GASTROENTERITIS
Also see Food poisoning
Definition:
Inflammation of the mucosal lining of the digestive tract; a generic term describing a group of clinical
syndromes characterized by upper GI tract symptoms (anorexia, nausea, vomiting, diarrhea and abdominal
pain)
Etiology:
1.
2.
3.
4.
5.
bacterial exotoxins
diarrhea from mucosal invasion or ulceration (Shigella, Salmonella, E. coli cause microscopic bleeding and secretion
of electrolytes and water)
viral infections
non-bacterial food poisoning
food intolerances (ie. lactose)
Signs and Symptoms:
Depends on the nature and dose of irritant, duration of its action, susceptibility/resistance of the patient and
extent of GI involvement; often sudden dramatic onset and may include any of the following:
1. anorexia
2. vomiting
3. nausea
4. borborygmi
5. abdominal cramps
6. diarrhea
7. malaise
8. muscular aches
9. reduced BP (sometimes)
10. rapid pulse
11. elevated temperature
12. eosinophilia (parasitic infection or allergies)
Lab Findings:
1. consider CBC, electrolytes, UA if prolonged to assess electrolyte and water balance and check for occult bleeding
2. rectal swab or stool culture to differentiate if severe
Course/Prognosis:
1. loss of electrolytes through diarrhea may cause complications
2. if diarrhea and vomiting persist, dehydration, shock, vascular collapse and oliguric renal failure may occur
3. with vomiting prominent, alkalosis with hypochloremia may occur
4. with diarrhea prominent, acidosis is more likely to occur
5. *although gastroenteritis may have a wide range of causes, treatment of fluid and electrolyte loss from diarrhea and
vomiting is the most important factor in management
6. fatality is uncommon where hydration and electrolytes have been maintained, as these illnesses are typically
self-limiting
7. further investigation is essential if gastroenteritis persists for more than a few days
Differential Diagnosis:
1. Cholera
2. Salmonellosis
3. Shigella
4. food poisoning
5. lactose intolerance
6. heavy metal poisoning
7. paralytic ileus (absence of bowel sounds)
8. UC
9. amebic dysentery
10. acute (surgical) abdomen
11. acute appendicitis
12. incomplete small bowel obstruction
13. colonic malignancy
14. Candidiasis
Nutrition:
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GASTROENTERITIS
Also see Food poisoning
1.
short fast recommended or follow the sample diet for acute phase (below)
Sample Diet:
Acute phase:
1. breakfast: whole brown rice cereal (cook 3-4 Tbsp. Rice flour with 2 cups water, stirring constantly over
heat), 2 tsp. olive oil
2. morning snack: raw grated apple or applesauce or baked apples (sour or semi-sour only)
3. lunch: vegetable soup from celery, parsley, zucchini, squash, pumpkin, carrot, potatoes (blend and strain),
steamed carrots and squash, rice or millet or barley or potato, 2 tsp. olive oil
4. afternoon snack: same as morning
5. dinner: same as lunch
As improvement occurs:
1. breakfast: oatmeal 3x/week; add soft boiled egg during one meal 3x/week
2. snacks: add almonds (raw and blanched) with apples
3. lunch and dinner: if no intolerance to dairy add yogurt (preferably goat), green beans, waxed beans,
lettuce, cucumber, green onion, parsley, celery, garlic, lentils, peaches, apricots, watermelon, grapefruit,
grapes, ripe bananas, goat whey
2.
3.
After stabilization (vegetarian sample diet):
1. cruciferous vegetables to be eaten only with carminatives (fennel, caraway, cumin, anise, dill)
2. be careful with food combinations; esp. avoid starch, sugar, protein combinations (ie. cheesecake)
3. avoid eating too many types of foods at one time
4. stick to one starch type per meal
5. eat more steamed vegetables than raw one
6. all foods must be eaten slowly, chewed and salivated well
a short fast (3-5 days) is recommended or an alkaline juice fast
potato broth, carrots (cooked), okra, parsnips (steamed and mashed), squash, pumpkin, figs and flaxseed tea,
steamed zucchini and squash, papaya, grated raw apple, applesauce, ripe peaches without skin, banana (not in Cold
conditions), rice polishings
Remedies:
a.
crush 6g garlic and discard skins, add an appropriate amount of salt and crush together, pour boiling
water over mixture and steep, drink BID
Avoid:
1.
2.
3.
4.
5.
6.
contraindications: artichoke, grape skins and seeds, roughage in general, raw foods, cold foods
meat, peanuts, corn, soybeans, most legumes, oranges
sugar and sweet foods
refined and processed foods
spicy, fried, fatty, rich and/or salty foods
alcohol, coffee, caffeine
Supplements:
For fever:
1. vitamin A (100,000 IU QD) TOXIC DOSE
2. vitamin C (3-6g QD)
3. zinc (60mg QD)
4. flaxseed oil (2 Tbsp. QD)
Hydrotherapy:
1. Scotch bath
2. heat on abdomen; before meals
3. hot fomentations to abdomen
4. heating pack to trunk
5. constitutional hydrotherapy
Physiotherapy:
1. relaxation breathing
Botanicals:
1.
