helicobacter pylori can be made by:
 Urea breath test (non-invasive and does not require EGD).
 Stool antigen test
 Measurement of antibody levels in the blood (does not require EGD).
Treatment
I. Acid reducing medication
Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists
before endoscopy is undertaken.
People who are taking nonsteroidal anti-inflammatories (NSAIDs) may also be prescribed a
prostaglandin analogue (misoprostol) in order to help prevent peptic ulcers. H2 antagonists or
proton-pump inhibitors decrease the amount of acid in the stomach, helping with healing of
ulcers (Najm, 2011).
II. H. pylori
When H. pylori infection is present, the most effective treatments are combinations of 2
antibiotics (e.g. clarithromycin, amoxicillin, tetracycline, metronidazole) and a proton-pump
inhibitor (PPI), sometimes together with a bismuth compound. In complicated, treatment-
resistant cases, 3 antibiotics (e.g. amoxicillin + clarithromycin + metronidazole) may be used
together with a PPI and sometimes with bismuth compound. An effective first-line therapy for
uncomplicated cases would be amoxicillin + metronidazole + pantoprazole (a PPI).

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III. Surgery Perforated peptic ulcer is a surgical emergency and requires surgical repair of
the perforation. Most bleeding ulcers require endoscopy urgently to stop bleeding with
cautery, injection, or clipping (Najm, 2011).

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DIARRHEA
Diarrhea, also spelled diarrhoea, is the condition of having at least three loose or liquid bowel
movements each day. It often lasts for a few days and can result in dehydration due to fluid loss.
Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable
behavior. This can progress to decreased urination, loss of skin color, a fast heart rate, and a
decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies
who are breastfed, however, may be normal (Basem, 2013).
The most common cause is an infection of the intestines due to a virus, bacteria, or parasite; a
condition known as gastroenteritis. These infections are often acquired from food or water that
has been contaminated by stool, or directly from another person who is infected. It may be
divided into three types: short duration watery diarrhea, short duration bloody diarrhea, and if it
lasts for more than two weeks, persistent diarrhea. The short duration watery diarrhea may be
due to an infection by cholera, although this is rare in the developed world. If blood is present it
is also known as dysentery (Basem, 2013). A number of non-infectious causes may also result in
diarrhea, including hyperthyroidism, lactose intolerance, inflammatory bowel disease, a number
of medications, and irritable bowel syndrome (John et al., 2013). In most cases, stool cultures are
not required to confirm the exact cause (John et al., 2013).
Prevention of infectious diarrhea is by improved sanitation, clean drinking water, and hand
washing with soap. Breastfeeding for at least six months is also recommended as is vaccination
against rotavirus. Oral rehydration solution (ORS), which is clean water with modest amounts of
salts and sugar, is the treatment of choice. Zinc tablets are also recommended (Basem, 2013).
These treatments have been estimated to have saved 50 million children in the past 25 years
(Basem, 2013). When people have diarrhea it is recommended that they continue to eat healthy

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food and babies continue to be breastfed. If commercial ORS are not available, homemade
solutions may be used. In those with severe dehydration, intravenous fluids may be required.
Most cases; however, can be managed well with fluids by mouth. Antibiotics, while rarely used
(Sarah et al., 2012), may be recommended in a few cases such as those who have bloody
diarrhea and a high fever, those with severe diarrhea following travelling, and those who grow
specific bacteria or parasites in their stool (John et al., 2013). Loperamide may help decrease the
number of bowel movements but is not recommended in those with severe disease (John et al.,
2013).
(picture showing An electron micrograph of rotavirus)
Source:"Diarrhea disease Fact sheet,(World Health Organization, 2014)”
Epidemiology
Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5
million deaths among children under the age of five. Greater than half of these were in Africa
and South Asia (Mandell et al., 2004). This is down from a death rate of 4.5 million in 1980 for
gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after
pneumonia (17%) in this age group (Basem, 2013).

