1.2 Gastro-Enteritis Flashcards
What is the difference between Diarrhoea and Gastroenteritis?
- Diarrhoea - subjective (A change in pattern indicated Diarrhoea)
- Gastroenteritis - objective (Diarrhoea + other symptoms)
What changes during Diarrhoea?
- Fluidity of the stool
- Frequency of the stool
What are the features of Gastroenteritis?
- 3+ loose stools per day
- Accompanying features
Is a positive stool culture needed to have Gastroenteritis?
No, but need to have 3+ loose stools per day the other symptoms
Note - It is an objective finding but clinical, not always biological
What is Dysentery?
Large bowel inflammation due to infection
What is present with Dysentery?
- Bloody stools
- A lot of pain
Note - it is quite obvious when someone has contracted Dysentery
What is the name of the chart which stools are measured against?
The Bristol Stool Chart:
1 - Separate hard lumps, hard to pass
4 - Sausage / Snake like, smooth and soft
7 - Watery, no solid pieces, entirely liquid
What is the Aetiology of Gastroenteritis?
- Contamination of foodstuffs (intensity of farming - e.g. Chicken and Campylobacter)
- Storage of produce (Bacterial proliferation at room temperature)
- Salmonella in outbreaks (also imported from abroad in Travel Related Infections)
- Campylobacter in isolated cases (can also be imported)
What is the Epidemiology of Gastroenteritis?
- 25% of the population have an infectious intestinal disorder each year
- 2% of the population visit the GP because of GI infection
- For every reported case, there are an unreported:
- a) 10 GP consultations
- b) 147 community cases
What is the most common cause of Gastroenteritis?
- Viruses (e.g. Norovirus)
- Campylobacter (most common bacterial pathogen with 280,000 cases per year)
- How many cases of food poisoning are there per year?
- How many are linked to poultry meat?
- 500,000
- 244,000
What is the bacterial pathogen of Gastroenteritis, which causes the most hospital admission each year?
Salmonella
What are the number of cases (in Scotland) of Gastroenteritis caused by:
1. Campylobacter?
2. Salmonella?
3. E. Coli O157?
- 6,366
- 736
- 253
Note - E. Coli O157 is not a big organism but it is important as it has more complex complications
What is the best defence against Gastroenteritis?
- Hand Hygiene
- Decrease Stomach pH - Taking PPI’s make you more susceptible to bacterial infection
- Normal Flora - taking antibiotics alter normal flora (e.g. C. Diff infection)
- Immunity - Immunosuppression leaves you more susceptible to infection
How is Gastroenteritis treated?
- Rehydration therapy:
- a) Oral salt/sugar solution
- b) IV saline
- Antimicrobials
- Treatment of complications
Why is a salt/sugar solution used in Oral Rehydration?
The salt is being lost from the gut lining, so the salt is replaced.
Glucose is used as well as they share a transporter and so increased absorption
Should routine antidiarrhoeals be given in Gastro-enteritis?
No
How long can those with Campylobacter Gastroenteritis be incubated for?
Up to 7 days, so dietary history may be inreliable
How long will it take for stool sample to be negative?
6 weeks
What clinical feature is associated with Campylobacter Gastroenteritis?
Severe abdominal pain