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Gastrointestinal illnesses
Coeliac disease and gluten intolerance
People with Coeliac disease can't eat foods containing gluten. Find out how it can affect your life and why it’s important to get diagnosed.
Constipation
Constipation is difficulty passing stools. It is very common, affecting both children and adults. Learn how to help prevent and treat constipation.
Crohn's disease
Crohn’s disease is an inflammatory bowel disease that causes painful swelling and redness inside the digestive tract.
Diarrhoea
Diarrhoea may last for only a few days, or may be a sign of something else. Find out here about causes, symptoms, diagnosis and treatments.
Diarrhoea and vomiting in children
Learn more about the causes of diarrhoea and vomiting in children, and use these handy tips to help alleviate the symptoms.
Gastritis
Gastritis occurs when the cells lining the stomach become inflamed, but often it has no symptoms. Find out here about its causes, treatments and more.
Gastroenteritis
Gastroenteritis (gastro) is an infection of the gut that can cause diarrhoea and vomiting. Learn here about the symptoms and how to treat them.
GORD (reflux)
Learn more about symptoms and treatments for gastro-oesophageal reflux disease (GORD), which is caused by stomach acid leaking into the oesophagus.
Irritable bowel syndrome (IBS)
IBS develops in as many as one in five Australians at some point in their lifetime. Here are the symptoms to look out for.
Ulcerative colitis
Ulcerative colitis is a bowel disease that causes inflammation and redness in the digestive tract. There is no cure, but treatment can help.
Vomiting
Vomiting in adults is usually not a sign of anything serious and tends to only last one or two days. Learn the causes and when to seek medical advice.
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Top results
Irritable bowel syndrome (IBS) information video | myVMC
Irritable bowel syndrome is a gastrointestinal condition that causes diarrhoea, bloating and cramping. It is not inflammatory bowel disease.
Read more on myVMC – Virtual Medical Centre website
A guide to irritable bowel syndrome Dietitians Association of Australia
A guide to irritable bowel syndrome Irritable bowel syndrome (IBS) is a condition of the digestive system that may result in a variety of uncomfortable symptoms
Read more on Dietitians Association of Australia website
Top results
Children with dehydration due to gastroenteritis need to be rehydrated, and this review did not show any important differences between giving fluids orally or intravenously | Cochrane
Children with dehydration due to gastroenteritis need to be rehydrated, and this review did not show any important differences between giving fluids orally or intravenously
Read more on Cochrane (Australasian Centre) website
Reduced osmolarity oral rehydration solution for treating dehydration caused by acute diarrhoea in children | Cochrane
Reduced osmolarity oral rehydration solution for treating dehydration caused by acute diarrhoea in children
Read more on Cochrane (Australasian Centre) website
Reintroducing a normal diet following acute diarrhoea | Cochrane
Many children in developing countries die from acute diarrhoea. Although it is usually caused by infectious viruses or bacteria, the exact organism is rarely known, as it is impractical to test for the organism. Treating the diarrhoea is thus standard therapy, with the recommended policy of using oral rehydration therapy and dietary supplements. Because the gut can be damaged by the infection, many doctors recommend a period of fasting followed by gradual reintroduction of food, although the evidence for when exactly a normal diet should be reintroduced is lacking. The authors here looked at children who received early refeeding (within 12 hours of the start of rehydration) or late refeeding (after 12 hours from the start of rehydration). The authors identified 12 trials that met their inclusion criteria, with a total of 1283 children under 5 years; of these, 1226 were used in the analysis (724 given early refeeding; 502 given late refeeding). There was no significant difference between the two refeeding groups in the number of participants who needed unscheduled intravenous fluids (813 participants, 6 trials), who experienced episodes of vomiting (466 participants, 5 trials), and who developed persistent diarrhoea i.e. greater than 14 days in duration (522 participants, 4 trials). The mean length of hospital stay was also similar (246 participants, 2 trials).There is therefore no evidence to suggest that early refeeding increases the risk of complications after acute diarrhoea such as the need for IV fluids, or increases the risk of developing persistent diarrhoea. Further studies are needed to fully examine other parameters such as duration of diarrhoea, and effect on weight gain.
Read more on Cochrane (Australasian Centre) website
Interventions to improve disposal of human excreta for preventing diarrhoea | Cochrane
Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. Many of the microbial agents associated with diarrhoea are transmitted via the faecal-oral route and are associated with exposure to human faeces. This review examined trials of interventions to improve the safe disposal of human faeces to prevent diarrhoea. In low-income settings, among the estimated 2.6 billion people who lack basic sanitation, this mainly consists of introducing or expanding the number and use of latrines and other facilities to contain or dispose of faeces. We identified 13 studies of such interventions involving more than 33,400 people in six countries. These trials provide some evidence that excreta disposal interventions are effective in preventing diarrhoeal diseases. However, major differences among the studies, including the conditions in which they were conducted and the types of interventions deployed, as well as methodological deficiencies in the studies themselves, makes it impossible to estimate with precision the protective effective of sanitation against diarrhoea. Further research, including randomized controlled trials, is necessary to understand the full impact of these interventions.