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The majority of such cases occur in the developing world, with over half of the recorded cases of
childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases,
respectively, compared to only 480 million in the rest of the world (Walker et al., 2013).
Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011
and 250 million lost school days (Walker et al., 2012). In the Americas, diarrheal disease
accounts for a total of 10% of deaths among children aged 1–59 months while in South East
Asia, it accounts for 31.3% of deaths (Walker et al., 2013). It is estimated that around 21% of
child mortalities in developing countries are due to diarrheal disease (Kosek et al., 2003).
Infections
There are many causes of infectious diarrhea, which include viruses, bacteria and parasites
(Navaneethan and Giannella, 2008). Infectious diarrhea is frequently referred to as gastroenteritis
(David, 2008). Norovirus is the most common cause of viral diarrhea in adults (Patel et al.,
2009), but rotavirus is the most common cause in children under five years old (Greenberg and
Estes, 2009). Adenovirus types 40 and 41, and astroviruses cause a significant number of
infections (Uhnoo et al., 1990).
Campylobacter spp. are a common cause of bacterial diarrhea, but infections by Salmonella spp.,
Shigella spp. and some strains of Escherichia coli are also a frequent cause (Viswanathan et al.,
2009).
In the elderly, particularly those who have been treated with antibiotics for unrelated infections, a
toxin produced by Clostridium difficile often causes severe diarrhea (Rupnik et al., 2009).
Parasites, particularly protozoa (e.g., Cryptosporidium spp., Giardia spp., Entamoeba histolytica,
Blastocystis spp., Cyclospora cayetanensis), are frequently the cause of diarrhea that involves

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chronic infection. The broad-spectrum antiparasitic agent nitazoxanide has shown efficacy
against many diarrhea-causing parasites (Rossignol et al., 2012).
Other infectious agents, such as parasites or bacterial toxins, may exacerbate symptoms. In
sanitary living conditions where there is ample food and a supply of clean water, an otherwise
healthy person usually recovers from viral infections in a few days (Wilson, 2005). However, for
ill or malnourished individuals, diarrhea can lead to severe dehydration and can become life-
threatening (Alam and Ashraf, 2003).
Causes
Major factors that causes diarrhea are as follows:-
a) Sanitation - Poverty is a good indicator of the rate of infectious diarrhea in a population.
This association does not stem from poverty itself, but rather from the conditions under
which impoverished people live. The absence of certain resources compromises the
ability of the poor to defend themselves against infectious diarrhea. "Poverty is associated
with poor housing, crowding, dirt floors, lack of access to clean water or to sanitary
disposal of fecal waste (sanitation), cohabitation with domestic animals that may carry
human pathogens, and a lack of refrigerated storage for food, all of which increase the
frequency of diarrhea. Poverty also restricts the ability to provide age-appropriate,
nutritionally balanced diets or to modify diets when diarrhea develops so as to mitigate
and repair nutrient losses. The impact is exacerbated by the lack of adequate, available,
and affordable medical care (Jamison and Dean,2006). “Open defecation is a leading
cause of infectious diarrhea leading to death”.
b) Water - One of the most common causes of infectious diarrhea is a lack of clean water.
Often, improper fecal disposal leads to contamination of groundwater. This can lead to

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widespread infection among a population, especially in the absence of water filtration or
purification. Human feces contain a variety of potentially harmful human pathogens
(Brown et al., 2013).
c) Nutrition - Proper nutrition is important for health and functioning, including the
prevention of infectious diarrhea. It is especially important to young children who do not
have a fully developed immune system (Black and Sazawal, 2001). Zinc deficiency, a
condition often found in children in developing countries can, even in mild cases
(Shankar and Prasad, 1998), have a significant impact on the development and proper
functioning of the human immune system. indeed, this relationship between zinc
deficiency and reduced immune functioning corresponds with an increased severity of
infectious diarrhea (Bahl et al., 1998). Children who have lowered levels of zinc have a
greater number of instances of diarrhea, severe diarrhea, and diarrhea associated with
fever. Similarly, vitamin A deficiency can cause an increase in the severity of diarrheal
episodes. However, there is some discrepancy when it comes to the impact of vitamin A
deficiency on the rate of disease. While some argue that a relationship does not exist
between the rate of disease and vitamin A status (Rice and Amy, 1998), others suggest an
increase in the rate associated with deficiency. Given that estimates suggest 127 million
preschool children worldwide are vitamin A deficient, this population has the potential
for increased risk of disease contraction (West, 2002).
Prevention
I) Sanitation - Numerous studies have shown that improvements in drinking water and
sanitation (WASH) lead to decreased risks of diarrhoea. Such improvements might
include for example use of water filters, provision of high-quality piped water and
sewer connections (Wolf , 2014).

