Transcript Acute diarrhoea and gastroenteritis among children

Current Health Problems
in Students’ Home Countries
Acute Diarrhoea
and Gastroenteritis
in Childhood
By:
Afifah binti Othman
Masrina binti Hj. Mhmad Tahar
Diarrhoea in the 21st Century
• Second most common cause of morbidity
and mortality worldwide
• WHO estimation (2002), diarrhoeal
disease results in:
2.5 million people die annually, mostly
children
1.6 million children <5yrs old (in developing
countries)
• In the U.S.
211-375 million episodes of diarrhoeal disease
occur annually
73 million physicians consultations
1.8 million hospitalization
Over 3000 death
• In Malaysia (2000)
About 2 million episodes of diarrhoea
annually among children < 15 yrs old
5% of total mortality among children <5 yrs
old
What is Diarrhoea?
• An increase in the frequency of bowel
movements or a decrease in the form of stool
(greater looseness of stool)
• Changes in frequency of
bowel movements and
looseness of stools can
vary independently of
each other, changes
usually occur in both.
Chronic diarrhoea
 Generally lasts > 3
weeks
 Common causes: IBS,
AIDS, bacterial
outgrowth of small
int., Colon cancer,
Chron’s disease
Acute diarrhoea
 lasts a few days or up
to a week
IMPORTANT !!!
distinguish between acute and chronic diarrhoea
>>>different diagnostis tests, different treatments
Common Causes of Acute Diarrhoea
• Infection – highly contagious
Viral gastroenteritis (“stomach flu”)
 Usually cause explosive,
watery diarrhoea
 Typically last only 4872hrs
 Usually no blood and
pus in stool
Rotavirus
Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool,
fever
E. Coli bacteria
•Contaminated food or water
•Usually affect small kids
Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool,
fever
Salmonella enteritidis bact
•In contaminated raw or
undercooked chicken and eggs
Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool,
fever
Shigella bacteria
Campylobacter
bacteria
Parasites
Cryptosporidium
Giardia lamblia
• in contaminated water –
can survive chlorination
• in contaminated water
•Usually not associated
with inflammation
Common Causes of Acute Diarrhoea –
cont.
• Food Poisoning
Brief illness cause by toxins produced by
bacteria
Cause abdominal pain, vomitting
Cause SI secrete high amnt of water – diarrhoea
Some bacteria produce toxins in food before
intake or in intestine after food is eaten
Symptoms usually appear within sev. hours
• Food Poisoning
Staphylococcus aureus
• Produces toxins in food before it is eaten
•Usually food contaminated left unrefrigerated
overnight
• Food Poisoning
Clostridium perfringens
• Multiplies in food
•Produces toxins in SI after contaminated food is eaten
Common Causes of Acute Diarrhoea –
cont.
• Traveller’s Diarrhoea
• Drugs / medications
Complications of Diarrhoea
• Dehydration
 Excessive loss of fluids and minerals (electrolytes) from
the body
 Common in infants and young children with viral
gastroenteritis or bacterial infection
 Kidney failure, eg in infection by E.coli
• Electrolyte deficiency
• Irritation to anus due to frequent passage of
watery stool containing irritating substances
When Treatment is Needed?
• Severe or prolonged episode
of diarrhoea
• Fever
• Repeated vomiting, refusal to
drink fluids
• Severe abdominal pain
• Diarrhoea that contains
blood or mucus
• Sign of dehydration
 Dry, sticky mouth
 Few or no tears when crying
 Sunken eyes
 Lack urine or wet diaper
 Dry, cool skin
 Fatigue or dizziness
Tests for Acute Diarrhoea
• Measurement of BP in upright and supine post –
demonstrate orthostatic hypotension, confirm
dehydration
• Moderate – severe diarrhoea, blood electrolytes
• Examination of small amount of stool under
microscope – if inflammation present, further test
particularly for bacterial and parasitic infection
Treatment
• Antibiotics or antiviral medications are not
prescribed for cases of diarrhoea caused by
virus or bacteria
• Antibiotics may be given to very young
children or children with weak immune
system
• In parasitic infection – antiparasitic
medicine usually given
Treatment – cont.
• Oral rehydration solutions (ORS)
Contain carbohydrate (glucose or rice syrup)
and electrolytes (Na, K, Cl, citrate, HCO3-)
Infants and children
 Infants with mild dehydration – ORS at home (with
doctor recommendation)
 Infants with moderate – severe dehydration, IV
fluids at hospital
 Avoid caffeine and lactose containing product
Prevention
• Wash hands thoroughly before and after
eating or when preparing the meals.
• Make sure that the tools used for eating
and preparing the meals are clean.
• Cover our food or put them in the fridge
to prevent any contamination.
References
1.
2.
3.
Wikipedia
http://en.wikipedia.org/wiki/Main_Page
Medical Journal Malaysia VOL 62
http://www.mma.org.my
World Health Organization – WHO
http://www.who.int/topics/diarrhoea/en/
4. http://www.medicinenet.com/diarrhea/article.h
tm
5. http://www.mayoclinic.com/health/diarrhea/D
S00292
6. http://www.kidshealth.org/parent/infections/co
mmon/diarrhea.html