Acute Gastroenteritis

• Disediakan Oleh : Nassruto

Learning Objectives:

• After lecture the students able to:• Define of Acute Gastroenteritis.• Define of diarrhea.• Describe the etiology of acute diarrhea.• Explain the pathysiology of diarrhea and dehydration.• Determine the classification of dehydration severities.

Learning Objectives:

• List down the manifestation of diarrhea.• What are the complication of diarrhea.• Describe the management of diarrhea cases.• Describe the health education needed for diarrhea cases.

Definition:

• AGE:• It is an acute Intestinal illness with the symptom of

diarrhea or vomiting causes of food or irritation intestine.• DIARRHOEA:• Refers to the frequently passage of loose or watery stools.

Pre- View:

• More common in infants or children.• Age: 6 months to 2 year old.• Drinking cow’s milk or infants formulas feedings.• Major health problem causing enormous morbidity and

mortality.• Socio-economic status contributes to the incidence of diarrhea.

Contain of stools:

• Blood ( dysentery ).• Mucus ( jelly ).• Watery ( liquid/no solid elements ).• Loose ( liquid with solid elements ).• Pasty ( like a paste / sticky ).• Formed ( normal solid ).

Classification of diarrhea:

• ACUTE:

• Had diarrhea in a few days.• Mild frequently diarrhea.• Mild or without muscle spasm.

• CHRONIC:

• Had diarrhea for more than 2 weeks.• Frequently diarrhea.• Severe muscle spasm.

Etiology of acute diarrhea:

• Virus / Bacteria / Parasite:• Food intake.• Infection in or outside of GIT.• Ingestion system of person.

• Administration of medications.• Antibiotic.• Laxative abuse ( herb ).

• Emotional disturbances.

Etiology of chronic:• Defects of the intestinal tract.• Chronic infections of intestinal tract.• Inflammation of the intestinal tract.• Food allergy.• Malabsurption.• Malnutrition.• Conditions outside the intestinal tract.

Pathogens:

• Causing damages to the colon wall of eupatorium cells.

• Bacteria / viruses.• Release of toxin.• Irritation occurs.

Pathophysiology of diarrhea:

CONTAMINATE FOOD

HCLPATHOGENS

RUIN OR DAMAGE INTESTINAL WALLS

RELEASE TOXINSINFLAMATION OCCURS

DIARRHOEA

Clinical Manifestation:• Rapidly diarrhea / vomiting.• Poor feeding.• Restless.• Fever.• Oliguria.• Lethargy.• Abdomen distended.• Abdominal pain.

Clinical Manifestation:

• Stools tend to be watery / fluid.• Nasty and contain mucus or blood.• Anorexia ( L.O.A ).• Lethargic / not active.• Crying ++ / no tears / not crying anymore.

Pathophysiology dehydration:

• Excessive water lost.• Less water + Na+ in blood• Input < output.• Electrolyte imbalance occurs.• Extra / intra cellular fluids loss.• dehydration appears.

Degree of dehydration:

• Mild:• Moderate.• Severe.

Investigations:

• Focus on stool / faces:• Gross examination on:• Color / contain / nature / blood / exudates.• Pro long diarrhea or bloody stools:• Rectum swab for C&S / FEME.• Rectum swab for E.h / Salmonella.• Smear for pshymorphonuclear leukocytes.

Investigations:

• Stool PH- Strips.• PH < 6 : • Stool for Sugar Intolerance.• Blood : FEME / FBC / BUSE to rule out

infection and renal impairment.• Urine : to detect other infection.

Complications:

• Effect from dehydration.• Abruption whole body system.• Metabolic acidosis.• Respiration acidosis.• Hypovolieumic shock.• Renal impairment.• Tissue hypoxia.• Death.

Treatment management:

• Purpose of treatment.• Determine the degree of severities.• Identify causes.• How to prepare ORS solution.• Preventive means.• How to use plan chart to treat.• Health education needed.

Purpose of treatment:

• To stopped diarrhea / vomiting.• To prevent dehydration.• To avoid electrolyte imbalance.• To treat the dehydration.• To support continuous nutriment.• To avoid from complication and mortality.

Determine the degree of severities:

• From sign and symptom.• History / examine patient.• Findings.• Vital organ function reduce.

Identify causes:

• Ask About:• Contain of stool.• Length duration / frequency of diarrhea.• Associated symptom.• Look For:• Severities of dehydration.• Check under nutrition occurs.

PENDIDIKAN KESIHATAN:

How to prepare ORS:

• Hand Washing.• Wash and pour clear drinking water to the container about

250ml.• Add Ors powder and steer until all partial resolve.• Tested it before serve.

Bill

Material Amounts

1. Sod. Chloride B.P 525mg.2. Presidium Citrate B.P 490mg.3. Pot. Chloride B.P 373mg.4. Glucose Anhydrous B.P 5.4 g

How to use plan chart to treat:

• PLAN A:• Rules to treat diarrhea at home.• PLAN B:• Rules to avoid dehydration.• PLAN C:• Rules to treat severe dehydration.

Need to be admit:

• Loss 10% dehydration.• Refuse to drink.• Toxic looking patient.• Had mild fever.

Prevention means:

• For Patients:• Increase fluid intake.• Frequently breast feeding.• Provide mixes food / fruits juice.• Use purify water for domestic activities.• Hand Washing.• Use Clean instrument.

Preventive Means:

• For public:• Care of environment hygiene.• Proper toilet using.• Purify water resources.• Med-check up for those handling with food.• Immunization.• Notification.• Plan out the intervention activities to prevent.