Diarrhea & Dehydration
Dr . Ahmed Naji Alsaeedi
Definition of diarrhea
WHO defines diarrhea as ≥ 3 loose or watery stools per day *
or more frequent passage than normal for the individual
: Classification of diarrhea(duration)
i. Acute Diarrhea : - Starts acutely
Watery without visible blood -
.Last less than 14 days -
ii. Persistent diarrhea: Started as acute diarrhea (watery or
.dysentery) but persists more than 14 days
iii. Chronic diarrhea : diarrdea of gradual onset last for
. >1month or recurrent due to non infectious causes
other classification
:by Severity
Mild = 4_6motions /day *
Moderate =6_10 motions /day *
Severe > 10 motions /day *
: by the nature of diarrhea
, bloody , watery , frothy , with mucus
by the causes
Acute non infectious diarrhea▪1
Dietitic .1
o Over feeding
,o Under feeding: Starvation diarrhea (scanty
)greenish, Ĺ mucus
o Bad feeding : -Change in formula type or
concentration
.Introduction of new unsuitable food - -
Drugs .2
o Prolonged oral antibiotics (e.g. ampicillin)
.o Laxatives to the baby or to lactating mother
2▪Acute infectious diarrhea (Gastro Enteritis)
Gastroenteritis is due to infection acquired through the
fecal-oral route or by ingestion of contaminated food or water
:Causes of Gastroenteritis
Viral (60%) .1
Examples
.Rota virus -
Norwalk like viruses -
Adenovirus -
Clinical features of viral gastroentitis:
- Age usually less than 2 years.
- Common in winter
- May be associated upper respiratory tract infections
- Pyrexia if present usually (< 38.5 qC).
- Diarrhea is: - Mild to moderate.
- Transient = (5-7 days)
- Watery
- Odorless
Protozoal . 2 Entameaba histolytica #
Giardia Lambelia# Bloody, may be with -
Watery - tenesmus
Offensive - No fever usually -
No fever -
3 . Bacterial gastroentritis :
Clinical features
- Common in summer
- With high fever >38.5 C°
- Cramping abdominal pain
- Usually severe diarrhea which may be:-
- :Bloody with * Watery*
Salmonella- Shigella (diarrheal type) -
.Shigella desentyrie type 1 - Entero pathogenic E-Coli -
.Entero invasive E-Coli - Entero toxigenic E-Coli -
Entero hemorrhagic E-Coli - .Vibrio cholerae O1 -
Watery offensive for 2-4 days then turn bloody due to *
.Campylobacter jejuni
Complication of gastroentritis
-Dehydration
Metabolic acidosis- .a
Acute renal failure - .b
Electrolyte disturbance (hypernatraemia,- .c
hyponatraemia, hypokalaemia)
Shock - .d
convulsions- .e
.Malnatrion - .f
Iatrogenic complications (due to inappropriate - .g
composition or amount of intravenous fluids)
Death- .h
Investigations
Treatment for gastroenteritis
Treatment depends on the cause and severity of
: dehydration may include
.Plenty of fluids*
Oral rehydration solution , available from your*
.pharmacist
Admission to hospital and intravenous fluid*
.replacement, in severe cases
.Antibiotics, if bacteria are the cause*
Drugs to kill the parasites, if parasites are the*
.cause
Avoiding anti-vomiting or anti-diarrhoea drugs*
,unless prescribed or recommended by your doctor
because these medications will keep the infection
.inside your body
Prevention of gastroentritis
,frequent hand-washing▪
,prompt disinfection of contaminated surfaces▪
prompt washing of soiled articles of clothing ▪
avoiding food or water that is thought to be▪
contaminated
