[Clinical aspects and management of adult patients with acute gastroenteritis in primary care].

Aim: In patients with acute gastroenteritis, general behaviour of patients as well as medical care remain poorly documented. The aim of this work was to determine clinical and demographic characteristics, reason for visiting a doctor, and medical care in adult patients with acute gastroenteritis.

Methods: During the winter epidemic peak of acute diarrhea, 2,217 general practitioners filled in standardized clinical observations of 17,273 patients (mean age 40 yrs) with acute gastroenteritis.

Results: There were abdominal pain, nausea, and vomiting in respectively 72%, 53% and 43% of patients. Thirty one percent of patients had fever. Nausea and vomiting were more frequently observed in younger patients (15-25 yrs) than in older ones. More severe diarrhea more frequent nausea, vomiting and abdominal pain (p<0.0001). Time for consulting was less than 24 and 48h in respectively 42% and 87% of patients, and was different according to professional classes. Predominant reason for consulting was the physical consequences of the disease (78%). Self medication was reported in 42% of patients and was different according to age and professional classes. Prescription of antidiarrheal drugs was reported by 91% of patients, sometimes in association with antiemetic (43%) and/or antispasmodic agents (35%). Additional explorations (mainly biological work-up) were rare but they were more frequently considered in older and female patients as well as in patients with severe and prolonged diarrhea. Stoppage of work was different among professional classes. It was reported in one third of patients, and was more frequent in patients with severe diarrhea.

Conclusions: This study describes the behaviour of patients and doctors facing acute gastroenteritis and illustrates important fluctuations according age and professional classes. It shows high discomfort and repercussions of acute gastroenteritis especially regarding stoppage of work.