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E. coli enteritis

E. coli enteritis is swelling (inflammation) of the small intestine from Escherichia coli (E. coli) bacteria. It is the most common cause of travelers' diarrhea.

Alternative Names

Traveler's diarrhea - E. coli; Food poisoning - E. coli; E. coli diarrhea; Hamburger disease

Causes

E. coli is a type of bacteria that lives in the intestines of humans and animals. Most of the time, it does not cause any problems. However, certain types (or strains) of E. coli can cause food poisoning. One strain (E. coli O157:H7) can cause a severe case of food poisoning.

Bacteria may get into your food in different ways:

  • Meat or poultry may come into contact with normal bacteria from the intestines of an animal while it is being processed.
  • Water used during growing or shipping may contain animal or human waste.
  • Food may be handled in an unsafe way during transport or storage.
  • Unsafe food handling or preparation may occur in grocery stores, restaurants, or homes.

Food poisoning can occur after eating or drinking:

  • Food prepared by a person who did not wash hands well
  • Food prepared using unclean cooking utensils, cutting boards, or other tools
  • Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long
  • Frozen or refrigerated foods that are not stored at the proper temperature or are not properly reheated
  • Fish or oysters
  • Raw fruits or vegetables that have not been washed well
  • Raw vegetable or fruit juices and dairy products
  • Undercooked meats or eggs
  • Water from a well or stream, or city or town water that has not been treated

Although not common, E. coli can be spread from one person to another. This may happen when someone does not wash his or her hands after a bowel movement and then touches other objects or someone else's hands.

Symptoms

Symptoms occur when E. coli bacteria enter the intestine. Most of the time symptoms develop 24 to 72 hours after being infected. The most common symptom is sudden, severe diarrhea that is often bloody.

Other symptoms may include:

  • Fever
  • Gas
  • Loss of appetite
  • Stomach cramping
  • Vomiting (rare)

Symptoms of a rare but severe E. coli infection include:

  • Bruises that happen easily
  • Pale skin
  • Red or bloody urine
  • Reduced amount of urine

Exams and Tests

Your health care provider will perform a physical exam. A stool culture can be done to check for disease-causing E.coli.

Treatment

Most of the time, you will recover from the most common types of E. coli infection within a couple of days. The goal of treatment is to make you feel better and avoid dehydration. Getting enough fluids and learning what to eat will help keep you or your child comfortable.

You may need to:

You can drink oral rehydration mixtures to replace fluids and minerals lost through vomiting and diarrhea. Oral rehydration powder can be purchased from a pharmacy. Be sure to mix the powder in safe water.

You can make your own rehydration mixture by dissolving ½ teaspoon of salt, ½ teaspoon of baking soda and 4 tablespoons of sugar in 4 ¼ cups (1 liter) of water.

You may need to get fluids through a vein (IV) if you have diarrhea or vomiting and cannot drink or keep enough fluids in your body. You will need to go to your health care provider's office or the emergency room.

If you take diuretics (water pills), talk to your health care provider. You may need to stop taking the diuretic while you have diarrhea. Never stop or change medicines without first talking to your health care provider. You can buy medicines at the drugstore that can help stop or slow diarrhea. Do not use these medicines without talking to your health care provider if you have bloody diarrhea or a fever. Do not give these medicines to children.

Outlook (Prognosis)

Most people will get better in a few days, without treatment. Some uncommon types of E. coli can cause severe anemia or kidney failure.

When to Contact a Medical Professional

Call for an appointment with your health care provider if:

  • You are unable to keep down fluids.
  • Your diarrhea does not get better in 5 days (2 days for an infant or child), or it gets worse.
  • Your child has been vomiting for more than 12 hours (in a newborn under 3 months, call as soon as vomiting or diarrhea begins).
  • You have abdominal pain that does not go away after a bowel movement.
  • You have a fever above 101°F, or your child has a fever above 100.4°F with diarrhea.
  • You have recently traveled to a foreign country and developed diarrhea.
  • You see blood or pus in your stool.
  • You develop symptoms of dehydration, such as not peeing (or dry diapers in a baby), thirst, dizziness, or light-headedness.
  • You develop new symptoms.

References

Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 15.

Sodha SV, Griffin PM, Hughes JM. Foodborne disease. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 99.

Craig SA. Gastroenteritis. In Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 94.

Updated: 2/9/2014

Daniel Levy, MD, PhD, Infectious Diseases, Lutherville Personal Physicians, Lutherville, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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