Acute Diarrhoea Acute Diarrhoea and and

Gastroenteritis Gastroenteritis in Childhoodin Childhood

Acute Diarrhoea Acute Diarrhoea and and

Gastroenteritis Gastroenteritis in Childhoodin Childhood

By: Afifah binti Othman

Masrina binti Hj. Mhmad Tahar

Current Health Problems in Students’ Home Countries

Diarrhoea in the 21Diarrhoea in the 21stst CenturyCenturyDiarrhoea in the 21Diarrhoea in the 21stst CenturyCentury• Second most common cause of

morbidity and mortality worldwide• WHO estimation (2002), diarrhoeal

disease results in:2.5 million people die annually, mostly

children1.6 million children <5yrs old (in

developing countries)

• In the U.S.211-375 million episodes of diarrhoeal

disease occur annually73 million physicians consultations1.8 million hospitalizationOver 3000 death

• In Malaysia (2000)About 2 million episodes of diarrhoea

annually among children < 15 yrs old5% of total mortality among children <5

yrs old

What is Diarrhoea?What is Diarrhoea?What is Diarrhoea?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 Common Causes of Acute DiarrhoeaDiarrhoea

Common Causes of Acute Common Causes of Acute DiarrhoeaDiarrhoea

• Infection – highly contagiousViral gastroenteritis (“stomach flu”)

Rotavirus

Usually cause explosive, watery diarrhoea

Typically last only 48-72hrs

Usually no blood and pus in stool

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

Cryptosporidium

• in contaminated water – can survive

chlorination

Parasites

Giardia lamblia

• in contaminated water

•Usually not associated with inflammation

Common Causes of Acute Common Causes of Acute Diarrhoea – cont.Diarrhoea – cont.

Common Causes of Acute Common Causes of Acute Diarrhoea – cont.Diarrhoea – cont.

• Food PoisoningBrief illness cause by toxins produced by

bacteriaCause abdominal pain, vomittingCause SI secrete high amnt of water –

diarrhoeaSome 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 Common Causes of Acute Diarrhoea – cont.Diarrhoea – cont.

Common Causes of Acute Common Causes of Acute Diarrhoea – cont.Diarrhoea – cont.• Traveller’s Diarrhoea• Drugs / medications

Complications of DiarrhoeaComplications of DiarrhoeaComplications of DiarrhoeaComplications of Diarrhoea

• DehydrationExcessive loss of fluids and minerals

(electrolytes) from the bodyCommon in infants and young children with

viral gastroenteritis or bacterial infectionKidney failure, eg in infection by E.coli

• Electrolyte deficiency• Irritation to anus due to frequent passage

of watery stool containing irritating substances

• 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 mouthFew or no tears when cryingSunken eyesLack urine or wet diaperDry, cool skinFatigue or dizziness

When Treatment is Needed?When Treatment is Needed?When Treatment is Needed?When Treatment is Needed?

• 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

Tests for Acute DiarrhoeaTests for Acute DiarrhoeaTests for Acute DiarrhoeaTests for Acute Diarrhoea

• 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

TreatmentTreatmentTreatmentTreatment

• 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

Treatment – cont.Treatment – cont.Treatment – cont.Treatment – cont.

PreventionPreventionPreventionPrevention

• 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.

1. Wikipedia http://en.wikipedia.org/wiki/Main_Page

2. Medical Journal Malaysia VOL 62 http://www.mma.org.my

3. World Health Organization – WHO http://www.who.int/topics/diarrhoea/en/

4. http://www.medicinenet.com/diarrhea/article.htm

5. http://www.mayoclinic.com/health/diarrhea/DS00292

6. http://www.kidshealth.org/parent/infections/common/diarrhea.html

ReferencesReferencesReferencesReferences