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In institutions, communities, and households, interventions that promote hand
washing with soap lead to significant reductions in the incidence of diarrhea. The
same applies to preventing open defecation at a community-wide level and providing
access to improved sanitation (Ejemot et al., 2008). This includes use of toilets and
implementation of the entire sanitation chain connected to the toilets (collection,
transport, disposal or reuse of human excreta).
II) Hand washing - Basic sanitation techniques can have a profound effect on the
transmission of diarrheal disease. The implementation of hand washing using soap
and water, for example, has been experimentally shown to reduce the incidence of
disease by approximately 42–48% (Curtis and Cairncross, 2003). "Hand washing is
integral to disease prevention in all parts of the world (Cairncross et al., 2010);
however, access to soap and water is limited in a number of less developed countries”
This lack of access is one of many challenges to proper hygiene in less developed
countries." Solutions to this barrier require the implementation of educational
programs that encourage sanitary behaviors”.
III) Water - Given that water contamination is a major means of transmitting diarrheal
disease, efforts to provide clean water supply and improved sanitation have the
potential to dramatically cut the rate of disease incidence (Brown et al., 2013). In fact,
it has been proposed that we might expect an 88% reduction in child mortality
resulting from diarrheal disease as a result of improved water sanitation and hygiene
(Shaankar and Prasad , 1998). Similarly, a meta-analysis of numerous studies on

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improving water supply and sanitation shows a 22–27% reduction in disease
incidence, and a 21–30% reduction in mortality rate associated with diarrheal disease.
Chlorine treatment of water, for example, has been shown to reduce both the risk of
diarrheal disease, and of contamination of stored water with diarrheal pathogens
(Arnold and Colford, 2007).
IV) Vaccination - Immunization against the pathogens that cause diarrheal disease is a
viable prevention strategy, however it does require targeting certain pathogens for
vaccination. In the case of Rotavirus, which was responsible for around 6% of
diarrheal episodes and 20% of diarrheal disease deaths in the children of developing
countries, use of a Rotavirus vaccine in trials in 1985 yielded a slight (2-3%) decrease
in total diarrheal disease incidence, while reducing overall mortality by 6-10%.
Similarly, a Cholera vaccine showed a strong reduction in morbidity and mortality,
though the overall impact of vaccination was minimal as Cholera is not one of the
major causative pathogens of diarrheal disease. Since this time, more effective
vaccines have been developed that have the potential to save many thousands of lives
in developing nations, while reducing the overall cost of treatment, and the costs to
society (Rheingans et al., 2009).
A rotavirus vaccine decrease the rates of diarrhea in a population. New vaccines
against rotavirus, Shigella, Enterotoxigenic Escherichia coli (ETEC), and cholera are
under development, as well as other causes of infectious diarrhea.
V) Nutrition - Dietary deficiencies in developing countries can be combated by
promoting better eating practices (Black, 2003). Supplementation with vitamin A
and/or zinc (Bhutta et al., 1999). Zinc supplementation proved successful showing a
significant decrease in the incidence of diarrheal disease compared to a control group
(Wilson et al., 2011). The majority of the literature suggests that vitamin A
supplementation is advantageous in reducing disease incidence. Development of a

