Gastroenteritis

Question 1

What is Gastroenteritis?

Answer 1

• Infective Gastroenteritis is a temporary disorder due to an enteric infection
• Presents as sudden onset diarrhoea with/ without vomiting

Question 2

Which organisms cause Viral Gastroenteritis?

Answer 2

• Rotavirus - most common cause in infants
• Norovirus - most common in all age groups
• Adenovirus

Question 3

What are the bacterial organisms for Gastroenteritis?

Answer 3

• Campylobacter
• E.Coli - can cause Haemorrhagic Colitis and Haemolytic Uraemic Syndrome

Question 4

What are the clinical Features of Gastroenteritis?

Answer 4

• loose/ watery stool
• Vomiting
• Abdominal Pain
• Mild Fever
• Recent contact with someone with diarrhoea

Question 5

Who are at risk of dehydration?

Answer 5

• Young Children
• Children who have passed >5 diarrhoea stools
• Children who have vomited >2 times
• Children who have stopped breast feeding during the illness

Question 6

What investigations would you consider in Gastroenteritis?

Answer 6

• Stool Sample should be sent if:
  1. Septicaemia
  2. Blood/ Mucus in the stool
  3. The child is immunocompromised
• Blood Tests (Na+, K+, Cr, Ur and Glucose) if:
  1. IV fluids are to be used
  2. Signs/ Symptoms of Hypernatraemia

Question 7

What is the Managment of Gastroenteritis?

Answer 7

Immediate:
- Continue Breast Feeding/ Other milk feeds
- Encourage fluid intake

Dehydrated:
- Offer Oral Rehydration Salt Solution
- 50ml/kg over 4 hours to replace loss + maintenance fluid
- If the child is refusing consider a NG tube
- IV fluid if shock is suspected

Following:
- Give full strength milk straight away
- Slowly re-introduce the child’s solid food
- Avoid sharing towels and ensure handwashing. The child should avoid school for 48hours and child should not swim for 2 weeks

Question 8

What are the complications of Gastroenteritis?

Answer 8

• Haemolytic Uraemic Syndrome: Rare but serious complication of infectious gastroenteritis that occurs in young children. Life- threatening complication causing acute renal failure and haemolytic anaemia
• Reiter’s Syndrome ( Urethritis, Arthritis and Uveitis)
• Toxic Megacolon (complication of Rotavirus Gastroenteritis)
• Accquired/ Secondary Lactose Intolerance (Occurs due to the lining of the intestine being damaged, leads to symptoms of bloating, abdo pain, wind and watery stools, improves when the infection resolves and the gut lining heals)