ACUTE DIARRHEA WORLD WIDE 1 BILLION EPISODE/YEAR AGE & SEX EQUAL 3-5 MILLION DEATHS/YEAR SPREAD PERSON TO PERSON-CONTAMINATED FOOD & WATER
Diarrhea Definition ?
Diarrhea Definition Frequency Consistency
Acute Diarrhea < 2Weeks Chronic Diarrhea > 2weeks
Etiology ؟
- Viral - Bacterial - Parasitic - Food poisoning - Extra-Intestinal - Munchausen Syndrom
VIRAL GASTROENTERITIS - - Rota virus - Entero adenovirus- Astrovirus-calcivirus - -Infants > Older children - -Begin with vomiting in 80% then diarrhea - -Vellus damage - -Diarrhea is not bloody - -Dx Stool for ELISA Disaccharidase def.
Bacterial Gastroenteritis -E coli EPEC-ETEC-EIEC-EHEC -Salmonella Egg-Milk-Poultry -Shegella -Campylobacter jejuni Chicken -Yersinia enterocoliticua -Clostridium dificile Antibiotic related
Parasitic Gastroenteritis -Entamoeba Histolytica Bloody -Giardia Lamblia Not bloody -Cryptosporidium Immunocompromised patients
Complications -Dehydration Mild-Moderate-Sever -Electrolyte imbalance - Acidosis -Shock -Prerenal insufficiency -Disaccaridase def -Hemolytic Uremic Syndrom (HUS) Na
Investigations Serum Electrolyte,Urea & Creatinine Stool analysis, c/s,Elisa for rota virus Blood Gases Others
Treatment -Non (Breast fed) -Fluid & elecrolyte replacement ORS vs IVF -Lactose free formula -NO ANTIDIARRHEAL AGENTS
PATHOGENESIS Secretory cAMP & cGMP Osmotic Lactose Transit time Inflamation & T4 Absorption / Digestion
ORS Oral rehydration solution 2.5% glucose mEq/l Na mEq/l cl 30 mEq/l Bicarbonate