24
supplementation strategy should take into consideration the fact that vitamin A
supplementation was less effective in reducing diarrhea incidence when compared to
vitamin A and zinc supplementation, and that the latter strategy was estimated to be
significantly more cost effective (Chhagan et al., 2013).
VI) Breastfeeding - Breastfeeding practices have been shown to have a dramatic effect
on the incidence of diarrheal disease in poor populations. Studies across a number of
developing nations have shown that those who receive exclusive breastfeeding during
their first 6 months of life are better protected against infection with diarrheal
diseases. Exclusive breastfeeding is currently recommended during, at least, the first
six months of an infant's life by the WHO (Sguassero, 2013).
Other means of preventing diarrhea is through the use of Probiotics, Probiotics decrease the risk
of diarrhea in those taking antibiotics.
Treatment or Management
In many cases of diarrhea, replacing lost fluid and salts is the only treatment
needed. This is usually by mouth – oral rehydration therapy – or, in severe cases, intravenously
(Within or by means of a vein) Research does not support the limiting of milk to children as doing
so has no effect on duration of diarrhea. To the contrary (King et al., 2003), WHO recommends
that children with diarrhea continue to eat as sufficient nutrients are usually still absorbed to
support continued growth and weight gain, and that continuing to eat also speeds up recovery of
normal intestinal functioning.

25
Medications such as loperamide (Imodium) and bismuth subsalicylate may be beneficial; however
they may be contraindicated in certain situations (Schiller, 2007).
Treatment measures are as follows :
a) Fluids - Oral rehydration solution (ORS) slightly sweetened and salty water) can be used
to prevent dehydration. Standard home solutions such as salted rice water, salted yogurt
drinks, vegetable and chicken soups with salt can be given. Home solutions such as water
in which cereal has been cooked, unsalted soup, green coconut water, weak tea
(unsweetened), and unsweetened fresh fruit juices can have from half a teaspoon to full
teaspoon of salt (from one-and-a-half to three grams) added per liter. Clean plain water
can also be one of several fluids given. There are commercial solutions such as Pedialyte,
and relief agencies such as UNICEF widely distribute packets of salts and sugar. A WHO
publication for physicians recommends a homemade ORS consisting of one liter water
with one teaspoon salt (3 grams) and two tablespoons sugar (18 grams) added
(approximately the "taste of tears"). Rehydration Project recommends adding the same
amount of sugar but only one-half a teaspoon of salt, stating that this more dilute
approach is less risky with very little loss of effectiveness. Both agree that drinks with too
much sugar or salt can make dehydration worse (Webb and Starr , 2005).
Appropriate amounts of supplemental zinc and potassium should be added if available. But the
availability of these should not delay rehydration. As WHO points out, the most important thing
is to begin preventing dehydration as early as possible. In another example of prompt ORS
hopefully preventing dehydration.

26
Picture showing a person consuming oral rehydration solution.
Source: http://rehydrate.org/
Vomiting often occurs during the first hour or two of treatment with ORS, especially if a child
drinks the solution too quickly, but this seldom prevents successful rehydration since most of the
fluid is still absorbed. WHO recommends that if a child vomits, to wait five or ten minutes and
then start to give the solution again more slowly.
Drinks especially high in simple sugars, such as soft drinks and fruit juices, are not
recommended in children under 5 years of age as they may increase dehydration. A too rich
solution in the gut draws water from the rest of the body, just as if the person were to drink sea
water. Plain water may be used if more specific and effective ORT preparations are unavailable
or are not palatable.68
Additionally, a mix of both plain water and drinks perhaps too rich in sugar
and salt can alternatively be given to the same person, with the goal of providing a medium
amount of sodium overall. A nasogastric tube can be used in young children to administer fluids
if warranted.
b) Eating - WHO recommends a child with diarrhea continue to be fed. Continued feeding
speeds the recovery of normal intestinal function. In contrast, children whose food is
restricted have diarrhea of longer duration and recover intestinal function more slowly. A
child should also continue to be breastfed. The WHO states "Food should never be

