GASTROENTERITIS &

DEHYDRATION
• Acute enteritis or acute gastroenteritis refers to diarrhea,
which is abnormal frequency and liquidity of fecal discharges.

• Acute diarrhea can be defined as the abrupt onset of 3 or

more loose stools per day and lasts no longer than 14
days while chronic or persistent diarrhea is defined as an
episode that lasts longer than 14 days

• Infective diarrhea and vomiting remain an important cause of

morbidity in developed countries , and of mortality in
developing countries.
• Enteritis has many viral, bacterial, and parasitic causes

• The commonest cause of gastroenteritis is Rotavirus

infection.

• Bacterial causes are less common in developed

countries, and are suggested by the presence of blood in
the stools.
(e.g.Campylobacter jejuni , Shigella and some
salmonellae)
Mechanisms of Diarrhea
 ,
Cont Mechanisms of Diarrhea
 ‫ مهمه ا الوزوموتك‬Feeding =osmotic
‫ تتوقف عند الفاستنگ اول نوع ميتوقف‬osomtic‫و‬
Waterry=viral
‫ ت صير ورىميصير دياريا‬Bacteria
Mucous +blood =inflammation of colon
Increase suspicious of primary Lactase intolerance
Causes of Osmotic Diarrhea
Differential Diagnosis of Osmotic Vs Secretory Diarrhea
Common Infectious Causes of Diarrhea
 CLINICAL MANIFESTATIONS
Gastroenteritis may be accompanied by systemic findings,
such as fever, lethargy, and abdominal pain.
Patients with diarrhea and possible dehydration should be
evaluated to assess the degree of dehydration as evident from
clinical signs and symptoms, ongoing losses, and daily
requirements .
Viral diarrhea is characterized by watery stools, with no blood
nor mucus.
Vomiting may be present, and dehydration may be prominent.
Dysentery is diarrhea involving the colon and rectum, with
blood and mucus, possibly foul smelling, and fever.

Causes of bloody diarrhea include ??:

Entamoeba Histolytica (amebic dysentery)
Shigella
EIEC
EHEC
Campylobacter jejuni
Yersenia Enterocolitica
Non Typhoidal Salmonella Most imp
Dehydration and its complications are the usual cause of death in
gastroenteritis, and its correction is the fundamental aim of treatment.

Classification of dehydration:
A. According to severity of dehydration.
B. According to natraemic state (level of s.sodium)
C. WHO. classification

Classification according to severity of dehydration:

• Mild dehydration (3% to 5%):
normal pulse rate or minimal tachycardia, decreased urine output, thirst, and
normal physical examination.

• Moderate dehydration (5% to 10%) 6 .‫ا الرقام حفظ‬

• Severe dehydration (>10% ,up to 15%) 10

 10kg weight •
At night it becomes 9kg •
So there is dehydration +sign of dehydration severe •
So clinically ipredict •
9.5 .....10 •
mild ‫ بالمئة‬٥ ‫سو النقص‬ •
/ ‫سؤال‬ •
Infants are at particular risk of dehydration because of their:

1) greater surface area to weight ratio, leading to greater insensible

water losses
2) inability to gain access to fluids when thirsty
3) higher basal fluid requirements (100-120 ml/kg per day, i.e. 10-12%
of body weight)
4) immature renal tubular reabsorption processes
Clinical features of dehydration in an infant
Clinical assessment of dehydration