From the Guidelines
Gastroenteritis can last up to 10-14 days or longer, depending on the causative organism. The duration of symptoms varies by organism, and some patients may experience persistent carriage of certain etiologic agents, such as Salmonella, STEC, and Shigella 1. It is essential to note that the majority of patients with diarrhea will not have a laboratory diagnosis, making laboratory-based specific recommendations less useful.
Key Considerations
- The mode of spread of diarrheal diseases is typically fecal-oral, and patients should be educated on this to prevent further transmission 1.
- Careful hand hygiene is crucial, especially for patients involved in food preparation, child or adult education, or healthcare 1.
- Repeat stool cultures may be required in certain situations to enable return to employment and group social activities, and these requirements may differ by local jurisdiction 1.
Management
- Maintaining hydration through oral rehydration solutions is crucial, and adults should drink at least 2-3 liters of fluids daily while experiencing symptoms.
- Over-the-counter medications like loperamide (Imodium) can help control diarrhea in adults, but should be avoided in children and cases with high fever or bloody diarrhea.
- Bismuth subsalicylate (Pepto-Bismol) may also provide relief, but most cases resolve without antibiotics, as they're ineffective against viral causes and unnecessary for most bacterial cases.
Follow-up
- Regular and consistent follow-up of patients recovering from diarrhea-associated HUS is recommended until laboratory and clinical parameters have returned to normal values 1.
- If clinical symptoms worsen, antibiotic-associated diarrhea (non–C. difficile) should be considered, and stool should be assessed for C. difficile toxin or a toxigenic C. difficile strain (eg, NAAT) 1.
From the Research
Duration of Gastroenteritis
The duration of gastroenteritis can vary depending on several factors, including the cause of the infection and the individual's overall health.
- According to 2, travelers' diarrhea, a common form of gastroenteritis, is usually self-limited, but the exact duration is not specified.
- 3 mentions that subjects treated with bismuth subsalicylate for up to 21 days have improved odds of preventing travelers' diarrhea, but it does not provide a specific duration for the illness.
- 4 compares the efficacy of loperamide hydrochloride and bismuth subsalicylate in managing acute diarrhea, but it only reports on a two-day study period and does not provide information on the typical duration of gastroenteritis.
Treatment and Relief
- 3 suggests that bismuth subsalicylate can be beneficial for those at risk or affected by food and waterborne diarrheal disease, and may decrease the risk of inappropriate antibiotic utilization.
- 4 reports that loperamide significantly reduced the average number of unformed bowel movements and provided faster, more effective relief than bismuth subsalicylate.
- 2 recommends the use of bismuth subsalicylate or loperamide for mild travelers' diarrhea, and antibiotics such as fluoroquinolones, azithromycin, and rifaximin for moderate to severe cases.
- 5 is not relevant to the question of how long gastroenteritis lasts, as it discusses the treatment of Helicobacter pylori infection.