27
withheld and the child's usual foods should not be diluted. Breastfeeding should always
be continued." And in the specific example of cholera, CDC also makes the same
recommendation. In young children who are not breast-fed and live in the developed
world, a lactose-free diet may be useful to speed recovery (MacGillivray et al., 2013).
c) Medications - While antibiotics are beneficial in certain types of acute diarrhea, they are
usually not used except in specific situations (Dryden et al., 1996). There are concerns
that antibiotics may increase the risk of hemolytic uremic syndrome(excess nitrogenous
waste products in the urine) in people infected with Escherichia coli O157:H7(de Bruyn,
2008). In resource-poor countries, treatment with antibiotics may be beneficial. However,
some bacteria are developing antibiotic resistance, particularly Shigella (DuPont et al.,
2009). Antibiotics can also cause diarrhea, and antibiotic-associated diarrhea is the most
common adverse effect of treatment with general antibiotics. While bismuth compounds
(Pepto-Bismol) decreased the number of bowel movements in those with travelers'
diarrhea, they do not decrease the length of illness. Anti-motility agents like loperamide
are also effective at reducing the number of stools but not the duration of disease. These
agents should only be used if bloody diarrhea is not present (Pawlowski et al., 2009).
d) Alternative therapies - Zinc supplementation benefits children with diarrhea in
developing countries, but only in infants over six months old (Lazerini and
Ronfani,2013). This supports the World Health Organization guidelines for zinc, but not
in the very young (Allen et al., 2010).
Probiotics reduce the duration of symptoms by one day and reduced the chances of symptoms
lasting longer than four days by 60%. The probiotic lactobacillus can help prevent antibiotic-
associated diarrhea in adults but possibly not children (Kale-Pradhan et al., 2010).

28
GASTRITIS
Gastritis is inflammation of the lining of the stomach. It may occur as a short episode or may be
of a long duration. There may be no symptoms but, when symptoms are present, the most
common is upper abdominal pain. Other possible symptoms include nausea and vomiting,
bloating, loss of appetite and heartburn. Complications may include bleeding, stomach ulcers,
and tumors. When due to autoimmune problems, low red blood cells due to not enough vitamin
B12 may occur, a condition known as pernicious anemia.
Common causes include infection with Helicobacter pylori and use of NSAIDs.
Less common causes include alcohol, smoking, cocaine, severe illness, and autoimmune
problems, among others. During an acute attack drinking viscous lidocaine may help. If gastritis
is due to NSAIDs these may be stopped. If H. pylori is present it may be treated with a
combination of antibiotics such as amoxicillin and clarithromycin.1
For those with pernicious
anemia, vitamin B12 supplements are recommended either by mouth or by injection. People are
usually advised to avoid foods that bother them.
(A micrograph showing gastritis)

29
Epidemiology
Gastritis is believed to affect about half of people worldwide. In 2013 there were approximately
90 million new cases of the condition. As people get older the disease becomes more common.
It, along with a similar condition in the first part of the intestines known as duodenitis, resulted
in 60,000 deaths in 2013. H. pylori was first discovered in 1981 by Barry Marshall and Robin
Warren.10
Gastritis affects all age groups , the incidence of Helicobacter pylori increases with
age.
Signs and symptoms
Many people with gastritis experience no symptoms at all. However, upper central abdominal
pain is the most common symptom; the pain may be dull, vague, burning, aching, gnawing, sore,
or sharp. Pain is usually located in the upper central portion of the abdomen, but it may occur
anywhere from the upper left portion of the abdomen around to the back.
Other signs and symptoms may include the following:
 Nausea
 Vomiting (if present, may be clear, green or yellow, blood-streaked, or completely
bloody, depending on the severity of the stomach inflammation)
 Belching (if present, usually does not relieve the pain much)
 Bloating
 Early satiety
 Loss of appetite
 Unexplained weight loss

