AGE:

Acute Gastroenteritis
Kamar H. Callanga // Jashmir joyce F. Banua
DEFINITION:

Gastroenteritis is a catchall term for infection or

irritation of the digestive tract, particularly the
stomach and intestine.
ANATOMY AND PHYSIOLOGY:
PATHOPHYSILOGY:
Viral spread from person to person occurs by fecal-oral
transmission of contaminated food and water. Some viruses, like
noroviruses, may be transmitted by an airborne route. Clinical
manifestations are related to intestinal infection, but the exact
mechanism of the induction of diarrhea is not clear
ETIOLOGY :
Acute gastroenteritis is a common cause of morbidity and
mortality worldwide. Conservative estimates put diarrhea in the
top 5 causes of deaths worldwide, with most occurring in young
children in nonindustrialized countries.

Etiologies include bacteria, viruses, parasites, toxins, and drugs.

Viruses are responsible for a significant percentage of cases
affecting patients of all ages. Viral gastroenteritis ranges from a
self-limited watery diarrheal illness
RISK FACTORS:

Young children
Older adults
Schoolchildren, churchgoers or dormitory
residents.
Anyone with a weakened immune system.
SIGNS AND SYMPTOMS:

These include the following:

Diarrhea
Vomiting
Increase or decrease in urinary frequency
Abdominal pain
Signs and symptoms of infection - Presence of
fever, chills, myalgias, rash, rhinorrhea, sore
throat, cough; these may be evidence of
systemic infection or sepsis
 Changes in appearance and behavior - Including
weight loss and increased malaise, lethargy, or
irritability, as well as changes in the amount and
frequency of feeding and in the childs level of thirst
History of recent antibiotic use - Increases the
likelihood of Clostridium difficile
History of travel to endemic areas
TEST:

The symptoms of gastroenteritis are usually

enough to identify the illness.
Workup in pediatric gastroenteritis can include
the following:
Baseline electrolytes
Fecal leukocytes and stool culture
Stool analysis for C difficile toxins
Stool analysis for ova and parasites
Complete blood count (CBC) and blood
cultures
NSG. MANAGEMENT:

Wash hand thoroughly after giving care to avoid

spreading of infection, and use standard precaution
whenever handling vomitus or stools.
Monitor the patients fluids status carefully.
Assess vital signs at least every 4 hours, weigh him
daily, and record intake and output.
Teach the patient about gastroenteritis, describing its
symptoms and varied causes.
Teach the patient the proper preventive measures.
MEDICATION:
Probiotics

Zinc

Metronidazole

Tetracycline and doxycycline

Vaccine
NURSING DIAGNOSIS:

Diarrhea related to infectious process

Fluid Volume Deficit related to active fluid
volume loss
Risk for Impaired Skin Integrity related to
altered fluid status
UPDATES:
CDC finds norovirus the chief culprit in acute
gastroenteritis in young children
The availability of rotavirus vaccines has made norovirus the
most common cause of medically attended acute
gastroenteritis in American children younger than 5 years,
according to a 2013 study from the US Centers for Disease
Control and Prevention (CDC). The report indicates that
norovirus infection resulted in almost 1 million pediatric
medical-care visits in the United States in 2009 and 2010, with
treatment costs reaching hundreds of millions of dollars
annually. Approximately half of the norovirus-related visits
involved children aged 6-18 months
 Studies of the rotavirus vaccine have shown that it
can prevent about 74% of rotavirus infections. More
importantly, it can prevent approximately 98% of
severe infections and 96% of hospitalizations from
rotavirus. In one Massachusetts hospital, in two
years, the number of people with rotavirus dropped
from 65 to three.
 http://emedicine.medscape.com/article/176515-overview#a5
http://emedicine.medscape.com/article/801948-overview