Gastroenteritis Flashcards
Definition
Transient disorder due to enteric infection with viruses, bacteria or parasites.
What are the types of diarrhoea?
Acute diarrhoea – three or more episodes of watery stool lasting for <14 days.
Persistent diarrhoea – lasts longer than 14 days
Dysentry – loose stools w/ blood & mucus, often w/ pyrexia and ab cramps.
Traveller’s diarrhoea – disease starting shortly after foreign travel.
Antibiotic-associated diarrhoea – freq. cause C.diff.
What is the prevalence & patient demographics of GE?
Common 20% each year one in six attend GP for it. Been abroad, handled uncooked meats, visited any zoo/farm
What are the causes?
Rotavirus (child) Norovirus (adult) Adenovirus (resp. normally but can be GE in children) Campylobacter E.Coli Salmonella Shigella Yersinia enterocolitic Cryptosporidium Amoebiasis Giardia Toxins
What are the risk factors
Recent travel Certain Abx Poor hygiene Contact history Contaminated food Extremes of age Infected animals immunoC
How does GE present?
Sudden onset diarrhoea ± vomiting. Nausea, sudden onset of vomiting, blood or mucus in stool, systemic features.
Consider Ddx if these symptoms: fever, SOB or tachypnoea, altered consciousness, neck stiffness, bulging fontanelle in infants, non-blanching rash, blood in stool, bilious vomit, severe/localised ab pain, ab distension.
What are the differentials?
UTI Pneumonia Otitis media Systemic infection GI conditions Drugs Endocrinopathy HIV/AIDs
What investigations should be done?
Assessment of severity
Rehydration advice
Stool sample analysis
Antidiarrhoeal or antiemetic drugs
Ensure these details on request form: Clinical features, immunosuppression, food intake, foreign travel, recent ATX or PPI treatment, exposure to untreated water.
Follow-up if condition does not improve within 48 hours, symptoms worsen or warning signs (vomiting, dehydration, persistent fever, abdo distension or blood in stools).
What is the management?
- Amoebiasis is metronidazole
- Antibiotics
What are the complications?
Dehydration: electrolyte imbalance, acidosis and circulatory failure, hypoperfusion of vital organs.
Haemolytic uraemic syndrome – rare. Potentially life-threatening. Acute renal failure, haemolytic anaemia and thrombocytopenia. Decreased frequency of urination, fatigue and losing pink colour in cheeks and lower eyelids.
Reactive complications – arthritis, carditis, urticarial, erythema nodosum, conjunctivitis and Reiter’s syndrome (urethritis, arthritis and uveitis).
Systemic infection by Salmonella.
Toxic megacolon
Guillain-Barré syndrome
Malnutrition
Intractable diarrhoea
IBS
Acquired or 2° lactose intolerance
Reduced absorption of drugs
