PATHOPHYSIOLOGY OF ACUTEGASTROENTERITIS (AGE)

Acute gastroenteritis is usually caused by bacteria and protozoan. In the Philippines,one of the most
common causes of acute gastroenteritis is E. histolytica. The pathologicprocess starts with ingestion of
fecally contaminated food and water. The organism affects thebody through direct invasion and by
endotoxin being released by the organism. Through thesetwo processes the bowel mucosal lining is
stimulated and destroyed the eventually lead toattempted defecation or tenesmus as the body tries to
get rid of the foreign organism in thestomach.The client with acute gastroenteritis may also report
excessive gas formation that mayleads toabdominal distention and passing of flatus due to digestive and
absorptive malfunction in thesystem. Feeling of fullness and the increase motility of the gastrointestinal
tract may progress tonausea and vomiting and increasing frequency of defecation. Abdominal pain and
feeling offullness maybe relieved only when thepatient is able to pass a flatus.As the destruction of the
bowel continues the mucosal lining erodes due to toxin, directinvasion of the organism and the action of
the hydrochloric acid of the stomach. As theprotective coating of the stomach erodes the digestive
capabilities of the acid helps indestroying the stomach lining. Pain or tenderness of the abdomen is then
felt by the patient.When the burrows or ulceration reaches the blood vessels in the stomach bleeding
will beinduced. Dysentery may be characterized by melena or hematochezia depending on the siteand
quantity of bleeding that may ensue. Signs of bleeding may be observed also throughhematemesis.As
the bowel is stimulated by the organism and its toxin, the intestinal tract secreteswater andelectrolytes
in the intestinal lumen. The body secretes and therefore lost Chloride andbicarbonate ions in the bowel
as the body try to get rid of the organism by increasing peristalsisand number of defecation. Sodium and
water reabsorption in the bowel is inhibited with the lostof the two electrolytes.Mild diarrhea is
characterized by 2-3 stool, borborygmi (hyperactive bowel sound),fluidand electrolyte imbalance and
hypernatremia. When the condition continue to progress, proteinin the body is excreted to the lumen
that further decreases the reabsorption and the bodybecome overwhelmed that leads to intense
diarrhea with more than 10 watery stool. Seriousfluid volume deficit may lead to hypovolemic shock and
eventually death.