GI disorders d Flashcards
what is acute diarrhea defined as ?
more than 3 loose stools a day
lasting no longer than 14 days
what is chronic diarrhea defined as ?
diarrhea that lasts more than 14 days
what is persistent diarrhea ?
diarrhea that formerly started off as acute but is now lasting longer than 14 days
what must be one of the first `DDx when seeing an infant who is FTT with chronic diarrhea ?
CMPA
Celiac disease
following GE what other DDX must be considered ?
post gastroenteritis syndrome
temporary lactose intolerance
what disease must be considered following bowel resection, cholestatic liver disease or exocrine pancreatic dysfunction ?
malabsorption
what is the most common cause of GE in children ?
Rota virus
what are the common bacterial organisms associated with GE ?
campylobacter E.coli salmonella Shigella Cholera
what are the associated clinical findings with campylobacter ?
severe abdominal pain
what are the associated clinical findings with shigella and salmonella ?
blood and pus in stool
may be associated with fever
pain and tenesmus
what are the associated clinical findings with ecoli and cholera ?
blood diarrhea with no fever
rapidly dehydration diarrhea
what is the most serious complication associated with GE ?
dehydration and shock
what is the most accurate measure of dehydration ?
weight
more than 10% loss indicated shock
what are the signs of shock and dehydration ?
decreased consciousness depressed fontanelles sunken eyes , tearless dry mucosa decreased skin turgor prolonged capillary refill pale cold extremities hypotension tachycardia
what are the three types of dehydration ?
isonatremic
hyponatremic
hypernatremic ( only one where IV fluids are indicated )
when is a stool culture required ?
blood or mucous in stool
immunocompromised child
after recent travel
diarrhea not improved by day 7
what is the presentation of pyloric stenosis ?
more common in boys projectile vomiting immediately hungry after vomiting olive shaped mass in right up quadrant visible peristaltic gastric movements
what is the definitive treatment of pyloric stenosis ?
pyloromyotomy
what drugs should be avoided in the treatment of GE ?
anti diarrheal
when are antibiotics indicated inn GE ?
suspected or confirmed sepsis
extra-intestinal spread of bacterial infection
salmonella in a baby less than 6 months
malnourished or immunocomp
specific bacterial or protozoal infection
what is the cause of GE in developing vs developed country ?
developing - bacterial
developed - viral
what are the different causes of persistent diarrhea ?
CMPA
lactose intolerance
small intestine bacterial overgrowth
what is found in stool to confirm that there is a carbohydrate metabolism problem ?
reducing substance in stool
what is the presentation of small intestine bacterial overgroeth ?
abdominal pain
flatulence
bloating
