Wednesday, 4 December 2013

Enteritis - The Risk Factors

Acute Enteritis, in most cases is defined as a condition of inflammation of the small intestine as a result of eating and drinking contaminated water and foods infected by virus and bacteria. But according to the study by the University Hospital Aintree, chronic radiation enteritis is an increasing problem, as more patients receive radiotherapy as part of their cancer therapy and as the long-term survival of these patients improves(a). Other study indicated that acute radiation enteritis is almost inevitable in the curative treatment of malignant tumors of the abdomen and pelvic area. It is frequently a self-limiting disorder of intestinal function associated with reversible mucosal changes of the intestine(b). The prevalence of the disease although is decreasing, it still affects millions (approx 1 in 83 or 1.20% or 3.3 million people in USA ) of people in the U.S alone, according to the statistic. Chronic enteritis is a condition of inflammation caused by other health conditions, such as Crohn's or celiac disease.
Risk Factors
1. Intestinal illness
People who have a family memeber with intestinal illness are at increased risk to develop gastroenteritis.In the study to evaluate risk factors for childhood hemolytic-uremic syndrome (HUS) and gastroenteritis during an epidemic of Escherichia coli O157:H7 infection, showed that Patients with HUS and those with uncomplicated E. coli O157:H7 gastroenteritis differed only on measures of clinical severity. In the 7 days before the onset of gastrointestinal symptoms, children with HUS and those with uncomplicated gastroenteritis were more likely to have been exposed to a family member with diarrhea than were the healthy control subjects (odds ratio = 9 for HUS vs healthy control subjects; 95% confidence interval 2 to 43; p < 0.01)(13).

2. Undercooked ground meat and foods
Undercooked ground meat and foods traditionally consumed by the Inuit were not implicated as risk factors in E. coli O157:H7 infection(14).

3. Environmental risk
Campylobacter is a common cause of bacterial gastro-enteritis characterized by multiple environmental sources and transmission pathways. According to the study, regional characteristics associated with an increased regional risk of campylobacteriosis, for at least some geographical units, were high ruminant density, high poultry density, high population density, and presence of a large poultry slaughterhouse, whereas a reduction in risk was associated with a lower percentage of people with diplomas, a lower level of precipitation, and warmer temperature. Two clusters of elevated residual risk were observed, with different location and size depending on the geographical unit used(15).

4. Biologically plausible risk
In the study to to evaluate whether the increase in incidence of campylobacteriosis observed in humans in Norway from 1995 to 2001 was statistically significant and whether different biologically plausible risk factors were associated with the incidence of campylobacteriosis in the different counties in Norway, found that treated water was a protective factor against Campylobacter infections in humans with an IRR of 0.78 per percentage increase in people supplied. Campylobacter infections did not appear to be clustered in any particular county in Norway(16).

5. Immune dysfunction
Immune system is responsible in fighting against invasion of bacteria and virus. Cytomegalovirus infection of the gastrointestinal tract is common and is more often seen in patients with acquired immunodeficiency syndrome (AIDS)(17).

6. Aging
Elderly are more susceptible to bacterial and virus infection and inflammation, as a result of weakened immune system.

7. Etc.
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