10 GI infections Flashcards
clinical syndromes of GI infections
acute gastroenteritis
dysentery (diarrhoea, nausea and vomiting, abdominal pain, fever)
traveller’s diarrhoea
post-antibiotic diarrhoea (usually C.Diff)
chronic diarrhoea
define diarrhoea
3 or more loose stools per day
what is dysentery
bloody diarrhoea
how long is chronic diarrhoea
more than 2-3 weeks
causes of dysentery
tend to be bacterial and protozoal rather than viral, bloody diarrhoea needs mucosal discharge which viruses don’t usually produce
what type of diarrhoea does salmonella tend to give
watery diarrhoea due to increased secretion rather than bloody
How do antibiotics lead to diarrhoea
it disrupts normal gut flora, breaks down bile salts, makes more green bile in colon, affects mucosal absorption capacity
what are some post infection syndromes of parasites in traveller’s diarrhoea
irritable bowel- can happen up to 6 months after infection
malabsorption- damaged villi and reduced surface area
what is diverticular disease
digestive condition that affect the large intestine (colon)
small bulges or pockets (diverticula) develop in the lining of the intestine
older you are more likely to get it
other syndromes affecting GI tract (6)
inflammatory bowel disease diverticular disease ischaemic colitis colorectal carcinoma malabsorption extra-intestinal infection e.g. pneumonia
stool samples, when and how many
not always a clinical need to send from GP, but if ill enough to be hospitalised then investigate
aim for 3 specimens
general management of GI infections (8)
1 rehydration, oral or IV 2 analgesia e.g. paracetamol 3 anti-emetics e.g. ondansetron 4 avoid anti-diarrhoeal agents e.g. loperamide 5 isolation (in hospital) 6 notification to public health- look for source and might have to shut down restaurants etc 7 return to work or school 8 maybe antibiotic
C.diff diarrhoea diagnosis and treatment
post antibiotic diarrhoea, 4 or more loose stools per day, maybe bloody
treat= metronidazole or vancomycin
treatment for travellers diarrhoea
empirical ciprofloxacin or azithromycin (500mg stat)
if due to parasites than won’t respond to ciprofloxacin
give metronidazole (giardia) or nitazoxanide (for cryptosporidium)
do you give antibiotics for acute gastroenteritis
controversial, not a dramatic difference, may only shorten illness by 1-2 days IF started early
host response sorts out infection fairly quickly and most people don’t see a prescriber early enough to make a difference