Read more on Cochrane (Australasian Centre) website
Department of Health | Guidelines for the public health management of gastroenteritis outbreaks due to norovirus or suspected viral agents in Australia
The Communicable Disease Network Australia (CDNA) formed a working group in 2005 in order to develop national guidance regarding outbreaks of norovirus and suspected viral gastroenteritis, in response to increasing reports of outbreaks. These Guidelines are designed to complement existing state and territory guidelines.
Read more on Department of Health website
Interventions to improve water quality and prevent diarrhoea | Cochrane
This Cochrane Review summarizes trials evaluating different interventions to improve water quality and prevent diarrhoea. After searching for relevant trials up to 11 November 2014, we included 55 studies enrolling over 84,000 participants. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies), with unimproved water sources (30 studies), and unimproved or unclear sanitation (34 studies).
Read more on Cochrane (Australasian Centre) website
Probiotics for persistent diarrhoea in children | Cochrane
Persistent diarrhoea is defined as a diarrhoeal episode that starts acutely but then lasts for 14 days or more, and it is an important cause of morbidity and mortality in children under five years old in developing countries throughout the world. The cause of persistent diarrhoea is not completely understood but is likely to be complex; this in turn makes management of the condition difficult. Probiotics are bacteria and yeasts that are similar to the normal bacteria found in a healthy gut. These so called friendly bacteria have been used in several studies to treat acute infectious diarrhoea with encouraging results. This review found four trials involving children with persistent diarrhoea. Two studies with a combined total of 324, showed that probiotics shorten the duration of diarrhoea and reduce the stool frequency on day-5. One study (235 children) suggested that probiotics reduce the hospital stay. Three out of four trials reported that no adverse events occurred. However, this review is limited by few trials with small number of participants, and therefore may not represent a reliable estimate of probiotics' effect.
Read more on Cochrane (Australasian Centre) website
Probiotics for treating acute infectious diarrhoea | Cochrane
Episodes of acute infectious diarrhoea remain a major disease burden throughout the world, especially in developing countries. They are due to infection by many different organisms. Most episodes are self-limiting and usually investigations are not done to identify the infectious agent. The main risk to health is dehydration and management aims to improve and maintain hydration status. However, rehydration fluids do not reduce the stool volume or shorten the episode of diarrhoea. Probiotics are "friendly" bacteria that improve health and are not harmful in themselves. A number of randomized controlled trials have been done to see whether probiotics are beneficial in acute infectious diarrhoea. We have searched for as many of these trials as possible and collected together the data in a systematic way to try to discover whether or not probiotics are beneficial in acute diarrhoea. We identified 63 trials, which included a total of 8014 people - mainly infants and children. Probiotics were not associated with any adverse effects. Nearly all studies reported a shortened duration of diarrhoea and reduced stool frequency in people who received probiotics compared to the controls. Overall, probiotics reduced the duration of diarrhoea by around 25 hours, the risk of diarrhoea lasting four or more days by 59% and resulted in about one fewer diarrhoeal stool on day 2 after the intervention. However, there was very marked variability in the study findings and so these estimates are approximate. We concluded that these results were very encouraging but more research is needed to identify exactly which probiotics should be used for which groups of people, and also to assess the cost effectiveness of this treatment.
Read more on Cochrane (Australasian Centre) website
Vaccines for preventing diarrhoea caused by enterotoxigenic Escherichia coli bacteria | Cochrane
Enterotoxigenic E. coli (ETEC) is a type of bacteria that can infect both children and adults, causing diarrhoea. In particular, it affects people in developing countries. However, it is also a major cause of 'travellers' diarrhoea' in people visiting or returning from regions where this infection is common. It is transmitted from person to person by eating or drinking unclean food or water. Typically it causes watery diarrhoea, with abdominal pains and vomiting, that can last for several days. Vaccines are being considered as a way to prevent diarrhoea caused by ETEC bacteria. ETEC bacteria share some similarities with the bacteria that cause cholera. In this review, we examined the effectiveness of either vaccines designed to prevent cholera or vaccines designed specifically to prevent ETEC infection for preventing ETEC diarrhoea. We compared these vaccines against the use of a control vaccine (either an inert vaccine or a vaccine normally given to prevent an unrelated infection), no intervention, an alternative ETEC vaccine, or a different dose or schedule of the same ETEC vaccine.
Read more on Cochrane (Australasian Centre) website
Anti-sickness medication for vomiting in acute stomach upsets in children | Cochrane
Vomiting caused by acute gastroenteritis is very common in children and adolescents. Treatment of vomiting in children with acute gastroenteritis can be problematic and there is lack of agreement among clinicians on the indications for the use of antiemetics. There have also been concerns expressed about apparently unacceptable levels of side effects with some of the older generation of antiemetics. The small number of included trials provided evidence which appeared to favour the use of antiemetics over placebo to reduce the number of episodes of vomiting due to gastroenteritis in children. A single oral dose of ondansetron given to children with mild to moderate dehydration can control vomiting, avoid hospitalization and intravenous fluid administration which would otherwise be needed. There were no major side effects other than a few reports of increased frequency of diarrhea.
Read more on Cochrane (Australasian Centre) website
