acute gastroenteritis Flashcards
complications of acute gastroenetritis
dehydration
eletrolyte imbalance
perianal excoriation or skin breakdown
medication related complications
complications seen in older patients: falls, pressure injuries, destabilisation of chronic disease, delirium)
causes of severe abdominal pain
cause requiring surgical intervention eg. aappendicitis, mesenteric ischaemia, perforated vicus, bowel obstruction
vomiting without diarrhoea in children
urinary tract infection
increased ICP
bowel obstruction
cause requiring surgical intervention
poisoning
diarhhoea and vomiting in pregnant women
listeria monocytogenes
how to manage acute gastroenteritis
rehydration
manage electrolyte abnormalities
beware of AKI (eg. in pre-existing renal impairment, diabetes, medication associated with electrolyte imbalance)
consider antiemetics and antidiarrhoeals
probiotics and zinc suppliments may reduce duration in children
perianal excoriation or skin breakdown
use of ondansetron for children
reduces vomiting, improves intake or oral rehydration solutions and reduces the need for IV fluids and hospitalisation
it is well tolerted
BUT
it may worsen dirrhoe
antiemetic drugs for adults
you may use
dopamine receptor antagonists eg. metaclopramide, prochlorperazine
5-HT3 receptor antagonists eg. ondansetron
antidiaarhoel drugs for children
never use antidiarhoel drugs for infants and children
antidiarhoel drugs for adults
useful for short term control of symptoms during periods of social inconvenience
loperamide orally
when should you not use loperamide
contraindicted for bloody diarrhoea, high fever or systemic symptoms
because these patients may have invasive diarrhoeal infection
probiotics in kids for diarhhoea
some strains of probiotics reduce duration and severity of diarrhoea when given in addition to rehydration therpy
may be useful as adjunctive therapy
zinc supplements for acute gastroenteritis
reduces severity and duration of therapy in children 6months-5years
awareness of gastroeneteritis and the effects on regular medications
diarhoea and vomiting may reduce absorption of regular medications
some drugs are more likely to cause adverse effects eg. NSAIDs, ACEI, ARBs, etc.
transient lactose intolerance after gastroenetritis
temporary lactose intolerance may occur after gastroenteritis, particularly in infants and young children
a temporary change to lactose free formula for 2-4 weeks my alleviate symptoms