2.
3.
4.
5.
Aconitum napellus (toxic): acute inflammation according to indications
Alchemilla vulgaris: acute diarrhea, epidemic diarrhea of infants; may be combined with Agrimonia eupatoria
Atropa belladonna (toxic): as anti-mobility agent, anti-spasmodic, according to indications, may cause urinary
retention
Bentonite clay: absorbent
Berberis aquifolium: bacterial infections of GI tract
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GASTROENTERITIS
Also see Food poisoning
6.
7.
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Bryonia alba (toxic): opposes drying; acute inflammatory distress and pain, < from movement, pressure
Chamomilla spp.: anti-spasmodic, anti-inflammatory
Charcoal: absorbent
Collinsonia canadensis: irritated mucous membranes with congested portal circulation, spasmodic pain, anorexia,
diarrhea
Echinacea spp.
Mentha piperita: herb or enteric coated caps; anti-spasmodic, anti-emetic, carminative
Mentha viride: anti-emetic
Olea europaea: acute enteritis
Opium (tincture): as anti-motility agent
Rubus villosa (root): astringent, watery diarrhea, sore throat
Rumex crispus: laxative
Ulmus fulva: inflammation of stomach, duodenum, diarrhea, irritation from foods; combines well with Althea
officinalis
Valeriana spp.: anti-spasmodic
Viburnum opulus: anti-spasmodic
Zingiber officinale: anti-emetic
Formulas:
a.
b.
c.
d.
e.
Robert’s formula: Althea officinalis, Geranium maculatum, Echinacea angustifolia (root), Hydrastis
canadensis, Hibiscus esculentus, Ulmus fulva, Phytolacca americana (toxic); SIG: ¼ - ½ tsp. every 2
hours for acute
diarrhea with severe cramping: tinctures of Opium (camphorated)[2 dr], Citrullis colocynthis (colocynth)[5
drops], Dioscorea villosa [10 drops], fill with water to 1 oz.; SIG: 40 drops every hour till effect
irritant diarrhea: Aconitum napellus (toxic)[2 drops], Cephaelis ipecacuanha [5 drops], fill with water to 1
oz.; SIG: ½ tsp. every hour till effect, then every 3 hours
gastroenteritis with flatulence: Carum carve (caraway seed)[10g], Foeniculum vulgare [10g], Chamomilla
spp (flowers)[80g]; SIG: 2 tsp. to 1 cup boiling water, infuse, 2 cups of tea several times daily
gastroenteritis with poor gallbladder function: Carum carvi (caraway seed)[10g], Foeniculum vulgare
[10g], Mentha piperita (leaf)[30g], Chamomilla spp. (flowers)[50g]; SIG: 2 tsp. to 1 cup of boiling water,
infuse, 2 cups of tea several times daily
Homeopathy:
1. Arsenicum album: N/V and diarrhea caused by spoiled food, esp. bad meat or watery fruit; cannot bear sight of
food; great prostration; < about midnight; diarrhea following severe burns or when caused by sudden chilling of
stomach with ice water or ice cream; excess of alcoholic drinks, lobster salad, rancid fat, spoiled butter
2. Antimonium tartaricum: vomiting in any position, except lying on right side; nausea, retching and vomiting, esp.
after food, with deathly faintness and prostration; thirsty for cold water little and after diarrhea in eruptive diseases
3. Belladonna: pressive pains extending to the chest and shoulders; swelling of the pit of the stomach; abdomen
distended below navel; painful breathing; anguish with congestion to the head and dimness of vision; faintness;
great thirst; restlessness; sleeplessness
4. Bryonia: when weather suddenly changes from cold to warm or from warm to cold; in the summer, after eating
fruits or after vexation/anger; severe pains and high fever from a drink of cold water when perspiring; every motion
aggravates the pain and diarrhea; pains shooting from abdomen into chest
5. Hyoscyamus: stupor with incoherent speech; patient is unconscious of the severity of his case; yellow, watery,
involuntary stools; abdomen bloated; burning and inflammation of stomach with vomiting of blood; pit of stomach
sensitive
6. Ipecacuanha: constant N/V; with pale twitching of face, vomits food, bile, blood, mucous; severe pains in abdomen,
radiating to all sides; swelling of stomach; flatulent; clutching colic; diarrhea with pain; constant N/V, little thirst;
tongue usually clean
7. Phosphorus: cutting, burning pains in the stomach; severe pressure in the stomach after eating with vomiting food;
unquenchable thirst; a weak, empty gone sensation in the whole abdomen cavity
8. Veratrum: copious vomiting with nausea; < drinking, least motion; great weakness after vomiting; alternating
vomiting and diarrhea; great prostration; Hippocratic face; cold feeling in stomach and abdomen; cold sweat; cold
extremities; pinched face; violent thirst; painful retraction of abdomen during vomiting; also burning as form hot
coals in abdomen which is very sensitive; intestinal catarrh, coming on suddenly at night, in summer; stools watery,
greenish mixed with flakes
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