Gastroenteritis Flashcards
What is Gastroenteritis
Gastroenteritis is inflammation of the lining of the stomach and small and large intestines.
Classifications of Diarrhea
1.Duration
Acute, Chronic
- Causes
Infectious, post-infectious, drugs, endocrine, factitious.
3.Chronic Diarrhea
Pathophysiologic mechanism
Osmotic, secretory, inflammatory, abnormal motility
Define Acute Diarrhea
- Sudden onset and lasts <2 weeks
- 90% are Infectious in etiology
- 10% are caused by medications, toxin ingesting and ischemia
Define Chronic Diarrhea
- Diarrhea which last >14 days
2. Most of the causes are non-infectious
Causes of Gastroenteritis
VIRUS.
Norovirus
2. Rotavirus
BACTERIA
- Salmonella.
- Shigella.
- E. Coli
- Campylobactor
Osmotic Diarrhea
Mechanism:
-Retention of water in the bowel as a result of an accumulation of non-absorbable water-solution compounds.
Causes
- Purgatives like magnesium sulfate or magnesium containing antacids
- especially associated with excessive intake of Sorbitol and Mannitol.
- Disaccharide intolerance
- Generalized malabsorption
Secretory Diarrhea
Mechanism:
- Active intestinal secretion of fluids and electrolytes as well as decreased absorption.
- Large volume, painless, persist with fasting
Causes:
- Cholera enetrotoxibn, heat labile E. Coli enterotoxin
- Vasoactive intestinald peptide hormone in Verner-Morrison syndrome
- Bile salts in colon following ileam resection
- Laxatives like docusate sodium.
- Carcinoid tumors
Inflammatory Diarrhea
Mechanism :
- damage to the intestinal mucosal cell leading to a loss of fluid and blood
- pain, fever, bleeding, inflammatory manifestations
Causes :
- Immunodeficiency patient
- Infective conditions like Shigella dysentery
- Inflammatory conditions
1. Ulcerative colitis and Crohn’s disease
Abnormal Motility Diarrhea
Mechanism :
- Increased frequency of defecation due to underlying diseases
- large volume, signs of malabsorption (steatorrhea)
Causes :
- Diabetes mellitus- autonomic neuropathy
- Post vagotomy
- Hyperthyroid diarrhea
- Irritable Bowel Syndrome
Route of transmission Rotavirus
Rotavirus –fecal-oral in children -close contact in adults Incubation 1-3 days Highly contagious Common in young children
Route of transmission Norovirus
Norovirus: -waterborne -Foodborne -Person to person Incubation -24-48 hrs Highly contagious Common in adults and older children
ASSESSMENT OF DEHYDRATION
•Some dehydration
5% weight loss
- Reduced skin turgor < 2sec
- Restless or IrritableSunken eyes
- Dry mucous membrane
- Decreased urine output
- Thirsty or drinks eagerly
- Crying without tears
•Severe Dehydration
10% weight loss
- Reduced skin turgor > 2sec
- Restless or lethargic
- Very Sunken eyes & fontanel
- Severe dry mucous membrane
- Decreased urine output
- Capillary refill time <3s
- Tachycardia
•Shocked
> 10% weight loss
- Depressed LOC or lethargic
- Peripherally cold and shut down
- Pulses absent, weak or thread
- Capillary refill time > 3s
- Severe tachycardia
- Acidotic breathing
- Signs of dehydration could be absent
