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Patient Instructions

E. coli enteritis is inflammation of the small intestine from 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 occur with hemolytic uremic syndrome.

Risk factors include:

• Drinking untreated or contaminated water
• Eating unsanitary food
• Recent family illness with E. coli
• Recent family illness with vomiting or diarrhea
• Travel to places that have unclean drinking water

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, and may be bloody
• Fever
• Gas
• Loss of appetite
• Stomach cramping
• Vomiting (rare)

The health care provider 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 not be recommended, because it can slow the bacteria from leaving the digestive tract.

You may need electrolyte solutions if you are dehydrated. 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 without the advice of your health care provider.

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

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 (usually gets better in 1 - 2 weeks or less)

Call for an appointment with your health care provider if:

• You are unable to keep fluids down
• Diarrhea does not go away in 3 - 4 days
• You see blood in your stool
• You develop symptoms of dehydration
• Your symptoms worsen or do not improve with treatment
• You develop new symptoms

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 bacteria.

Traveler's diarrhea - E. coli; Food poisoning - E. coli; E. coli diarrhea; Hamburger disease

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

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.