Acute gastroenteritis, fluid

and electrolyte management

Supervisor: Dr Laili
Presentors:
Miqdad, Farizah, Thanusha, Syakirah, Fahimah
Acute Gastroenteritis
 Gastroenteritis is an inflammation of the lining of the
stomach, small or large intestine
 diarrheal disease of rapid onset with or without
accompanying symptoms, signs, such as nausea, vomiting,
fever or abdominal pain
AGE is a leading cause of childhood morbidity and mortality
and an important cause of malnutrition in developing
countries.
While in developed countries AGE contributes to increase in
hospital admissions.

Diarrhea
 increase in the frequency, fluidity and volume of stool
compared to normal
Aetiology
VIRAL

Transmision by fecal-oral route, including contaminated

water.

Causes :
-ROTAVIRUS is the most common cause
-Enteric adenovirus
-Astrovirus
-CMV ( in immunocompromised patient)

Presentation:
- Vomiting followed by watery diarrhea
-Low grade fever
-Diarrhea persisting for 5-7 days
BACTERIA

Transmission : fecal-oral route.

Causes:
-Campylobacter
-salmonella
-Shigella
-E.coli
-Yersinia
-Clostridium difficile

Presentation:
-High grade fever
-Shaking chills
-Dysentery
-Abdominal cramping
PARASITE
- <10% of cases
-Infection usually via fecal-oral route
-Pets and livestock can be hosts.

Causes:
-Giardia lamblia
-cryptosporidium
-entamoeba histolytica

Presentation:
- watery stools
- low grade fever
-Abdominal pain
-Abdominal distention
 SOURCE OF INFECTION
&
HIGH RISK GROUP
• Contaminated water and food
• Poor hygiene, poor bottle hygiene
• Nutritional deficiency
• Immune deficient individuals
• Malnutrition
• Travel to endemic areas
• Lack of breast feeding
• Exposure to unsanitary conditions
Symptoms and signs of AGE
Diarrhea
Vomiting
Stomach pain
Stomach cramp
Fever
Nausea
Headache
History taking
1. Diarrhea
-How many times? How many days?
-Amount
-Consistency of stool?
-Presence of blood, mucous?
-Explosive? Rice water?
2. Vomiting
- How many of episodes?
- Vomitus content? Mucus?
- Any blood and bile?
- Projectile/non-projectile

3. Fever

4. Urine output

5. Food and water intake- weight lose

6. Any history of taking outside food?

7. From dengue prone area?

8. Any sick contact/ family members having the same
symptoms ?

9. Any new food, milk?

10. Any medication taken?

11. Bottle feeding hygiene

12. Lethargy

13. Irritable

14. Abdominal pain

Physical examination

General appearance
Vital signs - temperature, pulse rate, respiratory rate,
blood pressure
Irritable/ Lethargic
Extremities - perfusion, capillary refill time
Anterior fontanelle markedly depressed
Eyes - sunken eyes, presence or absence of tears
Mucous membrane - moist or dry
Skin turgidity
Bowel sounds