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

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)


  • 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.


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

Rotavirus

Common Causes of Acute Diarrhoea

  • Infection – highly contagious

    • Viral gastroenteritis (“stomach flu”)


  • Bacterial enterocolitis

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


  • Bacterial enterocolitis

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


Shigella bacteria

Campylobacter bacteria

  • Bacterial enterocolitis

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


  • Giardia lamblia

  • in contaminated water

  • Usually not associated with inflammation

  • Parasites


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


  • Staphylococcus aureus

  • Produces toxins in food before it is eaten

  • Usually food contaminated left unrefrigerated overnight


  • 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
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

  • 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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