Current Health Problems

in Students’ Home Countries

Acute
Acute Diarrhoea
Diarrhoea
and
and Gastroenteritis
Gastroenteritis
in
in Childhood
Childhood
By:
Afifah binti Othman
Masrina binti Hj. Mhmad Tahar
Diarrhoea in the 21 Century st
st

• Second most common cause of morbidity and

mortality worldwide
• WHO estimation (2002), diarrhoeal disease
results in:
2.5 million people die annually, mostly children
1.6 million children <5yrs old (in developing
countries)
• In the U.S.
211-375 million episodes of diarrhoeal disease
occur annually
73 million physicians consultations
1.8 million hospitalization
Over 3000 death
• In Malaysia (2000)
About 2 million episodes of diarrhoea annually
among children < 15 yrs old
5% of total mortality among children <5 yrs old
 What is Diarrhoea?
• An increase in the frequency of bowel movements
or a decrease in the form of stool (greater
looseness of stool)

• Changes in frequency of
bowel movements and
looseness of stools can
vary independently of
each other, changes
usually occur in both.
 Chronic diarrhoea Acute diarrhoea
 Generally lasts > 3 weeks  lasts a few days or up to
 Common causes: IBS, a week
AIDS, bacterial outgrowth
of small int., Colon cancer,
Chron’s disease

IMPORTANT !!!
distinguish between acute and chronic diarrhoea
>>>different diagnostis tests, different treatments
 Common Causes of Acute Diarrhoea
• Infection – highly contagious
Viral gastroenteritis (“stomach flu”)

 Usually cause explosive,

watery diarrhoea
 Typically last only 48-
72hrs
 Usually no blood and pus
in stool
Rotavirus
 Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool, fever

E. Coli bacteria
•Contaminated food or water
•Usually affect small kids
 Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool, fever

Salmonella enteritidis bact

•In contaminated raw or
undercooked chicken and eggs
 Bacterial enterocolitis
 Sign of inflammation – blood or pus in stool, fever

Shigella bacteria
Campylobacter
bacteria
 Parasites

Cryptosporidium Giardia lamblia

• in contaminated water – can • in contaminated water
survive chlorination
•Usually not associated with
inflammation
Common Causes of Acute Diarrhoea –
cont.
• Food Poisoning
Brief illness cause by toxins produced by bacteria
Cause abdominal pain, vomitting
Cause SI secrete high amnt of water – diarrhoea
Some bacteria produce toxins in food before intake
or in intestine after food is eaten
Symptoms usually appear within sev. hours
• Food Poisoning

Staphylococcus aureus
• Produces toxins in food before it is eaten
•Usually food contaminated left unrefrigerated
overnight
• Food Poisoning

Clostridium perfringens
• Multiplies in food
•Produces toxins in SI after contaminated food is eaten
Common Causes of Acute Diarrhoea –
cont.
• Traveller’s Diarrhoea
• Drugs / medications
 Complications of Diarrhoea

• Dehydration
 Excessive loss of fluids and minerals (electrolytes) from
the body
 Common in infants and young children with viral
gastroenteritis or bacterial infection
 Kidney failure, eg in infection by E.coli
• Electrolyte deficiency
• Irritation to anus due to frequent passage of watery
stool containing irritating substances
 When Treatment is Needed?
• Severe or prolonged episode of
diarrhoea
• Fever
• Repeated vomiting, refusal to
drink fluids
• Severe abdominal pain
• Diarrhoea that contains blood or
mucus
• Sign of dehydration
 Dry, sticky mouth
 Few or no tears when crying
 Sunken eyes
 Lack urine or wet diaper
 Dry, cool skin
 Fatigue or dizziness
 Tests for Acute Diarrhoea
• Measurement of BP in upright and supine post –
demonstrate orthostatic hypotension, confirm
dehydration
• Moderate – severe diarrhoea, blood electrolytes
• Examination of small amount of stool under
microscope – if inflammation present, further test
particularly for bacterial and parasitic infection
 Treatment

• Antibiotics or antiviral medications are not

prescribed for cases of diarrhoea caused by
virus or bacteria
• Antibiotics may be given to very young
children or children with weak immune system
• In parasitic infection – antiparasitic medicine
usually given
 Treatment – cont.
• Oral rehydration solutions (ORS)
Contain carbohydrate (glucose or rice syrup) and
electrolytes (Na, K, Cl, citrate, HCO3-)
Infants and children
 Infants with mild dehydration – ORS at home (with
doctor recommendation)
 Infants with moderate – severe dehydration, IV fluids at
hospital
 Avoid caffeine and lactose containing product
 Prevention
• Wash hands thoroughly before and after eating
or when preparing the meals.
• Make sure that the tools used for eating and
preparing the meals are clean.
• Cover our food or put them in the fridge to
prevent any contamination.
 References
1. Wikipedia
http://en.wikipedia.org/wiki/Main_Page
2. Medical Journal Malaysia VOL 62
http://www.mma.org.my
3. World Health Organization – WHO
http://www.who.int/topics/diarrhoea/en/
4. http://www.medicinenet.com/diarrhea/article.htm
5. http://www.mayoclinic.com/health/diarrhea/DS002
92
6. http://www.kidshealth.org/parent/infections/commo
n/diarrhea.html