Acute Diarrhoea and Gastroenteritis in Childhood

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Acute Diarrhoea and Gastroenteritis in Childhood
Current Health Problems in Students Home
Countries

• By
• Afifah binti Othman
• Masrina binti Hj. Mhmad Tahar

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Diarrhoea in the 21st Century

• Second most common cause of morbidity and
  mortality worldwide
• WHO estimation (2002), diarrhoeal disease results
  in
• 2.5 million people die annually, mostly children
• 1.6 million children lt5yrs old (in developing
  countries)

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• In the U.S.
• 211-375 million episodes of diarrhoeal disease
  occur annually
• 73 million physicians consultations
• 1.8 million hospitalization
• Over 3000 death
• In Malaysia (2000)
• About 2 million episodes of diarrhoea annually
  among children lt 15 yrs old
• 5 of total mortality among children lt5 yrs old

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What is Diarrhoea?

• An increase in the frequency of bowel movements
  or a decrease in the form of stool (greater
  looseness of stool)

• Changes in frequency of bowel movements and
  looseness of stools can vary independently of
  each other, changes usually occur in both.

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• Chronic diarrhoea
• Generally lasts gt 3 weeks
• Common causes IBS, AIDS, bacterial outgrowth of
  small int., Colon cancer, Chrons disease

• Acute diarrhoea
• lasts a few days or up to a week

X
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Common Causes of Acute Diarrhoea

• Infection highly contagious
• Viral gastroenteritis (stomach flu)

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• Bacterial enterocolitis
• Sign of inflammation blood or pus in stool,
  fever

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• Bacterial enterocolitis
• Sign of inflammation blood or pus in stool,
  fever

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• Bacterial enterocolitis
• Sign of inflammation blood or pus in stool,
  fever

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• Parasites

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Common Causes of Acute Diarrhoea cont.

• Food Poisoning
• Brief illness cause by toxins produced by
  bacteria
• Cause abdominal pain, vomitting
• Cause SI secrete high amnt of water diarrhoea
• Some bacteria produce toxins in food before
  intake or in intestine after food is eaten
• Symptoms usually appear within sev. hours

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• Food Poisoning

• Staphylococcus aureus
• Produces toxins in food before it is eaten
• Usually food contaminated left unrefrigerated
  overnight

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• Food Poisoning

• Clostridium perfringens
• Multiplies in food
• Produces toxins in SI after contaminated food is
  eaten

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Common Causes of Acute Diarrhoea cont.

• Travellers Diarrhoea
• Drugs / medications

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Complications of Diarrhoea

• Dehydration
• Excessive loss of fluids and minerals
  (electrolytes) from the body
• Common in infants and young children with viral
  gastroenteritis or bacterial infection
• Kidney failure, eg in infection by E.coli
• Electrolyte deficiency
• Irritation to anus due to frequent passage of
  watery stool containing irritating substances

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When Treatment is Needed?

• Severe or prolonged episode of diarrhoea
• Fever
• Repeated vomiting, refusal to drink fluids
• Severe abdominal pain
• Diarrhoea that contains blood or mucus
• Sign of dehydration
• Dry, sticky mouth
• Few or no tears when crying
• Sunken eyes
• Lack urine or wet diaper
• Dry, cool skin
• Fatigue or dizziness

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Tests for Acute Diarrhoea

• Measurement of BP in upright and supine post
  demonstrate orthostatic hypotension, confirm
  dehydration
• Moderate severe diarrhoea, blood electrolytes
• Examination of small amount of stool under
  microscope if inflammation present, further
  test particularly for bacterial and parasitic
  infection

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Treatment

• Antibiotics or antiviral medications are not
  prescribed for cases of diarrhoea caused by virus
  or bacteria
• Antibiotics may be given to very young children
  or children with weak immune system
• In parasitic infection antiparasitic medicine
  usually given

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Treatment cont.

• Oral rehydration solutions (ORS)
• Contain carbohydrate (glucose or rice syrup) and
  electrolytes (Na, K, Cl, citrate, HCO3-)
• Infants and children
• Infants with mild dehydration ORS at home (with
  doctor recommendation)
• Infants with moderate severe dehydration, IV
  fluids at hospital
• Avoid caffeine and lactose containing product

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Prevention

• Wash hands thoroughly before and after eating or
  when preparing the meals.
• Make sure that the tools used for eating and
  preparing the meals are clean.
• Cover our food or put them in the fridge to
  prevent any contamination.

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References

• Wikipedia
• http//en.wikipedia.org/wiki/Main_Page
• Medical Journal Malaysia VOL 62
• http//www.mma.org.my
• World Health Organization WHO
• http//www.who.int/topics/diarrhoea/en/
• http//www.medicinenet.com/diarrhea/article.htm
• http//www.mayoclinic.com/health/diarrhea/DS00292
• http//www.kidshealth.org/parent/infections/common
  /diarrhea.html