Diarrhea Flashcards
Causes of diarrhea
Drug-induced
Foods
Stomach flu
Travel
Common treatments of diarrhea
Hydration
Imodium
Pepto
Sudden causes of diarrhea
Food poisoning
Travellers diarrhea
Stomach flu
Chronic diarrhea causes
Celiac disease
Food intolerance/allergy
Milk/soy protein intolerance
IBS
Medications
Drug induced diarrhea
20% of people taking antibiotics
Diarrhea usually starts 2-3 days into treatment
Treatment of drug-induced diarrhea
Withdraw the drug OR
Continue treatment but Add loperamide to counteract AE
OR adjust dose (very unlikely)
What is the main cause of paediatric diarrhea?
Viral gastroenteritis (VGE) - aka stomach flu
What is mild dehydration in peds?
Up to 5% body weight loss
Increased thirst
Slightly dry mucous membrane
What is moderate dehydration in peds?
6-9% body weight loss
Irritable, alert, thirsty
Dry mucous membrane
What is severe dehydration in peds?
> 10% body weight loss
No urine output
Parched mucous membrane
Cold extremities
When should you refer for peds?
Anything past mild dehydration
<6 months
<1yr = 1 day duration
2yr = 2 day duration
3yr = 3 day duration
If fever, vomiting >8hr, blood in stool is present
What are the treatment for VGE at home?
Rehydration therapy (key treatment)
Anti-diarrheal agents for kids (not really any that are recommended)
What is the presentation of travellers diarrhea?
E. Coli is the common cause
Diarrhea within 3-7 days upon arrival
Average of 4-5 BMs per day
Low grade fever
Usually self-limiting over several days
What is montezuma’s revenge?
3% have >10 BM/day
15% also have vomit
10% last >week
Prevention for travellers diarrhea
Giving rx antibiotic before leaving - start at destination for max of 3 weeks
Pepto-bismol - 2T 262mg QID for 3 weeks max (great for adults)
Treatment options for travellers diarrhe
Main: 1-3 days of rx antibiotic + loperamide
OR loperamide alone
OR pepto alone
What is the side effect of an rx antibiotic + loperamide?
Bloody stools
Treatment of travellers diarrhea for children
First choice: fluid
Loperamide only if kid is suffering
Pepto 2 x 262mg q30 minutes for 8 doses
What are the side effect of pepto?
Harmless darkening of tongue or stools
Ulcer, bleeding
Cause of diarrhea from hep A
Contaminated water, ice, shellfish, raw fruits or vegetables
Symptoms of diarrhea with hep A
Mild illness lasting 1-2 weeks to a severely disabling disease lasting months
Common causes of diarrhea from hep B
Unprotected sex, sharing needles, tattooing. Body fluids and blood
Can take 2-6 months for symptoms to appear
Symptoms of hep B
N+V
Fever
Dark urine
Can develop into jaundice
What is the dosing for Imodium(loperamide)?
2 caps immediately, then 1 after each loose BM (16mg max per day)
Not recommended for 2-12 yo
CI <2yo
Probiotics use in diarrhea cases
For antibiotic induced diarrhea
Indications of pepto
Indigestion
Upset stomach
N+D
Heartburn
But there is usually better options for each indication
Can give to children > 3yo
