Flashcards in Gastroenteritis Deck (13):
Viral causes of gastro
• Rotavirus: seasonal peak in Autumn and Winter
• Adenovirus: 7-17% of cases require admission
• CMV enteritis: consider in immunocompromised patients
Bacterial causes of gastro (5-10%)
• Salmonella spp.
• Campylobacter jejuni
• Yersinia enterocolitica
• Escherichia coli
• C. difficile: follows antibiotic therapy
• Entamoeba histolytica: consider in developing countries
Parasitic causes of gastro
• Cryptosporidium: consider in immunocompromised patients
• Giardia: commonly a cause of persistent diarrhoea with flatulence and bloating
DDx of gastro
• Surgical abdomen: intussusception, Hirschprung's, malrotation, pyloric stenosis
• Malabsorptive disorders: Coeliac disease, CMPI
What does doughy skin suggest?
What are some initial Ix you might do in severely dehydrated/unwell, or high loss gastros?
Glucose, UEC, ABG/VBG
What are other options for feeding if a patient can't tolerate normal oral intake?
• Slower, smaller feeds
• If not tolerating NGT:
○ Slow rate
○ Give ondansetron
○ Then IV
Why is NGT preferred to IV?
Safer: a) electrolytes b) skin (not necessarily less invasive)
How can feeding affect breathing?
- Stomach pushes on diaphragm
- Esp in smaller children, requires a lot of energy to feed
What is the most preferred oral rehydration solution? How do ORSs work?
- ORS works via glucose-facilitated sodium transport
What should you consider if there is persistent diarrhoea after re-introduction of feeds?
What pharmacotherapy is recommended for gastro?
• No treatment with antidiarrhoeals is recommended
• Most bacterial infections do not require Abx even if there is presence of blood or mucous
• Ondansetron once
• Indications for Abx treatment
○Sepsis, extra-intestinal spread of bacterial infection