Acute diarrhoea and gastroenteritis in childhood
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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 21 st Century. Second most common cause of morbidity and mortality worldwide

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Acute Diarrhoea and Gastroenteritis in Childhood

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Acute diarrhoea and gastroenteritis in childhood

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 21 st century

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)


Acute diarrhoea and gastroenteritis in childhood

  • 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

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.


Acute diarrhoea and gastroenteritis in childhood

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

X


Common causes of acute diarrhoea

  • Usually cause explosive, watery diarrhoea

  • Typically last only 48-72hrs

  • Usually no blood and pus in stool

Rotavirus

Common Causes of Acute Diarrhoea

  • Infection – highly contagious

    • Viral gastroenteritis (“stomach flu”)


Acute diarrhoea and gastroenteritis in childhood

  • E. Coli bacteria

  • Contaminated food or water

  • Usually affect small kids

  • Bacterial enterocolitis

    • Sign of inflammation – blood or pus in stool, fever


Acute diarrhoea and gastroenteritis in childhood

  • Salmonella enteritidis bact

  • In contaminated raw or undercooked chicken and eggs

  • Bacterial enterocolitis

    • Sign of inflammation – blood or pus in stool, fever


Acute diarrhoea and gastroenteritis in childhood

Shigella bacteria

Campylobacter bacteria

  • Bacterial enterocolitis

    • Sign of inflammation – blood or pus in stool, fever


Acute diarrhoea and gastroenteritis in childhood

  • Cryptosporidium

  • in contaminated water – can survive chlorination

  • Giardia lamblia

  • in contaminated water

  • Usually not associated with inflammation

  • Parasites


Acute diarrhoea and gastroenteritis in childhood

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


Acute diarrhoea and gastroenteritis in childhood

  • Food Poisoning

  • Staphylococcus aureus

  • Produces toxins in food before it is eaten

  • Usually food contaminated left unrefrigerated overnight


Acute diarrhoea and gastroenteritis in childhood

  • Food Poisoning

  • Clostridium perfringens

  • Multiplies in food

  • Produces toxins in SI after contaminated food is eaten


Acute diarrhoea and gastroenteritis in childhood

Common Causes of Acute Diarrhoea – cont.

  • Traveller’s Diarrhoea

  • Drugs / medications


Acute diarrhoea and gastroenteritis in childhood

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


Acute diarrhoea and gastroenteritis in childhood

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


Acute diarrhoea and gastroenteritis in childhood

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


Acute diarrhoea and gastroenteritis in childhood

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


Acute diarrhoea and gastroenteritis in childhood

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

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.


Acute diarrhoea and gastroenteritis in childhood

References

  • 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/

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

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

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


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