24: Digestive System Infections
Gastrointestinal (GI) diseases are so common that, unfortunately, most people have had first-hand experience with the unpleasant symptoms, such as diarrhea, vomiting, and abdominal discomfort. The causes of gastrointestinal illness can vary widely, but such diseases can be grouped into two categories: those caused by infection (the growth of a pathogen in the GI tract) or intoxication (the presence of a microbial toxin in the GI tract).
Foodborne pathogens like Escherichia coli O157:H7 are among the most common sources of gastrointestinal disease. Contaminated food and water have always posed a health risk for humans, but in today’s global economy, outbreaks can occur on a much larger scale. E. coli O157:H7 is a potentially deadly strain of E. coli with a history of contaminating meat and produce that are not properly processed. The source of an E. coli O157:H7 outbreak can be difficult to trace, especially if the contaminated food is processed in a foreign country. Once the source is identified, authorities may issue recalls of the contaminated food products, but by then there are typically numerous cases of food poisoning, some of them fatal.
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- 24.1: Anatomy and Normal Microbiota of the Digestive System
- The human digestive system, or the gastrointestinal (GI) tract, begins with the mouth and ends with the anus. The parts of the mouth include the teeth, the gums, the tongue, the oral vestibule (the space between the gums, lips, and teeth), and the oral cavity proper (the space behind the teeth and gums). Other parts of the GI tract are the pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus.
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- 24.2: Microbial Diseases of the Mouth and Oral Cavity
- Despite the presence of saliva and the mechanical forces of chewing and eating, some microbes thrive in the mouth. These microbes can cause damage to the teeth and can cause infections that have the potential to spread beyond the mouth and sometimes throughout the body.
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- 24.3: Bacterial Infections of the Gastrointestinal Tract
- Major causes of gastrointestinal illness include Salmonella spp., Staphylococcus spp., Helicobacter pylori, Clostridium perfringens, Clostridium difficile, Bacillus cereus, and Yersinia bacteria. C. difficile is an important cause of hospital acquired infection. Vibrio cholerae causes cholera, which can be a severe diarrheal illness. Different strains of E. coli, including ETEC, EPEC, EIEC, and EHEC, cause different illnesses with varying degrees of severity.
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- 24.4: Viral Infections of the Gastrointestinal Tract
- Common viral causes of gastroenteritis include rotaviruses, noroviruses, and astroviruses. Hepatitis may be caused by several unrelated viruses: hepatitis viruses A, B, C, D, and E. The hepatitis viruses differ in their modes of transmission, treatment, and potential for chronic infection.
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- 24.5: Protozoan Infections of the Gastrointestinal Tract
- Like other microbes, protozoa are abundant in natural microbiota but can also be associated with significant illness. Gastrointestinal diseases caused by protozoa are generally associated with exposure to contaminated food and water, meaning that those without access to good sanitation are at greatest risk. Even in developed countries, infections can occur and these microbes have sometimes caused significant outbreaks from contamination of public water supplies.
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- 24.6: Helminthic Infections of the Gastrointestinal Tract
- Helminths are widespread intestinal parasites. These parasites can be divided into three common groups: round-bodied worms also described as nematodes, flat-bodied worms that are segmented (also described as cestodes), and flat-bodied worms that are non-segmented (also described as trematodes). The nematodes include roundworms, pinworms, hookworms, and whipworms. Many of these parasites are so well adapted to the human host that there is little obvious disease.
Thumbnail: This is an adult Taenia saginata tapeworm. Humans become infected by ingesting raw or undercooked infected meat. In the human intestine, the cysticercus develops over 2 mo. into an adult tapeworm, which can survive for years, attaching to, and residing in the small intestine. (Public Domain; UC CDC)