Diarrhoea

Question 1

What are the causes of acute diarrhoea?

Answer 1

1. Infection
2. Thyrotoxicosis
3. Malabsorption - coeliac, IBD

Question 2

What are the causes of chronic diarrhoea in infants?

Answer 2

1. Cow’s milk protein intolerance
2. Coeliac disease
3. Post-gastroenteritis lactose intolerance

Question 3

What is this a presentation of?
Pre-school age, frequently passing loose stools but otherwise well and thriving. Presence of undigested food in stools. Resolves without intervention.

Answer 3

Toddler diarrhoea

Question 4

What is the most common cause of gastroenteritis?

Answer 4

Viral - rotavirus most commonly

Question 5

What is the route of transmission of gastroenteritis?

Answer 5

Faeco-oral (highly contagious)

Question 6

When is the peak incidence of gastroenteritis and in which group of children is the incidence reduced?

Answer 6

1. 9 months to 2 years old

2. Breast-fed babies

Question 7

What is this a presentation of?

Vomiting, loose stools, abdominal cramps, general malaise, dehydration.

Answer 7

Gastroenteritis

Question 8

What signs may be present in severe gastroenteritis?

Answer 8

1. Dehydration - sunken fontanelle and eyes, dry mucous membranes, tachycardia, lethargy.
2. Shock - pale/mottled skin, cold hands and feet, CRT >2s, weak peripheral pulse, hypotension.

Question 9

How is gastroenteritis diagnosed?

Answer 9

1. Clinical diagnosis

2. Stool sample - if blood/mucus, immunocompromised, recent travel

Question 10

What is the management of gastroenteritis?

Answer 10

1. Supportive, usually resolves after 48hrs
2. Loose stools may persist for 1-2 weeks
3. Discourage fruit juice and fizzy drinks
4. Oral rehydration therapy (Dioralyte)
5. Admit for IV fluids if still dehydrated