E. coli enteritis is an inflammation of the small intestine caused by Escherichia coli (E. coli) bacteria. It is the most common cause of travelers' diarrhea.

E. coli enteritis is a type of bacterial gastroenteritis.

Certain types of E. coli infection are associated with hemolytic uremic syndrome, a disease marked by destruction of the red blood cells, drastic decrease in the platelets, and acute kidney failure.

Risk factors include recent family illness with E. coli, recent family illness with vomiting or diarrhea, eating unsanitary food, or drinking untreated or contaminated water. Travel to places that may not have clean drinking water is also a risk factor.

The symptoms occur when the E.coli bacteria enters the intestine. The time between being infected and developing symptoms is usually 24 - 72 hours. Symptoms may include:

• Abdominal pain
• Diarrhea that is sudden and severe, may be bloody
• Fever
• Gas
• Loss of appetite
• Stomach cramping
• Vomiting (rare)

The doctor will perform a physical exam. A stool culture can be done to check for disease-causing E. coli.

Cases usually clear up on their own in 1 - 3 days, and no treatment is required.

Antidiarrheal medication may delay the organism from leaving the digestive tract, and therefore may not be recommended.

Rehydration with electrolyte solutions may be necessary if dehydration occurs. Persons with diarrhea (especially young children) who are unable to drink fluids because of nausea may need medical care and intravenous fluids.

If you take diuretics and develop diarrhea, you may need to stop taking the diuretic during the acute episode. Do not stop taking any medicine unless your doctor tells you to.

Avoid dairy products. They may make the diarrhea worse due to the temporary lactose intolerance that can arise.

The illness usually runs its course in a few days, without treatment. A small number of patients may need to be admitted to the hospital if they become very dehydrated or they develop hemolytic uremic syndrome.

• Dehydration
• Prolonged diarrhea
• Temporary lactose intolerance afterwards

Call for an appointment with your health care provider if you are unable to keep fluids down, if diarrhea does not go away in 3 - 4 days, or if you see blood in the stool.

Call your health care provider if you develop symptoms of dehydration, symptoms worsen or do not improve with treatment, or new symptoms develop.

Careful hand washing may be helpful. Do not drink untreated or possibly contaminated food or water. Always cook meats well, especially ground meats. Cook meats at high enough temperatures to kill organisms.

Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006.

Guerrant RL. Escherichia enteric infections. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap. 327.