Traveler’s diarrhea - E. coli

Alternative names
E. coli enteritis; Food poisoning - E. coli; E. coli diarrhea; Hamburger disease

Definition
E. coli enteritis is an inflammation of the small intestine caused by Escherichia coli bacteria.

Causes, incidence, and risk factors
E. coli enteritis is a type of bacterial gastroenteritis. The symptoms are a result of toxins or bacterial invasion into the intestine. The incubation period is 24 to 72 hours. In adults, the infection is usually not severe, but in children and infants, the infection frequently requires hospitalization, and in some cases is life-threatening.

Certain types of E. coli infection are associated with hemolytic uremic syndrome, a disease characterized by destruction of the red blood cells, drastic decrease in the platelets, and acute kidney failure.

Risk factors include recent family illness with E. coli, recent family illness with gastroenteritis symptoms, recent travel to an area with unsanitary food services, or drinking untreated or contaminated water.

Symptoms

     
  • diarrhea that is acute and severe, both bloody and nonbloody  
  • stomach cramping  
  • gas  
  • vomiting (although rare)  
  • loss of appetite  
  • abdominal pain  
  • fever

Signs and tests
A stool culture grows disease-causing E. coli, which is tested in the laboratory to distinguish it from the regular “friendly” E. coli in your intestine.

Treatment

Cases usually resolve themselves in 1 to 3 days, and no treatment is required. Antidiarrheal medication may delay the elimination of the organism from the digestive tract, and therefore may not be recommended.

Rehydration with electrolyte solutions may be necessary if dehydration from diarrhea occurs. People with diarrhea (especially in young children) who are unable to take oral fluids because of nausea may need medical attention and intravenous fluids.

People taking diuretics need to be cautious with diarrhea, and may need to stop taking the diuretic during the acute episode, as directed by the health care provider.

Dairy products should be avoided, as they can make the diarrhea worse (due to the temporary lactose intolerance that can arise.)

Expectations (prognosis)
The illness usually runs its course without treatment in a few days.

Complications

     
  • dehydration  
  • prolonged diarrhea  
  • temporary lactose intolerance afterwards

Calling your health care provider
Call for an appointment with your health care provider if you are unable to keep fluids down, if diarrhea does not resolve in 3 to 4 days, or if blood in stools is noted.

Call your health care provider if symptoms of dehydration develop, symptoms worsen or do not improve with treatment, or new symptoms develop.

Prevention
Careful handwashing may be helpful. Do not drink untreated or possibly contaminated food or water. Always cook meats adequately, especially ground meats. Cook meats at high enough temperatures to kill organisms.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.