30
Causes of gastritis disease
Common causes include Helicobacter pylori and NSAIDs. Less common causes include alcohol,
cocaine, severe illness and Crohn disease(Crohn was an United States physician who specialized
in diseases of the intestines; he was the first to describe regional ileitis which is now known as
Crohn's disease (1884-1983), among others:
a) Helicobacter pylori - Helicobacter pylori colonizes the stomachs of more than half of the
world's population, and the infection continues to play a key role in the pathogenesis of a
number of gastro duodenal diseases. Colonization of the gastric mucosa with
Helicobacter pylori results in the development of chronic gastritis in infected individuals,
and in a subset of patient’s chronic gastritis progresses to complications (e.g., ulcer
disease, gastric neoplasias, and some distinct extragastric disorders). However, over 80
percent of individuals infected with the bacterium are asymptomatic and it has been
postulated that it may play an important role in the natural stomach ecology.
b) Critical illness - Gastritis may also develop after major surgery or traumatic injury
("Cushing ulcer"), burns ("Curling ulcer"), or severe infections. Gastritis may also occur
in those who have had weight loss surgery resulting in the banding or reconstruction of
the digestive tract.
c) Diet - Evidence does not support a role for specific foods including spicy foods and
coffee in the development of peptic ulcers. People are usually advised to avoid foods that
bother them.
Diagnosis
Often, a diagnosis can be made based on the patient's description of their symptoms, but other
methods which may be used to verify gastritis include:

31
 Blood tests:
o Blood cell count
o Presence of H. pylori
o Liver, kidney, gallbladder, or pancreas functions
 Urinalysis
 Stool sample, to look for blood in the stool
 X-rays
 ECGs(A graphical recording of the cardiac cycle produced by an electrocardiograph)
 Endoscopy, to check for stomach lining inflammation and mucous erosion
 Stomach biopsy, to test for gastritis and other conditions21
Treatment
Antacids are a common treatment for mild to medium gastritis. When antacids do not provide
enough relief, medications such as proton pump inhibitors that help reduce the amount of acid
are often prescribed.
Cytoprotective agents are designed to help protect the tissues that line the stomach and small
intestine. They include the medications sucralfate and misoprostol. If NSAIDs are being taken
regularly, one of these medications to protect the stomach may also be taken. Another
Cytoprotective agent is bismuth subsalicylate.
Several regimens are used to treat H. pylori infection. Most use a combination of two antibiotics
and a proton pump inhibitor. Sometimes bismuth is also added to the regimen(medicine) a
systematic plan for therapy (often including diet).

32
GASTRIC CANCER
Stomach cancer, also known as gastric cancer, is cancer developing from the lining of the
stomach. Early symptoms may include heartburn, upper abdominal pain, nausea and loss of
appetite. Later signs and symptoms may include weight loss, yellowing of the skin and whites of
the eyes, vomiting, difficulty swallowing, and blood in the stool among others. The cancer may
spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of
the abdomen and lymph nodes. The most common cause is infection by the bacterium
Helicobacter pylori, which accounts for more than 60% of cases. Certain types of H. pylori have
greater risks than others. Other common causes include eating pickled vegetables and smoking.
About 10% of cases run in families and between 1% and 3% of cases are due to genetic
syndromes inherited from a person's parents.
Most of the time, stomach cancer develops in stages over years .Diagnosis is usually by biopsy
done during endoscopy. This is followed by medical imaging to determine if the disease has
spread to other parts of the body.
A Mediterranean diet lowers the risk of cancer as does the stopping of smoking. There is
tentative evidence that treating H. pylori decreases the future risk. If cancer is treated early, many
cases can be cured. Treatments may include some combination of surgery, chemotherapy,
radiation therapy, and targeted therapy. If treated late, palliative care may be advised. Outcomes
are often poor with a less than 10% 5-year survival rate globally.

33
(A stomach ulcer that was diagnosed as cancer on
biopsy and surgically removed.)
Epidemiology
Worldwide, stomach cancer is the fifth most common cancer with 952,000 cases diagnosed in
2012. It is more common in men and in developing countries. In 2012, it represented 8.5% of
cancer cases in men, making it the fourth most common cancer in men. In 2012 number of
deaths were 700,000 having decreased slightly from 774,000 in 1990 making it the third leading
cause of cancer death after lung cancer and liver cancer.
Less than 5% of stomach cancers occur in people under 40 years of age with 81.1% of that 5% in
the age-group of 30 to 39 and 18.9% in the age-group of 20 to 29.
In 2014, stomach cancer accounted for 0.61% of deaths (13,303 cases) in the United States.In
China, stomach cancer accounted for 3.56% of all deaths (324,439 cases).The highest rate of
stomach cancer was in Mongolia, at 28 cases per 100,000 people.
In the United Kingdom, stomach cancer is the fifteenth most common cancer (around 7,100
people were diagnosed with stomach cancer in 2011), and it is the tenth most common cause of
cancer death (around 4,800 people died in 2012). Although this bacteria is found in Africa,
evidence has supported that different strains with mutations in the bacterial genotype may

