Diarrhea

Diarrhea

Diarrhea

Acute diarrhea ( gastroenteritis): is an inflammation of the stomach and intestines caused by various bacterial, viral and parasitic pathogens.

Diarrhea: increase frequency, fluidity and volume of faeces.

As why diarrheal disorders are serious during infancy? this is because dehydrated much more quickly than adults.

Aetiology:

Acute and infectious factors:

- Bacterial such as E.coli, salmonella, Shigella and Vibro cholera.

- Viral such as Rotavirus and Adeovirus .

- Fungal such as candida enteritis.

- Parasitic such as Giardia Lamblia.

- Normal flora after ingestion of antibiotic.

- Non-infectious factors.

- Allergy to certain foods.

- Metabolic disorders ( celiac disease ).

- Overfeeding.

- The unsuitable formula for age.

- Environmental factors.

- The rise of atmospheric temperature.

- Poor sanitation.

- Exposure to cold drafts.

- Low socio-economical status.

- Clinical manifestations:

Stool:

- Greenish to yellow-green in colour.

- Loose and fluid in consistency.

- May contain pus, mucus or blood.

- Frequency various from 2 to 20 time.

- Fever, anorexia, vomiting, rapid respiration, irritability and general weakness.

Dehydration:

- Poor skin turgor, and dry mucous membrane.

- Decreased urinary output.

- Sunken eyes and anterior fontanel.

- Rapid pulse, low blood pressure.

- Dry mouth, thirst.

- Loss of weight.

Complications:

- Dehydration.

- Acidosis.

- Electrolyte imbalance.

- Infection.

Diagnostic evaluation:

- Health history.

- General physical appearance.

Laboratory studies :

- Serum electrolytes .

- Arterial blood gases analysis.

- CBC ( high HCT ) .

- Urine and stool analysis and culture.

Treatment:

- Prevention.

- Breastfeeding. 

- Health education for mothers.

- Enteric isolation precautions to prevent the spread of infection.

- Maintain hydration.

- Supportive care.

Oral Rehydration Solution:

 - Indication for all cases of dehydration as long as the child strong to drink.

Drug treatment:

- Symptomatic antidiarrheal drugs are usually not recommended.

- Anti-emetic drugs are not indicated.

- Antibiotic in the treatment of diarrhea.



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