Gastroenteritis
start Clinical Pathway
Vomiting
Diarrhoea
- passage of 3 or more stools in a 24 hour period
- acute watery
- acute invasive i.e. bloody i.e. dysentery
- IF >2 weeks = chronic
Enteric fever (see Salmonella below)
infectious (called food poisoning if from food whether bacterial toxin or infectious)
compare with
non infectious diarrhoea (allergic..)
Foodborne intoxication
...
Infectious
Virus:
Rotavirus
Norwalk virus (noro)
Adenovirus
Bacterial:
gm pos rods
Clostridium difficile (antibiotics)
gm neg rods
Campylobacter jejuni (helical)
Vibrio cholerae: painless profuse watery diarrhoea
Escherichia coli
Salmonella typhi/paratyphi (enteric fever/meningitis)
Shigella
Yersinia entercolitica (pseudoappendicitis)
Protista
Amoeba:
Entamoeba histolytic
Excavata:
Giardia
SAR:
Balantidium coli (dysentery)
Cryptosporidium
Isospora belli
Sarcocystosis
Rx
Ondansetron
TOF with ORS
Rapid rehydration
IVF maint and replacement over 24 hours
Zn for chronic diarrhoea or acute at risk children
Secondary lactose intolerance
Stool
Vomiting
Diarrhoea
- passage of 3 or more stools in a 24 hour period
- acute watery
- acute invasive i.e. bloody i.e. dysentery
- IF >2 weeks = chronic
Enteric fever (see Salmonella below)
infectious (called food poisoning if from food whether bacterial toxin or infectious)
compare with
non infectious diarrhoea (allergic..)
Foodborne intoxication
...
Infectious
Virus:
Rotavirus
Norwalk virus (noro)
Adenovirus
Bacterial:
gm pos rods
Clostridium difficile (antibiotics)
gm neg rods
Campylobacter jejuni (helical)
Vibrio cholerae: painless profuse watery diarrhoea
Escherichia coli
Salmonella typhi/paratyphi (enteric fever/meningitis)
Shigella
Yersinia entercolitica (pseudoappendicitis)
Protista
Amoeba:
Entamoeba histolytic
Excavata:
Giardia
SAR:
Balantidium coli (dysentery)
Cryptosporidium
Isospora belli
Sarcocystosis
Rx
Ondansetron
TOF with ORS
- active SGLT-1 Na(2)/Glucose(1) cotransporter
- H2O absorbed passively following the osmotic gradient
- Research ? starch: if amylase sens > converted to glucose in SI if brush border intact, if resistant or no amylase > colonic fermentation
Rapid rehydration
IVF maint and replacement over 24 hours
Zn for chronic diarrhoea or acute at risk children
Secondary lactose intolerance
Stool