34
contribute to the difference in cancer development between African countries and others outside
of the continent.
Signs and symptoms
Stomach cancer is often either asymptomatic (producing no noticeable symptoms) or it may
cause only nonspecific symptoms (symptoms that are specific to stomach cancer and to other
related or unrelated disorders) in its early stages. By the time symptoms occur, the cancer has
often reached an advanced stage and may have metastasized (spread to other, perhaps distant,
parts of the body), which is one of the main reasons for its relatively poor prognosis. Stomach
cancer can cause the following signs and symptoms:
Early cancers may be associated with indigestion or a burning sensation (heartburn). However,
less than 1 in every 50 people referred for endoscopy due to indigestion has cancer. Abdominal
discomfort and loss of appetite, especially for meat, can occur.
Gastric cancers that have enlarged and invaded normal tissue can cause weakness, fatigue,
bloating of the stomach after meals, abdominal pain in the upper abdomen, nausea and
occasional vomiting, diarrhea or constipation. Further enlargement may cause weight loss or
bleeding with vomiting blood or having blood in the stool,

35
(Endoscopic image of linitis plastica ,a type of stomach
cancer where the entire stomach is invaded ,leading to a leather bottle like appearance with
blood coming out of it)
Causes of gastric cancer
Gastric cancer occurs as a result of many factors. It occurs twice as common in males as females.
Estrogen may protect women against the development of this cancer form. The causes may include :
a) Infection - Helicobacter pylori infection is an essential risk factor in 65–80% of gastric
cancers, but only 2% of people with Helicobacter infections develop stomach cancer. The
mechanism by which H. pylori induces stomach cancer potentially involves chronic
inflammation, Other factors associated with increased risk are AIDS.
b) Smoking - Smoking increases the risk of developing gastric cancer significantly, from
40% increased risk for current smokers to 82% increase for heavy smokers. Gastric
cancers due to smoking mostly occur in the upper part of the stomach near the esophagus.
Some studies show increased risk with alcohol consumption as well.
c) Diet - Dietary factors are not proven causes, but some foods including smoked foods,salt
and salt-rich foods, red meat, processed meat, pickled vegetables, and bracken are
associated with a higher risk of stomach cancer. Nitrates and nitrites in cured meats can
be converted by certain bacteria, including H. pylori, into compounds that have been
found to cause stomach cancer in animals.

36
Fresh fruit and vegetable intake, citrus fruit intake, and antioxidant intake are associated with a
lower risk of stomach cancer. A Mediterranean diet is associated with lower rates of stomach
cancer.
d) Genetics - About 10% of cases run in families and between 1% and 3% of cases are due
to genetic syndromes inherited from a person's parents When the gene experiences a
particular mutation, gastric cancer develops through a mechanism that is not fully
understood.
This mutation is considered autosomal dominant meaning that half of a
carrier’s children will likely experience the same mutation. Diagnosis of hereditary
diffuse gastric cancer usually takes place when at least two cases involving a family
member, such as a parent or grandparent, are diagnosed, with at least one diagnosed
before the age of 50. The diagnosis can also be made if there are at least three cases in the
family, in which case age is not considered. The International Cancer Genome
Consortium is leading efforts to identify genomic changes involved in stomach cancer. A
very small percentage of diffuse-type gastric cancers. Genetic testing and treatment
options are available for families at risk.
Other causes may include diabetes,pernicious anemia and intestinal metaplasia(abnormal change
of body tissue )
Diagnosis
To find the cause of symptoms, the doctor asks about the patient's medical history, does a
physical exam, and may order laboratory studies. The patient may also have one or all of the
following exams:
 Gastroscopic exam is the diagnostic method of choice. This involves insertion of a fibre optic
camera into the stomach to visualize it.

