Diarrhoea - Gastroenteritis, CMPA, Coeliac

Question 1

Gastroenteritis
-causative organisms
-presentation
-investigations
-management

Answer 1

MOST COMMON - VIRAL (ROTAVIRUS)
MOST COMMON CAUSE OF ACUTE DIARRHOEA

Diarrhoea+N+V lasting U14 days
Abdo pain
If bacterial => fever
Exposure to
-contaminated food and water sources
-infected individuals
-poor hygiene

ASSESS DEHYDRATION
-dry mucous membranes
-high HR, low BP
-reduced UOP

Clinical diagnosis

50ml/kg ORS over 4hrs + maintenance ORS often in small amounts
Continue breastfeeding
Supplement with milk or water, NOT FRUIT JUICE

Question 2

Cow milk protein intolerance
-presentation
-investigations
-management

Answer 2

First 3 months of life in formula fed infants

Regurgitation, comiting
Diarrhoea
Atopic eczema, wheeze
Colic

CLINICAL DIAGNOSIS
-skin prick/patch testing
-total IgE and specific IgE for CMP

If formula fed
1st line - eHF
2nd line - AAF

If breastfed
1st line - continue breastfeeding, eliminate CMP from maternal diet

Question 3

Coeliac
-what is it
-presentation
-investigations
-management

Answer 3

Gluten protein sensitivity
Repeated exposure => villous atrophy

Presents before 3, after cereals have been introduced to the diet

Failure to thrive
Diarrhoea
Abdo distention
Older children may present with anemia

Total IgA, TTA IgA
Jejunal biopsy - villous atrophy

Avoid gluten