E. coli enteritis
Traveler's diarrhea - E. coli; Food poisoning - E. coli; E. coli diarrhea; Hamburger disease
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.
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Steps for proper handwashing include: 1. Take off any jewelry. 2. Wet your hands with clean water. 3. Apply soap and lather your hands by rubbing them together for at least 20 seconds. 4. Make sure you also lather the back of the hands, between the fingers, the thumb, and under the nails. Rinse well. 5. Dry with a clean towel or air dry. Proper handwashing is the best way to avoid spreading germs to help prevent infection.
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 their hands after a bowel movement and then touches other objects or someone else's hands.
If you have stomach cramps, diarrhea, fever, or nausea a few hours after eating something, chances are you may have food poisoning. Let's talk about food poisoning. Food poisoning happens when you eat food or drink water that's been contaminated with bacteria, parasites, viruses, or toxins. Most cases of food poisoning are due to common bacteria, such as Staphylococcus or E. coli. Bacteria may get into your food in different ways. Meat or poultry may come into contact with intestinal bacteria when it gets processed. Water that's used during growing or shipping may contain animal or human waste. Food poisoning may also occur when people handle your food without washing their hands properly, when food is prepared using unclean cooking utensils or cutting boards, when perishable foods are left out of the refrigerator for too long, and when people eat raw foods like fish or oysters or undercooked meats or eggs. Untreated water can also cause food poisoning. So, what do you do about food poisoning? Well, fortunately, you'll usually recover from the most common types of food poisoning within 12 to 48 hours. Your goal should be to make sure that your body gets enough fluids so that you don't become dehydrated. Don't eat solid foods until diarrhea has passed, and avoid dairy products. Drink any fluid (except milk and caffeinated beverages) to replace fluids in your body. If you have eaten toxins from mushrooms or shellfish, seek medical attention right away. The emergency room doctor will then empty out your stomach and remove the toxin. Most people will recover from the most common types of food poisoning pretty quickly. However, if food poisoning leads to dehydration because you can't keep anything down, you should seek immediate medical attention.
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
- Kidney failure
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:
- Manage the diarrhea
- Control nausea and vomiting
- Get plenty of rest
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 one half teaspoon (3 grams) of salt, one half teaspoon (2.5 grams) of baking soda and 4 tablespoons (50 grams) of sugar in 4¼ 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 provider's office or the emergency room.
If you take diuretics (water pills), talk to your provider. You may need to stop taking the diuretic while you have diarrhea. Never stop or change medicines without first talking to your provider. You can buy medicines at the drugstore that can help stop or slow diarrhea. Do not use these medicines without talking to your 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
Contact your provider for an appointment 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 (38.3°C), or your child has a fever above 100.4°F (38°C) 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 lightheadedness.
- You develop new symptoms.
Prevention
References
Nguyen T, Akhtar S. Gastroenteritis. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 84.
Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 16.
Wong KK, Griffin PM. Foodborne disease. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 101.
Version Info
Last reviewed on: 10/26/2021
Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