37
 Upper GI series (may be called barium roentgenogram-(A radiogram made by exposing
photographic film to X rays; used in medical diagnosis)
Prevention
Getting rid of H. pylori in those who are infected decreases the risk of stomach cancer, Low
doses of vitamins, especially from a healthy diet, decrease the risk of stomach cancer. A previous
review of antioxidant supplementation did not find supporting evidence and possibly worse
outcomes. A 2014 meta-analysis of observational studies found that a diet high in fruits,
mushrooms, garlic, soybeans, and green onions was associated with a lower risk of stomach
cancer.
Management
Cancer of the stomach is difficult to cure unless it is found at an early stage (before it has begun
to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is
usually advanced when the diagnosis is made. Treatment for stomach cancer may include
surgery, chemotherapy, and/or radiation therapy .New treatment approaches such as biological
therapy and improved ways of using current methods are being studied in clinical trials.
 Surgery - Surgery remains the only curative therapy for stomach cancer.Of the different
surgical techniques, endoscopic mucosal resection (EMR) is a treatment for early gastric
cancer (tumor only involves the mucosa) that was pioneered in Japan and is available in
the United States at some centers. In this procedure, the tumor, together with the inner
lining of stomach (mucosa), is removed from the wall of the stomach using an electrical
wire loop through the endoscope. The advantage is that it is a much smaller operation
than removing the stomach. Endoscopic submucosal dissection (ESD) is a similar
technique pioneered in Japan, used to resect a large area of mucosa in one piece .If the

38
pathologic examination of the resected specimen shows incomplete resection or deep
invasion by tumor, the patient would need a formal stomach resection.
 Chemotherapy -The use of chemotherapy to treat stomach cancer has no firmly
established standard of care. Unfortunately, stomach cancer has not been particularly
sensitive to these drugs, and chemotherapy, if used, has usually served to palliatively
reduce the size of the tumor, relieve symptoms of the disease and increase survival time.
The relative benefits of these different drugs, alone and in combination, are
unclear.Clinical researchers have explored the benefits of giving chemotherapy before
surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining
cancer cells.
 Radiation - Radiation therapy (also called radiotherapy) may be used to treat stomach
cancer, often as an adjuvant to chemotherapy and/or surgery.
CONCLUSION
Gastrointestinal pathogens are transmitted by the fecal – oral route. They may invade the gut,
causing systemic diseases(e.g. diarrhea )or multiply and produce locally acting toxins and

39
damage only the gastrointestinal tract. The length and complexity of the gastrointestinal tract is
matched by the variety of the microorganisms that can be acquired by this route ,causing damage
locally or invading to cause disseminated disease.
Dehydration is the main danger of gastrointestinal infections ,so rehydration is important,
but most gastrointestinal infections are self limited and resolved within few days . However ,In a
healthcare setting and in specific populations(newborns/infants, immunocompromized patients
or elderly populations)they are potentially serious . gastrointestinal disease is a major cause of
morbidity and mortality in malnourished populations in the developing world and will only be
combated successfully when there are adequate public health measures. Meanwhile in the
developed world ,diarrheal disease is still common and causes severe illness in the very young
and old.
SUMMARY
Gastrointestinal infections are viral , bacterial or parasitic infections that cause gastrointestinal
,an inflammation of the gastrointestinal tract involving both the stomach and the small intestine
symptoms include diarrhea ,vomiting and abdominal pain.Major causes of gastrointestinal tract
infections include organisms which are Helicobacter pylori ,campylobacter ,salmonellae,
Shigellae ,Escherichia coli(Norovirus ,Adenovirus ,Astroviruses and Rotavirus may occur in the
case of Diarrhea ) ,The use of Non-steroidal anti-inflammatory drugs (NSAIDS) is also a major
cause of G.I tract diseases, while minor causes include stress, diet and others. The report has
talked about some of the gastrointestinal tract infections or disease which are peptic ulcer, gastric
cancer gastritis and diarrhea, in which rapid diagnosis, appropriate treatment and infection
control measures are therefore looked on.

40
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